Adolescent substance use is associated with a number of pressing problems on the
public health agenda, including an increased risk of contracting sexually transmitted
diseases, teenage pregnancy, violence-related injuries, depression, homicide, sexual
assault, and accidental death. Teenage substance use remains high in South Africa, with
a prevalence of smoking and alcohol binge-drinking estimated at 18.5% and 23%
respectively. A previous quantitative cross-sectional analysis of data from a study
cohort from which this study’s sample was drawn, demonstrated an association
between adolescents’ sense of coherence (SOC) – a measure of coping ability – and
smoking. The current study, using a qualitative approach, thus sought to gain more
insight into adolescent substance use, particularly smoking, and to better understand
how it may relate to coping. A mixed method sampling strategy was used in selecting
22 research participants between the ages of 16 and 19 in two high schools in Pretoria.
They were then interviewed individually by an interviewer blinded to their SOC level
and substance use status as documented in the quantitative survey in which this study
builds on. The interviews were transcribed in full and a content analysis strategy was
used in the analysis of the data. The results obtained were then merged with
participants’ substance use status and SOC levels.
Of the 22 participants, 6 had strong SOC and had never used substances; 8 had weak
SOC and were current substance users. The other 8 also had weak SOC but were not
current substance users. Further analysis of the results showed that adolescents’
substance use is associated with stress and coping as they (substance users) reported
using substances in attempting to manage stressful life events. Of the 8 current
substance users, 7 reported avoidance-oriented (disengagement) coping styles. Five of
the 7 reported load imbalance such as academic and social pressures and distress (e.g.
schoolwork overload, peer demands, and family problems) as a reason for using
substances. The non-substance using adolescents with weak SOC reported strong social
support, especially family and peer support in coping with life stressors. Hence,
substances were more likely to make up for compromised coping where contextuallevel
risk factors (demands/stressors) exceeded coping resources such as social support.
Also, of the 8 substance users- in addition to stress related reasons for using substances-
4 reported sensation seeking, whilst 2 reported curiosity/experimentation- which are all
non-stress related.
Furthermore, although family and peer support were observed to be complementary in
most cases, the reliance on peers for support was stronger amongst those whom family
support was considered weak, which presented the context for social/peer pressure and
vulnerability to substance use. The study findings suggest family support as a
moderator of the influence of the adolescents’ inability to cope with stress (or have low
SOC) on smoking behaviour.
On the other hand, a close relationship was observed between strong SOC and using
engagement coping responses and reporting family and school support as sources of
support. Notably, all the participants with strong SOC reported that they had never used
substances despite being equally affected by life stressors.
The implications of the findings are also discussed, especially as related to enhancing
SOC. More practically, in addition to providing life skills training to educate
adolescents about substance use, school-based programmes could incorporate the
notion of stress and coping in helping adolescents to develop desirable and effective
coping strategies to deal with social demands as well as adopting advantageous
lifestyles to meet their needs for stimulation and adventure (sensation seeking and
experimentation). On the whole, the enhancement of social support and adolescents’
connectedness to various social systems may be the key to substance use prevention among South African adolescents.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:wits/oai:wiredspace.wits.ac.za:10539/6777 |
| Date | 23 March 2009 |
| Creators | O'Hara, Oscar Reno |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Thesis |
| Format | application/pdf |
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