Cannabis use and its psychosocial correlates among school-going adolescents in Sierra Leone.

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Leone. Augustus Osborne, Peter Bai James, Comfort Z. Olorunsaiye, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-3205061/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background: Adolescents who use cannabis are more prone to participate in risky activities, such as taking other drugs, doing poorly in school, and exhibiting psychotic symptoms. No recent estimates of cannabis use and its correlates among adolescents have been documented in Sierra Leone. This study aimed to examine the prevalence of cannabis use and to determine its associated factors among school-going adolescents in Sierra Leone. Method: We analyzed secondary data from the 2017 Sierra Leone Global School-Based Health Survey. We used bivariate and multivariable logistic regression analysis to determine the factors associated with cannabis usage. Results: The result showed that the prevalence of cannabis use was 4.3% among school-going adolescents in Sierra Leone. Males [aOR= 2.956, 95% CI = 1.169-7.603], alcohol use [aOR= 3.379, 95% CI = 1.208-9.448], ever used amphetamines or methamphetamines [aOR= 20.469, 95% CI = 8.905-47.053], suicidal attempt [aOR= 4.180, 95% CI = 1.468-11.905] and sexual risk behaviour [aOR= 2.798, 95% CI = 1.369-5.717] were associated cannabis use. Conclusion: The use of cannabis is prevalent among Sierra Leonean in-school adolescents. School-based health intervention programmes should be developed, considering the risk factors associated with cannabis use among adolescents. School-going adolescents Cannabis use Prevalence Sierra Leone Figures Figure 1 Introduction According to the UNODC World Drug Report 2022, cannabis is the most often used illegal drug worldwide. An estimated 192 million people aged 15–64 was using it in 2018 [ 1 ]. Among adolescents aged 15–19 years, the global annual prevalence of cannabis use was 13.8 per cent in 2018, which translates to about 45 million adolescents [ 1 ]. In Africa, cannabis remains the most prevalent illicit substance, with the highest rates of use reported in West and Central Africa [ 1 ]. Some adverse effects of cannabis use include impaired cognitive function, increased risk of psychotic disorders, reduced academic achievement, and involvement in other risky behaviours [ 2 ]. Cannabis use among adolescents varies between countries in Africa. A study by Bangura et al. [ 3 ] reported that the prevalence of cannabis use was 2.2% among school-going pupils in Bo, southern Sierra Leone. According to a study by Asante [ 4 ] based on the 2012 Ghanaian Global School-based Student Health Survey, the past-month prevalence of cannabis use among school-going adolescents aged 11–19 years was 5.3%. In another study in Zambia by Siziya et al., [ 5 ] the overall prevalence of self-reported ever-used cannabis was 37.2%. Eneh and Stanley [ 6 ] found that 26% of secondary school students in Port Harcourt, Nigeria, used cannabis. Meanwhile, Abdulkarim et al. [ 7 ] reported that 3.4% of students in Ilorin, Nigeria, used cannabis. In Zimbabwe, Khan and Arnott [ 8 ] found that 3.4% of students in rural secondary schools had ever used cannabis. Another study in Zimbabwe by Acuda and Eide [ 9 ] found that 6.2% of students in rural and urban secondary schools had ever used cannabis. In KwaZulu-Natal, South Africa, Taylor et al. [ 10 ] found that 16.9% of school pupils in high schools had ever used cannabis. Differences in definitions of the prevalence of cannabis use may partly explain the observed variations of cannabis use prevalence in Africa. Previous studies have established several factors associated with cannabis use among adolescents, including male gender [ 5 , 11 , 12 ] and older age [ 11 , 13 ]. Also, certain actions connected to mental health, such as anxiety [ 14 , 15 ], loneliness [ 12 ], suicidal behaviour [ 16 ] and risky sexual behaviour, among other health risks [ 5 , 11 , 12 , 17 ], alcohol use [ 5 ] and current smoking [ 12 , 18 ] are associated with cannabis use. The literature has shown that school social dynamics are associated with cannabis usage: being bullied [ 5 , 19 ], physical fighting and being physically attacked [ 19 ], school truancy [ 4 , 18 – 20 ], lack of peer support [ 18 ], having a more significant number of friends [ 4 , 21 , 22 ] and hunger [ 12 ]. Furthermore, parental characteristics, including parental substance use [ 14 , 23 ], lack of parental support and monitoring [ 18 ], lack of parental connectedness [ 14 ] and lack of maternal demandingness [ 12 ], have been shown to influence cannabis use among school-going adolescents. Currently, studies on cannabis use among adolescents are scarce in Sierra Leone. A study by Bangura et al. [ 3 ] reported that the prevalence of cannabis use was 2.2% among school-going pupils in Bo, southern Sierra Leone. However, this study has certain vital limitations. Firstly, it was conducted more than two decades ago. Therefore, given the demographic transitions and increased urbanization in Sierra Leone over the years, its findings may no longer be valid. Secondly, the study findings are not representative of the whole country, given that it was only conducted in Bo, the second capital city of Sierra Leone. We, therefore, used the Global School-Based Health Survey data to estimate the 2017 prevalence and sociodemographic correlates of cannabis use in Sierra Leone. We believe that the knowledge on the prevalence of use and the associated factors will add to the literature on illicit drug use in developing nations and inform public health policymakers and program planners on how best adolescent drug use may be prevented or its prevalence reduced. Materials and Methods Sample and procedure The 2017 Global School Health Survey in Sierra Leone provided a cross-sectional dataset we could utilize [ 24 ]. The Sierra Leone data collection uses a two-stage cluster sampling methodology to collect an accurate cross-section of the country's 10–19-year-old student population. The first step includes picking schools with a probability proportional to students' enrolment. The second stage is randomly picking classes such that every student has an equal chance of being selected. The response rates for Sierra Leone's GSHS schools were 94%, and the student response rate was 87% [ 24 ]. Our study aligns with STROBE guidelines for reporting observational studies (See supplementary file 1). Outcome Variable The study's dependent variable was cannabis use. The original question was, " During your life, how many times have you used marijuana?" Response options ranged from 1, representing zero times, through 5, representing 20 or more times. We recoded 1 = 0 and 2–5 = 1 for the analysis. The replies were classified based on research by [ 4 ]. Explanatory Variables The explanatory factors employed in the analysis were selected because of their availability in the GSHS dataset and historical connections with the dependent variables (e.g., [ 4 ]). Age, gender, grade, truancy, alcohol usage, suicidal thoughts, suicide attempt, loneliness, anxiety, and being bullied were some demographic and health risk characteristics examined. The protective factors are (peer support, close friends, and parental support). Our research variables have been widely utilized and verified in prior research [ 4 ]. (Table 1 ) displays a thorough explanation of the variables and the recoded replies. Table 1 Cannabis use and its psychosocial correlates among school-going adolescents in Sierra Leone. Variable Survey question Original response options Recoded Outcome Variable (Cannabis use) Cannabis use During your life, how many times have you used marijuana 1 = 0 times to 5 = 20 or more times 1 = 0 and 2–5 = 1 Independent Variables Age How old are you? 10–19 years (coded categorically) N/A Sex What is your sex? 1 = male; 2 = female 1 = male; 0 = female Grade In what grade are you? 1 Jnr Sec (JSS) 2 to 5 Snr Sec (SSS) 3 N/A Amphetamine use During your life, how many times have you used amphetamines or methamphetamine 1 = 0 times to 5 = 20 or more times 1 = 0 and 2–5 = 1 Suicidal Ideation During the past 12 months, did you ever seriously consider attempting suicide? Yes = 1; no = 2 Yes = 1 and no = 0 Suicidal plan During the past 12 months, did you plan how you would attempt suicide? Yes = 1; no = 2 Yes = 1 and no = 0 Suicidal attempt During the past 12 months, how many times did you attempt suicide? 1 = 0 times to 5 = 6 times or more 1 = 0 and 2–5 = 1 Close friends How many close friends do you have? 1 = 0 and 4 = 3 or more 1 = 0 and 2–4 = 1 Loneliness During the past 12 months, how often have you felt lonely? 1 = never to 5 = always 1–3 = 0 and 4–5 = 1 Anxiety During the past 12 months, how often have you been so worried about something that you could not sleep at night? 1 = never to 5 = always 1–3 = 0 and 4–5 = 1 Bullied During the past 30 days, how many days were you bullied? 1 = 0 days to 7 = all 30 days 1–3 = 0 and 4–7 = 1 Sexual risk behaviour During your life, with how many people have you ever had sexual intercourse? 1 = never had intercourse to 7 = 6 or more people 1 = 0 and 2–7 = 1 School truancy During the past 30 days, how many days did you miss classes or school without permission? 1 = 0 days to 5 = 10 or more days 1 = 0 and 2–5 = 1 Peer support During the past 30 days, how often were most of the students in your school kind and helpful? 1 = never to 5 = always 1–3 = 0 and 4–5 = 1 Statistical Analyses The data was analyzed using SPSS version 28. Pearson chi-square and binary logistic regression analyses were carried out for descriptive statistics. The frequency distributions and percentages utilized to illustrate the categories' distributions were descriptive. Second, the correlation between cannabis use (the outcome variable) and the explanatory factors was analyzed using the Pearson chi-square test. We used the complex sampling command on SPSS for weighting and complex sampling design. In the logistic regression, each variable was included., but only those with a significant connection (p 0.05) were used. The regression analysis findings were expressed as adjusted odds ratios (aOR) with 95% confidence intervals (CIs). The p-value needed to be less than 5% to be statistically significant. We assess multicollinearity among independent variables using the variance inflation factor (Additional file 2). Listwise deletion was used to address missing data. Ethical consideration Since we analysed a secondary dataset in which the participants' personal information had been removed, we didn't need to get formal ethical permission to perform this research. However, ethical permission was acquired from the Ministry of Health and Sanitation in Sierra Leone before conducting the surveys. Results As seen in (Fig. 1 ), The percentage of Sierra Leonean adolescents who had used cannabis while attending school was 4.3%. The results of the bivariate analysis are shown in Table 2 . Age and grade were not associated with cannabis use. The use of cannabis was linked to suicidal behaviour, including thought, planning, and attempt. Personal attributes such as truancy, alcohol use, amphetamine use and sexual risk behaviour were associated with cannabis use. School environmental factors such as bullying victimization were associated with cannabis use. Table 2 Bivariate analysis of cannabis use across the background characteristics in Sierra Leone Characteristics Variables Cannabis use p-value Total n (%) Yes n (%) No n (%) Age ≤ 14yrs 973(35.6) 38(28.5) 904(36.2) 0.360 > 15years 1807(64.4) 98(71.5) 1627(63.8) Sex Male 1258(51.6) 92(70.2) 1110(50.5) 0.012 Female 1484(48.4) 41(29.8) 1394(49.5) Grade JSS 1775(70.7) 65(55.3) 1649(71.8) 0.163 SSS 1000(29.3) 71(44.7) 878(28.2) Current Alcohol use Yes 574(18.7) 106(72.9) 408(14.8) < 0.001 No 2224(81.3) 32(27.1) 2138(85.2) Ever used amphetamines or methamphetamines Yes 191(7.9) 95(67.4) 88(4.5) < 0.001 No 1901(92.1) 35(32.6) 1816(95.5) Bullied Yes 435(17.4) 49(38.3) 358(16.1) < 0.001 No 2066(82.6) 73(61.7) 1927(83.9) Loneliness Less Lonely 2202(80.6) 98(71.4) 2032(81.5) 0.046 Lonelier 566(19.4) 36(28.6) 495(18.5) Anxiety Less or no anxiety 2264(81.5) 98(71.7) 2081(82.0) 0.067 Anxiety 520(18.5) 39(28.3) 454(18.0) Suicidal Ideation Yes 394(14.2) 41(33.4) 332(13.1) < 0.001 No 2300(85.8) 78(66.6) 2152(86.9) Suicidal plan Yes 453(16.0) 48(38.6) 373(14.5) < 0.001 No 2282(84.0) 71(61.4) 2141(85.5) Suicidal attempt Yes 541(19.1) 89(63.2) 401(16.1) < 0.001 No 2219(80.9) 47(36.8) 2115(83.9) Close friends No close friends 249(9.2) 16(12.3) 210(8.5) 0.249 Close friends 2482(90.8) 115(87.7) 2286(91.5) Sexual risk behaviour Yes 791(29.5) 91(69.8) 652(27.0) < 0.001 No 1854(70.5) 35(30.2) 1774(73.0) School truancy Yes 2143(78.0) 100(69.2) 839(33.1) < 0.001 No 655(22.0) 33(30.8) 1685(66.9) Peer support Yes 854(29.6) 37(32.6) 786(29.6) 0.494 No 1905(70.4) 93(67.4) 1733(70.4) Parental Support Yes 2143(78.0) 81(62.7) 1977(78.9) 0.017 No 655(22.0) 57(37.3) 569(21.1) The predictors of cannabis use are presented in Table 3 . In the multivariate analysis, after controlling for other variables, Males [aOR = 2.956, 95% CI = 1.169–7.603] were more likely to use cannabis than females. Alcohol use [aOR = 3.379, 95% CI = 1.208–9.448], Ever used amphetamines or methamphetamines [aOR = 20.469, 95% CI = 8.905–47.053], Suicidal attempt [aOR = 4.180, 95% CI = 1.468–11.905], and Sexual risk behaviour [aOR = 2.798, 95% CI = 1.369–5.717], were associated with cannabis use. Table 3 Multivariable regression analysis of predictors of cannabis use among in-school adolescents in Sierra Leone Characteristics Variables Cannabis use AOR (95%CI) Age ≤ 14yrs 1 > 15years 1.015(0.507–2.029) Sex Male 2.956(1.149–7.603) Female 1 Grade JSS 1 SSS 0.725(0.280–1.875) Current Alcohol use Yes 3.379(1.208–9.448) No 1 Ever used amphetamines or methamphetamines Yes 20.469(8.905–47.053) No 1 Bullied Yes 1.259(0.697–2.275) No 1 Loneliness Less Lonely 1 Lonelier 0 .924(0 .431- 1.983) Anxiety Less or no anxiety 1 Anxiety 1.774(0 .517- 6.087) Suicidal Ideation Yes 1.780(0 .813- 3.899) No 1 Suicidal plan Yes 0 .905(0 .329- 2.489) No 1 Suicidal attempt Yes 4.180(1.468–11.905) No 1 Close friends No close friends 1 Close friends 0 .355(0 .098- 1.294) Sexual risk behaviour Yes 2.798(1.369–5.717) No 1 School truancy Yes 1.809(0 .623 − 5.250) No 1 Peer support Yes 1.797(0 .602- 5.367) No 1 Parental Support Yes 0 .442(0 .153- 1.278) No 1 Discussion The purpose of this research was to ascertain the prevalence of cannabis use and to determine associated factors among school-going adolescents in Sierra Leone. The prevalence of 4.3% reported in this study is lower than the 5.3% reported in Ghana [ 4 ]. However, it is comparable to UNODC research [ 1 ], showing that teenage cannabis usage was low in Nigeria (4.4%) and Morocco (4.0%). In addition, recent research found that Namibia, Swaziland, and Mauritius had prevalence rates of prior 30-day cannabis usage of 5.3%, 4.6%, and 4.3%, respectively [ 12 ]. Still, comparing the prevalence from the current study to those reported in the African region, we note that ours is lower than the 37.2% reported in Zambia [ 5 ], 26% reported in Port Harcourt in Nigeria [ 6 ], and the 16.9% reported in KwaZulu-Natal in South Africa [ 10 ], and much higher than that reported in Zimbabwe of 3.4% in rural schools [ 8 ] and lower than the 6.2% in both rural and urban schools [ 9 ]. The current trend for cannabis use in sub-Saharan Africa is higher than the rates reported in this study. Results on the association between gender and cannabis use have been consistent. Ever use prevalence of cannabis for males was higher than that for females in the current study. This is in line with studies from elsewhere where cannabis smoking was more common among males than females [ 9 , 26 – 28 ]. It appears that girls have more concerns regarding their health than boys. Mental health variables such as anxiety and loneliness did not predict cannabis use. These findings are in opposition to earlier research that found such correlations. [ 12 , 14 – 16 ]. It is of interest that adolescents who reported having ever used cannabis also were more likely to report alcohol use and engaging in sexual risk behaviour. We suggest these findings confirm the clustering of harmful health lifestyles among adolescents reported in previous studies [ 6 , 27 ]. The results showed that school-related variable bullying victimization was associated with cannabis use. The relationship between bullying victimization and cannabis use could be due to prior bullying victimization that may predispose an adolescent to use cannabis as a maladaptive coping strategy. This result may also be consistent with the stress coping and self-medication theory, according to which victims of peer victimization, especially those with weak coping mechanisms or self-regulation skills, may turn to drugs or alcohol to ease the pains of their victimization experience [ 29 – 31 ]. With no anti-bullying policy in place within Sierra Leonean schools, and in addition to the high prevalence of bullying reported among adolescents in our study, this finding is a wake-up call for the Sierra Leone Ministry of Basic Education. The Ministry of Basic Education should develop programs to combat bullying in schools in Sierra Leone. According to earlier research, more friends are protective against drug use [ 17 , 18 ]. The current research found the opposite, with closer friends increasing the likelihood of cannabis usage. According to reports, friendship allows teenagers to pick up new social skills and experience beneficial developmental effects. Nevertheless, it is plausible that in this research setting, having many friends contributed to the emergence of risky peer behaviours like drug abuse. This highlights the need to prioritize supportive connections between peers and create measures to foster positive peer support. It is plausible that such poor peer interactions may be linked to increased health risk behaviours like cannabis usage. The results also show that cannabis usage was associated with school truancy. Numerous studies have shown a connection between school absences and illicit drug use, such as cannabis and amphetamine use [ 18 – 20 , 23 ], which aligns with this research's findings. Teenagers who don't attend school may have a diminished feeling of belonging at school, which may explain the connection between truancy and drug use. Schools have a significant role in social structures that control problematic behaviours in adolescents [ 32 ]. Reduced school attendance might expose young people to health-harming behaviours, such as drug use, yet adolescence is also a period of growing independence and the drive for autonomy [ 33 ]. Even though substance usage was linked to truancy, not all truants use drugs [ 34 ]. Policy and practice implication The need of improving adolescent health education in schools and communities was highlighted by our results. Such educational programs have to include mental health promotion initiatives aimed at addressing the particular health requirements of adolescents, such as enhancing accessibility to counselling and information. Additionally, parental engagement in everyday teenage activities and peer support will assist lower adolescent drug usage. Strengths and limitations of the study This research has several limitations. First off, cannabis usage, the main outcome variable, was self-reported. Biases based on social desirability and systematic bias may affect self-report. Second, most measures used were single-item tests, which only permitted a limited variable evaluation. Thirdly, since the findings are based on a cross-sectional database, we cannot prove causation. There is a need for longitudinal research on cannabis usage in teenage students. Finally, the research only included teenagers enrolled in school; 11 to 18-year-olds who were not enrolled were not included. As a result, not all teenagers in this age bracket are represented by the results. Despite these drawbacks, this is one of the first cross-sectional studies to examine the prevalence of cannabis use and its related characteristics among school-going teenagers using nationally representative data in Sierra Leone. Conclusion This research examined the prevalence and risk factors for cannabis usage among Sierra Leonean teenagers. This teenage population in Sierra Leone may not consume cannabis as often as in other high-income nations, nevertheless. The use of alcohol, amphetamines, suicide attempts, and sexually risky behaviour were among the risk variables for cannabis use that this research discovered. The risk factors related to cannabis use among teenage students in Sierra Leone should be taken into account when creating school-based health programs. Abbreviations CI: Confidence Intervals; GSHS: Global School Health Survey; OR: Odds ratio; SPSS: Statistical Package for The Social Sciences. Declarations Acknowledgements The authors would like to express their appreciation to the World Health Organization for providing them with the data used in this study. Participants in the 2017 GSHS in Sierra Leone are also thanked, as are the country's Education and Health Ministries. Authors contributions AO contributed to designing the study, contributed to the analysis, interpreted the results, and wrote the first draft of the manuscript. PBJ contributed to designing the study, conducting the analysis and contributed to writing the manuscript. CZO, CB and AL participated in the interpretation of the results and edited the manuscript. All authors read and approved the final manuscript. Funding No funding was obtained for this study. Availability of data and materials The dataset informing the findings of this study is publicly available. It can be freely accessed via the WHO NCD Microdata Repository https://extranet.who.int/ncdsmicrodata/index.php/catalog/GSHS. Declarations Ethics approval and consent to participate Since we analysed a secondary dataset in which the participants' personal information had been removed, we didn't need to get formal ethical permission to perform this research. The survey was carried out in Sierra Leone after receiving ethical clearance from the Ministry of Health. Consent for publication Not applicable. Competing interests The authors declare no competing interests. References United Nations, "UN Office on Drug and Crime (UNODC) World Drug Report 2022 highlight trends in cannabis post-legalization, environmental impacts of illicit drugs and drug use among Women and Youth," (office of Drug and Crime)http://www.unodc.org" accessed 7/9/2023. WHO: The world health report 2001. Mental health-new understanding, new hope. Geneva: World Health Organization; 2001. Abul Bangura S, Lisk RD. Tobacco and cannabis smoking in secondary school pupils in Bo, Sierra Leone. West Afr J Med. 1995;14(3):157-160. Oppong Asante, K. 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Augustus Osborne","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABD0lEQVRIiWNgGAWjYHADHjApxw8iEwoIqU5AaDGWbAAJGJCgJXHDARCFRwv/jPRrkj9/HLbn5z978HHlDhvGzedXJ354YMAgzy92AKsWiRs5ZdI8CYcTZ87ISzY8eyaN2ezG280SQIcZzpydgN2aGzlp0gwJhxMMbvCYSTa2HWYzu3F2A0hLgsFt7FrkgVokfyQctjc4fwak5T+P8Yyzm3/g02JwI/2YBNBhjBsO5IC0HJAw4O/dhtcWwzNvmK150tIhfmlsSzaQuMG7zSLBQAKnX+SOpz+8+cPGGhxiDxvb7Or7+89uvvmjwkaeXxqH9xl40KNAAqxSAodyEGB/gCbAfwCP6lEwCkbBKBiJAABYqGJf2UaSNQAAAABJRU5ErkJggg==","orcid":"","institution":"Njala University","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Leone.","middleName":"Augustus","lastName":"Osborne","suffix":""},{"id":222048353,"identity":"0e288f5f-df5f-47f2-864f-b2c860709e79","order_by":1,"name":"Peter Bai James","email":"","orcid":"","institution":"Southern Cross University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Peter","middleName":"Bai","lastName":"James","suffix":""},{"id":222048354,"identity":"7fb52c70-a011-47a8-b10c-d8af85ac5bee","order_by":2,"name":"Comfort Z. Olorunsaiye","email":"","orcid":"","institution":"Arcadia University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Comfort","middleName":"Z.","lastName":"Olorunsaiye","suffix":""},{"id":222048356,"identity":"1f9e60e3-3d93-4166-8683-0c91573944dc","order_by":3,"name":"Camilla Bangura","email":"","orcid":"","institution":"Njala University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Camilla","middleName":"","lastName":"Bangura","suffix":""},{"id":222048357,"identity":"8ea1b11d-90bd-47d2-af2d-797392530b93","order_by":4,"name":"Aiah Lebbie","email":"","orcid":"","institution":"Njala University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Aiah","middleName":"","lastName":"Lebbie","suffix":""}],"badges":[],"createdAt":"2023-07-26 06:14:30","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-3205061/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-3205061/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":40902020,"identity":"15e49be9-fa51-4725-8b6c-461479050844","added_by":"auto","created_at":"2023-08-01 18:31:34","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":11858,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003ePrevalence of cannabis use among school- going students in Sierra Leone\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-3205061/v1/f537a5c75fb3d32198823748.png"},{"id":40945166,"identity":"2f87113c-578b-4325-944d-b12e1015f3a1","added_by":"auto","created_at":"2023-08-02 11:52:32","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":429609,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-3205061/v1/7f74556b-dbb5-4fb6-a4ee-c2344c60e1c9.pdf"},{"id":40902164,"identity":"57d1a232-a953-448a-b873-173be8cb3f15","added_by":"auto","created_at":"2023-08-01 18:39:34","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":28594,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eSupplementary Information\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAdditional file 1. STROBE Statement—Checklist of items that should be included in reports of cross-sectional studies.\u003c/p\u003e","description":"","filename":"STROBEStatement.docx","url":"https://assets-eu.researchsquare.com/files/rs-3205061/v1/59adc425605021fddcaa1257.docx"},{"id":40902021,"identity":"47819846-b719-414b-8a26-d177bd630459","added_by":"auto","created_at":"2023-08-01 18:31:34","extension":"docx","order_by":2,"title":"","display":"","copyAsset":false,"role":"supplement","size":14239,"visible":true,"origin":"","legend":"\u003cp\u003eAdditional file 2. Test for multicollinearity.\u003c/p\u003e","description":"","filename":"Supplementaryfile2Testformulticollinearity.docx","url":"https://assets-eu.researchsquare.com/files/rs-3205061/v1/72b1ed0679db34ac4d3f03d9.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Cannabis use and its psychosocial correlates among school-going adolescents in Sierra Leone.","fulltext":[{"header":"Introduction","content":"\u003cp\u003eAccording to the UNODC World Drug Report 2022, cannabis is the most often used illegal drug worldwide. An estimated 192\u0026nbsp;million people aged 15\u0026ndash;64 was using it in 2018 [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Among adolescents aged 15\u0026ndash;19 years, the global annual prevalence of cannabis use was 13.8 per cent in 2018, which translates to about 45\u0026nbsp;million adolescents [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. In Africa, cannabis remains the most prevalent illicit substance, with the highest rates of use reported in West and Central Africa [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Some adverse effects of cannabis use include impaired cognitive function, increased risk of psychotic disorders, reduced academic achievement, and involvement in other risky behaviours [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eCannabis use among adolescents varies between countries in Africa. A study by Bangura et al. [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e] reported that the prevalence of cannabis use was 2.2% among school-going pupils in Bo, southern Sierra Leone. According to a study by Asante [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e] based on the 2012 Ghanaian Global School-based Student Health Survey, the past-month prevalence of cannabis use among school-going adolescents aged 11\u0026ndash;19 years was 5.3%. In another study in Zambia by Siziya et al., [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e] the overall prevalence of self-reported ever-used cannabis was 37.2%. Eneh and Stanley [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e] found that 26% of secondary school students in Port Harcourt, Nigeria, used cannabis. Meanwhile, Abdulkarim et al. [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e] reported that 3.4% of students in Ilorin, Nigeria, used cannabis. In Zimbabwe, Khan and Arnott [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e] found that 3.4% of students in rural secondary schools had ever used cannabis. Another study in Zimbabwe by Acuda and Eide [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e] found that 6.2% of students in rural and urban secondary schools had ever used cannabis. In KwaZulu-Natal, South Africa, Taylor et al. [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e] found that 16.9% of school pupils in high schools had ever used cannabis. Differences in definitions of the prevalence of cannabis use may partly explain the observed variations of cannabis use prevalence in Africa.\u003c/p\u003e \u003cp\u003ePrevious studies have established several factors associated with cannabis use among adolescents, including male gender [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e] and older age [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. Also, certain actions connected to mental health, such as anxiety [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e], loneliness [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e], suicidal behaviour [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e] and risky sexual behaviour, among other health risks [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e], alcohol use [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e] and current smoking [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e] are associated with cannabis use. The literature has shown that school social dynamics are associated with cannabis usage: being bullied [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e], physical fighting and being physically attacked [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e], school truancy [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan additionalcitationids=\"CR19\" citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e], lack of peer support [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e], having a more significant number of friends [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e] and hunger [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. Furthermore, parental characteristics, including parental substance use [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e], lack of parental support and monitoring [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e], lack of parental connectedness [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e] and lack of maternal demandingness [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e], have been shown to influence cannabis use among school-going adolescents.\u003c/p\u003e \u003cp\u003eCurrently, studies on cannabis use among adolescents are scarce in Sierra Leone. A study by Bangura et al. [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e] reported that the prevalence of cannabis use was 2.2% among school-going pupils in Bo, southern Sierra Leone. However, this study has certain vital limitations. Firstly, it was conducted more than two decades ago. Therefore, given the demographic transitions and increased urbanization in Sierra Leone over the years, its findings may no longer be valid. Secondly, the study findings are not representative of the whole country, given that it was only conducted in Bo, the second capital city of Sierra Leone. We, therefore, used the Global School-Based Health Survey data to estimate the 2017 prevalence and sociodemographic correlates of cannabis use in Sierra Leone. We believe that the knowledge on the prevalence of use and the associated factors will add to the literature on illicit drug use in developing nations and inform public health policymakers and program planners on how best adolescent drug use may be prevented or its prevalence reduced.\u003c/p\u003e"},{"header":"Materials and Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eSample and procedure\u003c/h2\u003e \u003cp\u003eThe 2017 Global School Health Survey in Sierra Leone provided a cross-sectional dataset we could utilize [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. The Sierra Leone data collection uses a two-stage cluster sampling methodology to collect an accurate cross-section of the country's 10\u0026ndash;19-year-old student population. The first step includes picking schools with a probability proportional to students' enrolment. The second stage is randomly picking classes such that every student has an equal chance of being selected. The response rates for Sierra Leone's GSHS schools were 94%, and the student response rate was 87% [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. Our study aligns with STROBE guidelines for reporting observational studies (See supplementary file 1).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eOutcome Variable\u003c/h2\u003e \u003cp\u003eThe study's dependent variable was cannabis use. The original question was, \" During your life, how many times have you used marijuana?\" Response options ranged from 1, representing zero times, through 5, representing 20 or more times. We recoded 1\u0026thinsp;=\u0026thinsp;0 and 2\u0026ndash;5\u0026thinsp;=\u0026thinsp;1 for the analysis. The replies were classified based on research by [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e].\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eExplanatory Variables\u003c/h2\u003e \u003cp\u003eThe explanatory factors employed in the analysis were selected because of their availability in the GSHS dataset and historical connections with the dependent variables (e.g., [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]). Age, gender, grade, truancy, alcohol usage, suicidal thoughts, suicide attempt, loneliness, anxiety, and being bullied were some demographic and health risk characteristics examined. The protective factors are (peer support, close friends, and parental support). Our research variables have been widely utilized and verified in prior research [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e) displays a thorough explanation of the variables and the recoded replies.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eCannabis use and its psychosocial correlates among school-going adolescents in Sierra Leone.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSurvey question\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eOriginal response options\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eRecoded\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOutcome Variable (Cannabis use)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCannabis use\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDuring your life, how many times have you used marijuana\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u0026thinsp;=\u0026thinsp;0 times to 5\u0026thinsp;=\u0026thinsp;20 or more times\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u0026thinsp;=\u0026thinsp;0 and 2\u0026ndash;5\u0026thinsp;=\u0026thinsp;1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eIndependent Variables\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHow old are you?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10\u0026ndash;19 years (coded categorically)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eN/A\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSex\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWhat is your sex?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u0026thinsp;=\u0026thinsp;male; 2\u0026thinsp;=\u0026thinsp;female\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u0026thinsp;=\u0026thinsp;male; 0\u0026thinsp;=\u0026thinsp;female\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGrade\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIn what grade are you?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 Jnr Sec (JSS) 2 to 5 Snr Sec (SSS) 3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eN/A\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAmphetamine use\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDuring your life, how many times have you used amphetamines or\u003c/p\u003e \u003cp\u003emethamphetamine\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u0026thinsp;=\u0026thinsp;0 times to 5\u0026thinsp;=\u0026thinsp;20 or more times\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u0026thinsp;=\u0026thinsp;0 and 2\u0026ndash;5\u0026thinsp;=\u0026thinsp;1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSuicidal Ideation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDuring the past 12 months, did you ever seriously consider attempting suicide?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eYes\u0026thinsp;=\u0026thinsp;1; no\u0026thinsp;=\u0026thinsp;2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eYes\u0026thinsp;=\u0026thinsp;1 and no\u0026thinsp;=\u0026thinsp;0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSuicidal plan\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDuring the past 12 months, did you plan how you would attempt suicide?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eYes\u0026thinsp;=\u0026thinsp;1; no\u0026thinsp;=\u0026thinsp;2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eYes\u0026thinsp;=\u0026thinsp;1 and no\u0026thinsp;=\u0026thinsp;0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSuicidal attempt\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDuring the past 12 months, how many times did you attempt suicide?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u0026thinsp;=\u0026thinsp;0 times to 5\u0026thinsp;=\u0026thinsp;6 times or more\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u0026thinsp;=\u0026thinsp;0 and 2\u0026ndash;5\u0026thinsp;=\u0026thinsp;1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eClose friends\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHow many close friends do you have?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u0026thinsp;=\u0026thinsp;0 and 4\u0026thinsp;=\u0026thinsp;3 or more\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u0026thinsp;=\u0026thinsp;0 and 2\u0026ndash;4\u0026thinsp;=\u0026thinsp;1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLoneliness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDuring the past 12 months, how often have you felt lonely?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u0026thinsp;=\u0026thinsp;never to 5\u0026thinsp;=\u0026thinsp;always\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u0026ndash;3\u0026thinsp;=\u0026thinsp;0 and 4\u0026ndash;5\u0026thinsp;=\u0026thinsp;1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAnxiety\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDuring the past 12 months, how often have you been so worried about something that you could not sleep at night?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u0026thinsp;=\u0026thinsp;never to 5\u0026thinsp;=\u0026thinsp;always\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u0026ndash;3\u0026thinsp;=\u0026thinsp;0 and 4\u0026ndash;5\u0026thinsp;=\u0026thinsp;1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBullied\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDuring the past 30 days, how many days were you bullied?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u0026thinsp;=\u0026thinsp;0 days to 7\u0026thinsp;=\u0026thinsp;all 30 days\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u0026ndash;3\u0026thinsp;=\u0026thinsp;0 and 4\u0026ndash;7\u0026thinsp;=\u0026thinsp;1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSexual risk behaviour\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDuring your life, with how many people have you ever had sexual intercourse?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u0026thinsp;=\u0026thinsp;never had intercourse to 7\u0026thinsp;=\u0026thinsp;6 or more\u003c/p\u003e \u003cp\u003epeople\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u0026thinsp;=\u0026thinsp;0 and 2\u0026ndash;7\u0026thinsp;=\u0026thinsp;1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSchool truancy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDuring the past 30 days, how many days did you miss classes or school without permission?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u0026thinsp;=\u0026thinsp;0 days to 5\u0026thinsp;=\u0026thinsp;10 or more days\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u0026thinsp;=\u0026thinsp;0 and 2\u0026ndash;5\u0026thinsp;=\u0026thinsp;1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePeer support\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDuring the past 30 days, how often were most of the students in your school kind\u003c/p\u003e \u003cp\u003eand helpful?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u0026thinsp;=\u0026thinsp;never to 5\u0026thinsp;=\u0026thinsp;always\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u0026ndash;3\u0026thinsp;=\u0026thinsp;0 and 4\u0026ndash;5\u0026thinsp;=\u0026thinsp;1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eStatistical Analyses\u003c/h2\u003e \u003cp\u003eThe data was analyzed using SPSS version 28. Pearson chi-square and binary logistic regression analyses were carried out for descriptive statistics. The frequency distributions and percentages utilized to illustrate the categories' distributions were descriptive. Second, the correlation between cannabis use (the outcome variable) and the explanatory factors was analyzed using the Pearson chi-square test. We used the complex sampling command on SPSS for weighting and complex sampling design. In the logistic regression, each variable was included., but only those with a significant connection (p 0.05) were used. The regression analysis findings were expressed as adjusted odds ratios (aOR) with 95% confidence intervals (CIs). The p-value needed to be less than 5% to be statistically significant. We assess multicollinearity among independent variables using the variance inflation factor (Additional file 2). Listwise deletion was used to address missing data.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eEthical consideration\u003c/h2\u003e \u003cp\u003eSince we analysed a secondary dataset in which the participants' personal information had been removed, we didn't need to get formal ethical permission to perform this research. However, ethical permission was acquired from the Ministry of Health and Sanitation in Sierra Leone before conducting the surveys.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eAs seen in (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e), The percentage of Sierra Leonean adolescents who had used cannabis while attending school was 4.3%.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eThe results of the bivariate analysis are shown in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e. Age and grade were not associated with cannabis use. The use of cannabis was linked to suicidal behaviour, including thought, planning, and attempt. Personal attributes such as truancy, alcohol use, amphetamine use and sexual risk behaviour were associated with cannabis use. School environmental factors such as bullying victimization were associated with cannabis use.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eBivariate analysis of cannabis use across the background characteristics in Sierra Leone\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCharacteristics\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003eCannabis use\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003eTotal n (%)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003eYes n (%)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003eNo n (%)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026le;\u0026thinsp;14yrs\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e973(35.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e38(28.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e904(36.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.360\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;15years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1807(64.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e98(71.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1627(63.8)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eSex\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1258(51.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e92(70.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1110(50.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.012\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1484(48.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e41(29.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1394(49.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eGrade\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eJSS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1775(70.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e65(55.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1649(71.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.163\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSSS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1000(29.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e71(44.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e878(28.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCurrent Alcohol use\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e574(18.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e106(72.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e408(14.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2224(81.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e32(27.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2138(85.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eEver used amphetamines or methamphetamines\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e191(7.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e95(67.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e88(4.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1901(92.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e35(32.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1816(95.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eBullied\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e435(17.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e49(38.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e358(16.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2066(82.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e73(61.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1927(83.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eLoneliness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLess Lonely\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2202(80.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e98(71.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2032(81.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.046\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLonelier\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e566(19.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e36(28.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e495(18.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eAnxiety\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLess or no anxiety\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2264(81.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e98(71.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2081(82.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.067\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAnxiety\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e520(18.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e39(28.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e454(18.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eSuicidal Ideation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e394(14.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e41(33.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e332(13.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2300(85.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e78(66.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2152(86.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eSuicidal plan\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e453(16.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e48(38.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e373(14.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2282(84.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e71(61.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2141(85.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eSuicidal attempt\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e541(19.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e89(63.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e401(16.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2219(80.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e47(36.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2115(83.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eClose friends\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo close friends\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e249(9.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e16(12.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e210(8.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.249\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eClose friends\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2482(90.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e115(87.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2286(91.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eSexual risk behaviour\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e791(29.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e91(69.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e652(27.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1854(70.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e35(30.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1774(73.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eSchool truancy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2143(78.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e100(69.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e839(33.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e655(22.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e33(30.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1685(66.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ePeer support\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e854(29.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e37(32.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e786(29.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.494\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1905(70.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e93(67.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1733(70.4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eParental Support\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2143(78.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e81(62.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1977(78.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.017\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e655(22.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e57(37.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e569(21.1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe predictors of cannabis use are presented in Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e. In the multivariate analysis, after controlling for other variables, Males [aOR\u0026thinsp;=\u0026thinsp;2.956, 95% CI\u0026thinsp;=\u0026thinsp;1.169\u0026ndash;7.603] were more likely to use cannabis than females. Alcohol use [aOR\u0026thinsp;=\u0026thinsp;3.379, 95% CI\u0026thinsp;=\u0026thinsp;1.208\u0026ndash;9.448], Ever used amphetamines or methamphetamines [aOR\u0026thinsp;=\u0026thinsp;20.469, 95% CI\u0026thinsp;=\u0026thinsp;8.905\u0026ndash;47.053], Suicidal attempt [aOR\u0026thinsp;=\u0026thinsp;4.180, 95% CI\u0026thinsp;=\u0026thinsp;1.468\u0026ndash;11.905], and Sexual risk behaviour [aOR\u0026thinsp;=\u0026thinsp;2.798, 95% CI\u0026thinsp;=\u0026thinsp;1.369\u0026ndash;5.717], were associated with cannabis use.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eMultivariable regression analysis of predictors of cannabis use among in-school adolescents in Sierra Leone\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCharacteristics\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCannabis use AOR (95%CI)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026le;\u0026thinsp;14yrs\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;15years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.015(0.507\u0026ndash;2.029)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eSex\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e2.956(1.149\u0026ndash;7.603)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eGrade\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eJSS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSSS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.725(0.280\u0026ndash;1.875)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCurrent Alcohol use\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e3.379(1.208\u0026ndash;9.448)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eEver used amphetamines or methamphetamines\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e20.469(8.905\u0026ndash;47.053)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eBullied\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.259(0.697\u0026ndash;2.275)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eLoneliness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLess Lonely\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLonelier\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0 .924(0 .431- 1.983)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eAnxiety\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLess or no anxiety\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAnxiety\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.774(0 .517- 6.087)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eSuicidal Ideation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.780(0 .813- 3.899)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eSuicidal plan\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0 .905(0 .329- 2.489)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eSuicidal attempt\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e4.180(1.468\u0026ndash;11.905)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eClose friends\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo close friends\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eClose friends\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0 .355(0 .098- 1.294)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eSexual risk behaviour\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e2.798(1.369\u0026ndash;5.717)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eSchool truancy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.809(0 .623\u0026thinsp;\u0026minus;\u0026thinsp;5.250)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ePeer support\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.797(0 .602- 5.367)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eParental Support\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0 .442(0 .153- 1.278)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe purpose of this research was to ascertain the prevalence of cannabis use and to determine associated factors among school-going adolescents in Sierra Leone. The prevalence of 4.3% reported in this study is lower than the 5.3% reported in Ghana [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. However, it is comparable to UNODC research [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e], showing that teenage cannabis usage was low in Nigeria (4.4%) and Morocco (4.0%). In addition, recent research found that Namibia, Swaziland, and Mauritius had prevalence rates of prior 30-day cannabis usage of 5.3%, 4.6%, and 4.3%, respectively [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. Still, comparing the prevalence from the current study to those reported in the African region, we note that ours is lower than the 37.2% reported in Zambia [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e], 26% reported in Port Harcourt in Nigeria [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e], and the 16.9% reported in KwaZulu-Natal in South Africa [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e], and much higher than that reported in Zimbabwe of 3.4% in rural schools [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e] and lower than the 6.2% in both rural and urban schools [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. The current trend for cannabis use in sub-Saharan Africa is higher than the rates reported in this study.\u003c/p\u003e \u003cp\u003eResults on the association between gender and cannabis use have been consistent. Ever use prevalence of cannabis for males was higher than that for females in the current study. This is in line with studies from elsewhere where cannabis smoking was more common among males than females [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan additionalcitationids=\"CR27\" citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. It appears that girls have more concerns regarding their health than boys. Mental health variables such as anxiety and loneliness did not predict cannabis use. These findings are in opposition to earlier research that found such correlations. [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan additionalcitationids=\"CR15\" citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIt is of interest that adolescents who reported having ever used cannabis also were more likely to report alcohol use and engaging in sexual risk behaviour. We suggest these findings confirm the clustering of harmful health lifestyles among adolescents reported in previous studies [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. The results showed that school-related variable bullying victimization was associated with cannabis use. The relationship between bullying victimization and cannabis use could be due to prior bullying victimization that may predispose an adolescent to use cannabis as a maladaptive coping strategy. This result may also be consistent with the stress coping and self-medication theory, according to which victims of peer victimization, especially those with weak coping mechanisms or self-regulation skills, may turn to drugs or alcohol to ease the pains of their victimization experience [\u003cspan additionalcitationids=\"CR30\" citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e]. With no anti-bullying policy in place within Sierra Leonean schools, and in addition to the high prevalence of bullying reported among adolescents in our study, this finding is a wake-up call for the Sierra Leone Ministry of Basic Education. The Ministry of Basic Education should develop programs to combat bullying in schools in Sierra Leone.\u003c/p\u003e \u003cp\u003eAccording to earlier research, more friends are protective against drug use [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. The current research found the opposite, with closer friends increasing the likelihood of cannabis usage. According to reports, friendship allows teenagers to pick up new social skills and experience beneficial developmental effects. Nevertheless, it is plausible that in this research setting, having many friends contributed to the emergence of risky peer behaviours like drug abuse. This highlights the need to prioritize supportive connections between peers and create measures to foster positive peer support. It is plausible that such poor peer interactions may be linked to increased health risk behaviours like cannabis usage.\u003c/p\u003e \u003cp\u003eThe results also show that cannabis usage was associated with school truancy. Numerous studies have shown a connection between school absences and illicit drug use, such as cannabis and amphetamine use [\u003cspan additionalcitationids=\"CR19\" citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e], which aligns with this research's findings. Teenagers who don't attend school may have a diminished feeling of belonging at school, which may explain the connection between truancy and drug use. Schools have a significant role in social structures that control problematic behaviours in adolescents [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e]. Reduced school attendance might expose young people to health-harming behaviours, such as drug use, yet adolescence is also a period of growing independence and the drive for autonomy [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e]. Even though substance usage was linked to truancy, not all truants use drugs [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e].\u003c/p\u003e \u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003ePolicy and practice implication\u003c/h2\u003e \u003cp\u003eThe need of improving adolescent health education in schools and communities was highlighted by our results. Such educational programs have to include mental health promotion initiatives aimed at addressing the particular health requirements of adolescents, such as enhancing accessibility to counselling and information. Additionally, parental engagement in everyday teenage activities and peer support will assist lower adolescent drug usage.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eStrengths and limitations of the study\u003c/h2\u003e \u003cp\u003eThis research has several limitations. First off, cannabis usage, the main outcome variable, was self-reported. Biases based on social desirability and systematic bias may affect self-report. Second, most measures used were single-item tests, which only permitted a limited variable evaluation. Thirdly, since the findings are based on a cross-sectional database, we cannot prove causation. There is a need for longitudinal research on cannabis usage in teenage students. Finally, the research only included teenagers enrolled in school; 11 to 18-year-olds who were not enrolled were not included. As a result, not all teenagers in this age bracket are represented by the results. Despite these drawbacks, this is one of the first cross-sectional studies to examine the prevalence of cannabis use and its related characteristics among school-going teenagers using nationally representative data in Sierra Leone.\u003c/p\u003e \u003c/div\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis research examined the prevalence and risk factors for cannabis usage among Sierra Leonean teenagers. This teenage population in Sierra Leone may not consume cannabis as often as in other high-income nations, nevertheless. The use of alcohol, amphetamines, suicide attempts, and sexually risky behaviour were among the risk variables for cannabis use that this research discovered. The risk factors related to cannabis use among teenage students in Sierra Leone should be taken into account when creating school-based health programs.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eCI: Confidence Intervals; GSHS: Global School Health Survey; OR: Odds ratio; SPSS: Statistical Package for The Social Sciences.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors would like to express their appreciation to the World Health Organization for providing them with the data used in this study. Participants in the 2017 GSHS in Sierra Leone are also thanked, as are the country\u0026apos;s Education and Health Ministries.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors contributions\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAO contributed to designing the study, contributed to the analysis, interpreted the results, and wrote the first draft of the manuscript. PBJ contributed to designing the study, conducting the analysis and contributed to writing the manuscript. CZO, CB and AL participated in the interpretation of the results and edited the manuscript. All authors read and approved the final manuscript.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNo funding was obtained for this study.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe dataset informing the findings of this study is publicly available. It can be freely accessed via the WHO NCD Microdata Repository\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003ehttps://extranet.who.int/ncdsmicrodata/index.php/catalog/GSHS.\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDeclarations Ethics approval and consent to participate\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSince we analysed a secondary dataset in which the participants\u0026apos; personal information had been removed, we didn\u0026apos;t need to get formal ethical permission to perform this research. The survey was carried out in Sierra Leone after receiving ethical clearance from the Ministry of Health.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interests.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eUnited Nations, \u0026quot;UN Office on Drug and Crime (UNODC) World Drug Report 2022 highlight trends in cannabis post-legalization, environmental impacts of illicit drugs and drug use among Women and Youth,\u0026quot; (office of Drug and Crime)http://www.unodc.org\u0026quot; accessed 7/9/2023.\u003c/li\u003e\n\u003cli\u003eWHO: The world health report 2001. Mental health-new understanding, new hope. 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J Adolesc Health. 2005; 37:19\u0026ndash;28. https://doi.org/10.1016/j.jadohealth.2004.06.004. \u003c/li\u003e\n\u003cli\u003ePeltzer K, Pengpid S, Tepirou C. Associations of alcohol use with mental health and alcohol exposure among school-going students in Cambodia. Nagoya J Med Sci. 2016; 78:415\u0026ndash;22. https://doi.org/10.18999/nagjm s.78.4.415.\u003c/li\u003e\n\u003cli\u003eAsiseh F, Owusu A, Quaicoe O. An analysis of family dynamics on high school adolescent risky behaviours in Ghana. J Child Adolesc Subst Abuse. 2017; 26:425\u0026ndash;31. https://doi.org/10.1080/1067828X.2017.1322019.\u003c/li\u003e\n\u003cli\u003eWHO. NCD Microdata Repository. Global School-based Student Health Survey. 2021. https://extranet.who.int/ncdsmicrodata/index.php/catalog/ GSHS. It was accessed on 2 March 2023.\u003c/li\u003e\n\u003cli\u003eUnited Nations Office on Drugs and Crime (UNODC). World drug report 2016. Sales No. E.16.XI.7, 2017. New York: United Nations Publication.\u003c/li\u003e\n\u003cli\u003ePatrick ME, Collins LM, Smith E, Caldwell L, Flisher A, Wegner L: A Prospective Longitudinal Model of Substance use Onset among South African Adolescents. Subst Use Misuse 2009, 44:647\u0026ndash;662. \u003c/li\u003e\n\u003cli\u003eFaeh D, Viswanathan B, Chiolero A, Warren W, Bovet P: Clustering of smoking, alcohol drinking and cannabis use in adolescents in a rapidly developing country. BMC Public Health 2006, 6:169. \u003c/li\u003e\n\u003cli\u003eReddy P, Resnicow K, Omardien R, Kambaran N: Prevalence and correlates of substance use among high school students in South Africa and the United States. Am J Public Health 2007, 97:1859\u0026ndash;1864\u003c/li\u003e\n\u003cli\u003eManiglio R. Severe mental illness and criminal victimization: a systematic review. Acta Psychiatr Scand. 2009; 119:180\u0026ndash;91. https://doi.org/10.111 1/j.1600-0447.2008.01300.x. \u003c/li\u003e\n\u003cli\u003eManiglio R. Association between adolescent peer victimization and cannabis use: a systematic review. Aggress Violent Behav. 2015; 25:252\u0026ndash;8. https://doi.org/10.1016/j.avb.2015.09.002. \u003c/li\u003e\n\u003cli\u003eMorojele NK, Brook JS. Substance use and multiple victimizations among adolescents in South Africa. Addict Behav. 2006; 31:1163\u0026ndash;76. https://doi. org/10.1016/j.addbeh.2005.09.009\u003c/li\u003e\n\u003cli\u003eHenry KL, Thornberry TP. Truancy and escalation of substance use during adolescence. J Stud Alcohol Drugs. 2010; 71:115\u0026ndash;24. https://doi. org/10.15288/jsad.2010.71.115. \u003c/li\u003e\n\u003cli\u003esSumter SR, Bokhorst CL, Steinberg L, Westenberg PM. The developmental pattern of resistance to peer influence in adolescence: Will the teenager ever be able to resist? J Adolesc. 2009; 32:1009\u0026ndash;21. https://doi. org/10.1016/j.adolescence.2008.08.010. \u003c/li\u003e\n\u003cli\u003eHallfors D, Vevea JL, Iritani B, Cho H, Khatapoush S, Saxe L. Truancy, grade point average, and sexual activity: a meta-analysis of risk indicators for youth substance use. J Sch Health. 2002; 72:205\u0026ndash;11. https://doi. org/10.1111/j.1746-1561. 2002.tb06548. x.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"School-going adolescents, Cannabis use, Prevalence, Sierra Leone","lastPublishedDoi":"10.21203/rs.3.rs-3205061/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-3205061/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground:\u003c/strong\u003e Adolescents who use cannabis are more prone to participate in risky activities, such as taking other drugs, doing poorly in school, and exhibiting psychotic symptoms. No recent estimates of cannabis use and its correlates among adolescents have been documented in Sierra Leone. This study aimed to examine the prevalence of cannabis use and to determine its associated factors among school-going adolescents in Sierra Leone.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethod:\u003c/strong\u003e We analyzed secondary data from the 2017 Sierra Leone Global School-Based Health Survey. We used bivariate and multivariable logistic regression analysis to determine the factors associated with cannabis usage.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e The result showed that the prevalence of cannabis use was 4.3% among school-going adolescents in Sierra Leone. Males [aOR= 2.956, 95% CI = 1.169-7.603], alcohol use [aOR= 3.379, 95% CI = 1.208-9.448], ever used amphetamines or methamphetamines [aOR= 20.469, 95% CI = 8.905-47.053], suicidal attempt [aOR= 4.180, 95% CI = 1.468-11.905] and sexual risk behaviour [aOR= 2.798, 95% CI = 1.369-5.717] were associated cannabis use.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion:\u003c/strong\u003e The use of cannabis is prevalent among Sierra Leonean in-school adolescents. School-based health intervention programmes should be developed, considering the risk factors associated with cannabis use among adolescents.\u003c/p\u003e","manuscriptTitle":"Cannabis use and its psychosocial correlates among school-going adolescents in Sierra Leone.","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2023-08-01 18:31:29","doi":"10.21203/rs.3.rs-3205061/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"3874f7b8-245b-4005-9b55-9e843ad12673","owner":[],"postedDate":"August 1st, 2023","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2023-08-15T10:14:11+00:00","versionOfRecord":[],"versionCreatedAt":"2023-08-01 18:31:29","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-3205061","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-3205061","identity":"rs-3205061","version":["v1"]},"buildId":"WrCJVZZCHTDjtuVLN7oU0","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}