Multiple risk factors: Prevalence and correlates of alcohol, tobacco and other drug (ATOD) use among university students in Egypt

There is a lack of research on Alcohol, Tobacco and Other Drug (ATOD) use in the Eastern Mediterranean region (EMR). We assessed four ATOD behaviors (risk factors; smoking, alcohol consumption behavior, ones own illicit drug/s use, friends illicit drug/s use), two mental health indicators (depressive symptoms, perceived stress), two socio-demographic features (gender, age) and two policy variables (agree with smoking and alcohol bans at university). A self-administered questionnaire was completed by 3258 students at 11 faculties of Assiut University in Egypt (2009-2010). As for ATOD individual risk factors, about 8.8% of the participants smoked cigarettes (occasionally or daily), 3.8% reported "high frequency" alcohol use (a few times each week, every day and a few times each day), 4.5% had ever used illicit drugs, and 15.3% had a friend who used illicit drug/s. For ATOD multiple risk factors, 28.5% of the sample reported any ATOD risk factor, and 8.7% of the sample reported ≥2 risk factors, and the frequencies were significantly higher among males. Depressive symptoms were positively associated with illicit drug/s use and with having a friend/s who use illicit drug/s. Smoking was positively associated with ones illicit drug/s use, but negatively associated with having a friend who use illicit drug/s. Higher frequency of alcohol use was positively associated with illicit drug/s use. Age and perceived stress were not associated with any of ATOD variables. These findings contribute to lack of research on ATOD use across the EMR, and provide a platform for planning prevention/intervention policies.