Lifetime, Last Month and Excessive Prevalence of Addictive Substances Consumption Among the General Population and University Students in the City of Tehran

Abstract

Background: The lack of epidemiological data over the past decade among Iranians and the inadequate conceptualization of substance consumption prevalence are two targeted problems. Objectives: The present research attempts to discriminate between lifetime, last month, and excessive prevalence of addictive substances consumption among the general population and university students and to follow up on public parks as high-risk environments. Materials and Methods: This cross-sectional study was conducted in Tehran during the fall of 2023 and 2024. A total of 2,183 valid participants were recruited by distributing 15,500 flyers containing a weblink and barcode to an online questionnaire assessing the experience, frequency, and initiation age of various substances consumption. Pearson's chi-squared test with Yates' continuity correction and Welch two sample t-test performed with R were used for statistical analysis. Results: Lifetime prevalence among the general population was as follows: Hookah (57.3%), cigarettes (54.4%), alcohol (41.9%), marijuana (16.0%), psychiatrics (12.5%), opium (7.5%), hashish (4.5%), crystal (1.6%), heroin (1.6%), LSD (1.3%), and ecstasy (1.1%). The highest priorities for last month prevalence are cigarettes (32.0%), alcohol (20.5%), hookah (17.6%), and marijuana (4.6%). Cigarettes had the highest excessive prevalence (8.5%), followed by hookah (2.7%) and alcohol (2.7%). The prevalence of almost all substances was significantly higher, and the age of initiation was lower in public parks compared to the general population (alpha < 0.01), and there was a notable enthusiasm for stimulant drugs. Despite the increase in prevalence for all substances through the public parks after one year follow-up, the lifetime prevalence of marijuana changed the most significantly (10 percentage points with P = 0.011). University students behave like the general population, except for the lower prevalence of hard drugs and the lack of a gender difference for cigarettes, alcohol, and psychiatrics. Conclusions: Considering the medical consequences of excessive consumption, tobacco cigarettes are the most malignant problem, but marijuana, with its accelerating prevalence, is the immediate challenge. The role of public parks as the market base points to the need for legalization of addictive behaviors and an economic paradigm shift to prevent a social catastrophe. The gender similarity among students hints at a cultural reformation rooted in universities jeopardized femininity.