Guwahati: More than one in five adolescents surveyed across six districts in India are at moderate-to-high risk of substance use, with schools in Guwahati emerging among the worst affected, according to a study published in The Lancet Regional Health–Southeast Asia.
The study, conducted across 108 government and private schools involving more than 6,000 adolescents, found that 21.4% of participants fell into the moderate-to-high substance use risk category. Of these, 10.3% were classified as being at moderate risk and 11.1% at high risk, while 78.6% were considered low risk.
Researchers surveyed students in Kamrup (Assam), Gorakhpur (Uttar Pradesh), Nagpur (Maharashtra), Rajkot (Gujarat), Deoghar (Jharkhand) and Puducherry.
The findings showed that schools in Guwahati and Deoghar recorded the highest proportion of adolescents in the moderate and high-risk categories, while schools in Nagpur and Puducherry were characterised by predominantly low-risk profiles.
The study found a 35.1 percentage-point gap in substance use risk between Guwahati and Nagpur. Researchers said nearly 40% of this difference could be explained by school characteristics, socio-demographic and economic conditions, and personality traits.
The research was conducted by scientists from institutions including the All India Institute of Medical Sciences (AIIMS), Gorakhpur, and the Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry.
The team assessed substance use risk using the World Health Organization‘s Alcohol, Smoking and Substance Involvement Screening Test (WHO ASSIST), while personality traits were evaluated using the Substance Use Risk Profile Scale (SURPS).
The researchers identified several modifiable factors associated with a higher risk of substance use, including easier access to addictive substances, greater digital exposure and risky behavioural environments. Stronger social engagement, however, was found to have a protective effect.
The study also found that male adolescents had lower odds of higher substance use risk than females.
The authors noted that few studies in India have examined multi-substance use risk among adolescents using standardised tools such as the WHO ASSIST, resulting in limited evidence on how the risk varies across regions and social settings.
The researchers recommended stronger enforcement to reduce adolescents’ access to addictive substances, improved media literacy to address harmful digital exposure, and wider implementation of peer-led initiatives such as the Community Based Peer-Led Intervention (CPLI) under the School Health Programme to help prevent substance use among schoolchildren.