Substance use among young people in China: a systematic review and meta-analysis

Abstract Background Substance use in young people is a global problem, with potential adverse effects on physical, mental, and social wellbeing. The situation of use varies geographically worldwide. We did a systematic review and meta-analysis to quantify the estimates of prevalence of use in people aged 10–24 years in China. Methods We searched PubMed, Ovid, China National Knowledge Infrastructure, Wangfang Data for studies published before January, 2016, with a combination of search terms, including substance medicine, adolescent or young people, and the corresponding Chinese terms. We used the random-effect model or the fixed-effect model to estimate the prevalence of use based on heterogeneity test. We did subgroup analysis and meta-regression to determine the effect of gender and school type on prevalence. Findings Among 2555 retrieved articles, 59 articles involving 531 842 adolescents were eligible for the meta-analysis. The findings showed that, during their lifetime, the proportion of young people ever having used any of these substances was 59·65% (95% CI 53·37–65·74) for alcohol, 23·22% (20·33–26·11) for tobacco, 8·22% (7·14–9·30) for sedatives, 6·65% (3·93–9·37) for analgesics, 4·80% (3·75–5·84) for solvents, and 1·70% (1·13–2·26) for illicit drugs. The prevalence of use in the past 30 days was as following: 27·20% (95% CI 21·38–33·03) for alcohol, 10·14% (8·35–11·92) for tobacco, 2·79% (0·14–5·44) for solvents, 1·30% (1·29–1·31) for illicit drugs, 1·08% (0·80–1·36) for sedatives, and 0·98% (0·22–1·74) for analgesics. Subgroups analysis showed that the lifetime prevalence of use was higher in male adolescents than in female adolescents. Alcohol and sedatives were mostly used among college students, whereas tobacco, analgesics, and illicit drugs were mostly used among vocational school students. Compared with before 2010, illicit drug use increased after 2010 but tobacco and prescription medicines decreased. For prescription medicines, cough medicine was the most common medicine used non-medically, accounting for 3·64% (95% CI 2·72–4·55), followed by diazepam, phenobarbital, and scopolamine hydrobromide tablets, tramadol, methaqualone, morphine, etc. For illicit drugs, methamphetamine was the most common illicit drug used (1·06%; 0·92–1·20), followed by ketamine, ecstasy, heroin, cannabis, and cocaine. Interpretation Substance use is common among young people in China, particularly alcohol, tobacco, and illicit drugs. Itu0027s urgent to take comprehensive measures to prevent adolescents use, especially for vocational and college students. Funding Thirteenth Five-Year the National Key Research and Development Plan of the Chinese Ministry of Science and Technology (2016YFC0800907).