Self-Esteem, attitudes towards alcohol and other substance use among undergraduate students in Nairobi, Kenya

A sex- disaggregated cross-sectional analysis

Abstract

This study examined the relationship between self-esteem and attitudes toward alcohol and other substance use (ASU) among undergraduate students in Nairobi, Kenya, focusing on sex differences. Studies across Africa have shown a high rate of ASU among university students due to the normalization of alcohol consumption and the accessibility of drugs. We analyzed data from 406 undergraduate students (51% male), with an average age of 19 years, at a public university in Nairobi. Alcohol and substance use were measured using the Assessment of Smoking and Substance Involvement Test (ASSIST), self-esteem was measured using the Rosenberg scale, and attitudes toward alcohol were assessed using the Attitudes Towards Alcohol scale. Sex disaggregated, modified Poisson regression models estimated the relative risk of ASU associated with covariates (self-esteem and attitudes towards alcohol use) as the primary explanatory variables of interest. Each per-point increase in social ease reduced the risk of current alcohol use by 17% in females and 18% in males. Living at home or in private residences consistently increased the risk of ASU for both sexes. These findings underscore the influence of social and contextual factors on ASU and highlight the need for university based prevention strategies to inform the ASU-related attitudes among students.