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Meta-Analysis
. 2024 Jun 20;19(6):e0304948.
doi: 10.1371/journal.pone.0304948. eCollection 2024.

Association between illegal drug use and cigarette smoking among Ethiopian students: A systematic review and meta-analysis

Chala Daba  1 , Mesfin Gebrehiwot  1 , Sisay Abebe Debela  2 , Belay Desye  3 , Yonatal Mesfin Tefera  4
Affiliations
Meta-Analysis

Association between illegal drug use and cigarette smoking among Ethiopian students: A systematic review and meta-analysis

Chala Daba et al. PLoS One. .

Abstract

Introduction: Cigarette smoking is a persistent public health problem as it is a risk factor for many diseases. Previous studies on the role of illegal drug use in cigarette smoking have yielded disparate and inconclusive results, hindering the development of effective intervention strategies to address this issue. Therefore, this systematic review and meta-analysis aimed to estimate the pooled prevalence of cigarette smoking and its associated factors, with a specific focus on the influence of illegal drug use among students in Ethiopia.

Methods: We conducted a comprehensive search of international databases, including PubMed, Cochrane Library, Science Direct, CINAHL, African Journals Online, HINARI, Global Health, and Google and Google Scholar. Grey literature was also identified from various university digital libraries. The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA) guidelines. Due to the high heterogeneity among the included studies (I2 = 98.6%; p-value <0.001), we employed a random-effects model with a 95% confidence interval (CI) to estimate the pooled effect using STATA 14 software. The publication bias was assessed using a statistical Egger regression test.

Results: A total of 22 studies involving 18,144 students met the eligibility criteria for this systematic review and meta-analysis. The pooled prevalence of lifetime and current cigarette smoking among students in Ethiopia was 13.8% (95% CI: 9.90-17.82) and 9.61% (95% CI: 7.19-12.03), respectively. Students who used illegal drugs were twenty-three times more likely to smoke cigarettes compared to their counterparts (OR = 23.57, 95% CI: 10.87-51.1). Living in urban settings (OR = 2.9; 95% CI: 1.15-7.28) and the habit of alcohol consumption (OR = 4.79; 95% CI: 1.57-14.64) were also identified as factors associated with cigarette smoking.

Conclusions: We found that more than one in eight students in Ethiopia have engaged in lifetime cigarette smoking. Notably, students who used illegal drugs exhibited a significantly higher likelihood of cigarette smoking. In light of these findings, it is imperative to implement comprehensive public health interventions that target illegal drug use, cigarette smoking, and alcohol consumption, with a particular emphasis on urban residents.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. PRISMA flow diagram of the included studies for the systematic review and meta-analysis on the association between illegal drug use and cigarette smoking among students in Ethiopia, 2023.
Fig 2
Fig 2. Forest plot of the pooled prevalence of lifetime cigarette smoking among students in Ethiopia, 2023.
Fig 3
Fig 3. Forest plot of the pooled prevalence of current cigarette smoking among students in Ethiopia, 2023.
Fig 4
Fig 4. Funnel plot of the pooled prevalence of lifetime cigarette among students in Ethiopia, 2023.
Fig 5
Fig 5. The funnel plot of a simulated meta-analysis.
Fig 6
Fig 6. Subgroup analysis by region of the pooled prevalence of lifetime cigarette smoking among students in Ethiopia, 2023.
Fig 7
Fig 7. Subgroup analysis by type of school of the pooled prevalence of lifetime cigarette smoking among students in Ethiopia, 2023.
Fig 8
Fig 8. Sensitivity analysis of the included studies.
Fig 9
Fig 9. Forest plot of odds ratio for the association between residence and cigarette smoking among students in Ethiopia, 2023.
Fig 10
Fig 10. Forest plot of odds ratio for the association between alcohol consumption and cigarette smoking among students in Ethiopia, 2023.
Fig 11
Fig 11. Association between illegal drug use and cigarette smoking among students in Ethiopia, 2023.
See this image and copyright information in PMC

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Grants and funding

The author(s) received no specific funding for this work.
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