Patterns of substance use and cessation intentions among youths in internally displaced persons camps and host community in Northeastern Nigeria, 2021

 Corresponding author: Irene Esu Copyright © 2025 Author(s) retain the copyright of this article. This article is published under the terms of the Creative Commons Attribution Liscense 4.0. Patterns of substance use and cessation intentions among youths in internally displaced persons camps and host community in Northeastern Nigeria, 2021 Fatima Lawan Bukar 1, Aisha Aliyu Abulfathi 1, Soter Ameh 2, Mohammed Abubakar Abiso 3, Chiamaka Blessing Ugwuja 4 and Irene Esu 5, * 1 Department of Community Medicine, University of Maiduguri, Borno State. 2 Department of Community Medicine, University of Calabar, Cross River State. 3 Department of Family Medicine, University of Maiduguri Teaching Hospital, Borno State. 4 College of Medicine, University of Nigeria Teaching Hospital, Enugu. 5 Department of Health Promotion Education and Behavior, Arnold School of Public Health, University of South Carolina, USA. World Journal of Advanced Research and Reviews, 2025, 26(02), 494-508 Publication history: Received on 18 March 2025; revised on 29 April 2025; accepted on 01 May 2025 Article DOI: https://doi.org/10.30574/wjarr.2025.26.2.1513 Abstract Introduction: Forced displacement leading to internal displacement, especially in developing countries, is a growing global public health problem. The additional presence of substance use and abuse among forcefully displaced young people worsens the challenge by posing long-term health, social and legal consequences for both substance users and the general public. A better understanding of the pattern and drivers of substance use will be useful for the prevention and control of the menace among this vulnerable population. This study, therefore, aims to assess and compare the prevalence and willingness to stop substance use among youths in Internally Displaced Persons (IDP) camps and their host communities in Borno State, Nigeria. Methods: A comparative cross-sectional study was conducted among youths (15-29 years old) in IDP camps and the host communities in Maiduguri, North-East Nigeria. A multistage sampling technique was used to recruit respondents from their households into the two study groups. Alcohol, Smoking and Substance Involvement Screening Test (ASSIST), and Stages of Changes Readiness and Treatment Eagerness Scale (SOCRATES) instruments, were pretested and used to assess the prevalence, types and pattern of substance use, as well as willingness to stop substance abuse, via interviewer-administration Results: Three hundred (300) respondents were surveyed, comprising one hundred and fifty (150) each, from IDP camp and their host communities. Male-to-female ratios were 1:0.85 for the host and 1:0.67 for IDP study groups. The mean age was 21.9 ± 4.58 years (15-29 years), with significantly younger respondents in IDP compared with host communities. Overall 138 respondents were involved in substance abuse, yielding a prevalence rate of 46.0%. The prevalence of substance use among host and IDP study groups was 59.3% and 32.7%, respectively (p<0.05). Among substance users, the mean age at onset of substance use was 17.9 ± 3.6 years, with significantly earlier onset among IDP compared with host groups (p<0.05). Also, the mean duration of substance use was 5.39 ± 3.3 years, but with a significantly longer duration of use among IDP compared with host groups (p<0.05). Tobacco was the most commonly abused substance with high (15.2%) and moderate (33.3%) degrees of dependence, and a significantly higher proportion among IDP compared with host groups (p<0.05). In both groups, the commonest social means of taking substances was with friends, who were also the most common introducers of substances to respondents in both study groups. Most subjects had low levels of recognition (94.9%), ambivalence (62.0%) and taking steps (72.3%). Compared with respondents in the host group, those in the IDP group had a significantly higher proportion of high degree for taking steps (20.4% vs. 4.5%, p<0.05). Multinomial regression analysis identified age and male gender as the significant World Journal of Advanced Research and Reviews, 2025, 26(02), 494-508 495 predictors of substance use (p<0.00). For every unit increase in age by one year, there was a 15% increased likelihood of substance use. More so, compared with females, males had a 12.28 times increased likelihood of substance use (p<0.05). Conclusion: There is a high prevalence of substance abuse among youths forcefully displaced due to Boko Haram insurgency in Northern Nigeria. Youths should be gainfully employed and/or engaged in diverse forms of capacitybuilding activities. Rehabilitation services should be made available in host communities and IDP camps, to provide health education and counselling, towards prevention, treatment and control of substance use and its consequences. Keywords: Substance use; IDPs; Host communities; Maiduguri 1. Introduction The World Health Organization (WHO) defines substance abuse as the harmful consumption of psychoactive substances, such as alcohol and illegal narcotics. (1) An estimated 296 million people, or 5.8% of the world's population between the ages of 15 and 64 years, used at least one drug in 2021. (2) According to projections, the prevalence of substance use will rise by 11% globally and by 40% in Africa. (3) The menace of substance use and eventual abuse has been associated with high morbidity and mortality, with youths using more drugs than adults, and having higher levels of use than in past generations. (3,4) An estimated 50% of people with substance use problems have been noted to have at least one form of mental health problem throughout their life course. (5) In sub-Saharan Africa (SSA), alcohol is the main psychoactive substance produced, while cannabis is the main illicit drug cultivated and consumed. (6) The illicit drug trade in West Africa is estimated at millions of US Dollars. (7) Among several factors associated with the high burden of substance use, vulnerability occasioned by conflict-related forced migration is key. Globally, over 71 million individuals were internally displaced across nations and continents. (8) Within the last two decades, Nigeria has had a persistent armed conflict due to banditry, kidnappings and the Boko Haram insurgency, mainly in the North East region. (9) In Nigeria, about 2,388,703 people were internally displaced. The Boko Haram insurgency started in 2009 and has displaced more than 2.5 million people, thereby, creating internally displaced persons (IDP) camps in several communities mostly in Northern Nigeria. This forced displacement potentially increases the risk of substance use, with untoward mental health problems. The common mental health problems among persons in IDP camps are depression, post-traumatic stress disorder (PTSD), generalized anxiety and panic attacks. Consequently, studies among displaced persons in diverse settings have reported varying rates of substance use, ranging from 31.8% in Pakistan to 20% in Nigeria. (10,11) The prevalence rate of substance use in northeastern Nigeria in 2017 was estimated at 13.6%. The relationship between mental illness and substance use has also been well documented. (12,13) In 2013, the United Nations on Drug and Crime (UNODC), the European Union (EU) and the Nigerian government started a project aimed at reducing substance abuse and crime rate, which is being funded by the EU and implemented by the UNODC. (14) In Nigeria, the National Drug Law Enforcement Agency (NDLEA) and the National Agency for Food and Drug Administration and Control (NAFDAC) monitor possession and consumption of substance use. (15,16) These international and local agencies highlight the growing problem of substance abuse and the need for it to be curbed. Despite the efforts by international and local agencies to curb the menace of abuse of substances, substance use, driven by insurgency, persists in IDP camps. Also, there is paucity of data on the prevalence of substance abuse in the IDP camps in the areas of insurgencies in northeast Nigeria. Therefore, the objective of this study is to determine the prevalence of substance abuse and associated factors in the study setting. 2. Material and methods 2.1. Study Area The study was conducted in Maiduguri, Borno State community and internally displaced camps. Borno State is situated in Northeastern Nigeria, and shares borders with the three neighbouring countries of Niger Republic, Chad, and Cameroun and the states of Adamawa, Gombe and Yobe in Nigeria. (17) Maiduguri has two Local Government Areas (Maiduguri Metropolitan Council and Jere). The LGA are urban with a population of 749,123 according to the 2006 census.(18) With an annual growth rate of 3.2%, the population is estimated at 1,180,617 in 2024. Of the population, 22.7% are youths (15-29 years) with 12.5% females and 10.2%. (19) The Boko Haram insurgency started in North-East Nigeria in 2009 with about 4 million people displaced from their homes due to the insurgency. This led to the creation of IDP camps within the state capital. (20) World Journal of Advanced Research and Reviews, 2025, 26(02), 494-508 496 There are 138 IDP camps in Maiduguri but only eight (NYSC camp, Bakasi camp, EYN Christain Association of Nigeria Centre camp, Mohammed Goni College of Legal and Islamic Studies (MOGCOLIS) camp, Teacher’s Village, Stadium camp, Farm Centre camp and Muna El Badawy camp) are operated and run by the government. Initially, the structure of the IDP camps was based on senatorial districts but was later merged due to lack of available space and logistics. Therefore, each camp has a representation of several local governments. (21) 2.2. Study Design The study was a comparative cross-sectional study involving youths in IDP camps and in the host communities. 2.3. Study Population and Duration The study populations were youths aged 15-29 years living in IDP camps and the host communities in Maiduguri, Borno State for at least one year. 2.4. Sample Size Determination The minimum sample size to determine a difference in substance use among youths living in IDP camps and the host communities with a significant at the 5% level and with a 90% chance of detecting the difference (power) was calculated using the formula for comparison of two proportions. (25) After calculating and adding an allowance for 10% nonresponse, a minimum sample size of 274 was increased to 300 respondents to increase the power of the study and for better generalization to the larger populace. 2.5. Sampling Technique After Community Entry, A Multistage Sampling Technique Was Used To Select 150 Respondents From Host Communities And 150 Respondents From IDP Camps Giving A Total Of 300 Respondents. In The Selection Of Respondents From The IDP Camps, Simple Random Sampling By Balloting Was Used To Select Four IDP Camps Out Of The Eight IDP Camps In Maiduguri. A Proportionate Allocation Ratio Of 3:1 Was Applied To Select Three Camps From MMC (Bakassi, Teacher’s Village, And Stadium) And One Camp From Jere LGA (Farm Center). Systematic Random Sampling Was Used To Select Households Within The Chosen Camps. Within Selected Households, One Eligible Youth (Aged 15-29) Was Chosen. In The Host Community, One Ward Was Selected From The 15 Wards In MMC (Shehuri North) And One From The 12 Wards In Jere LGA (Mairi) Using Simple Random Sampling By Balloting. One Settlement Was Randomly Selected From Each Ward: Gangamari In MMC And Gomari Costin In Jere. Systematic Random Sampling Was Used To Select Households. Within Selected Households, One Eligible Youth (Aged 15-29) Was Chosen. 2.6. Data Management A semi-structured interviewer-administered questionnaire was used. This was adapted from a WHO-designed instrument the alcohol, smoking and substance involvement screening test (ASSIST) and Stages of Changes Readiness and Treatment Eagerness Scale 8d (SOCRATES). The latter is an experimental instrument designed to assess readiness for change in alcohol /drug users. SOCRATES subscales into acceptable range (ambivalence = 0.54; recognition = 0.87; taking steps = 0.84). (22–24) The data were cleaned by checking for any data collection or coding errors. Data entry and analysis were carried out with the aid of the International Business Machines-Statistical Package for the Social Sciences (IBM-SPSS) Version 21.0. Frequency distributions of the variables were developed. Means and proportions were calculated, while associations between variables were tested using appropriate statistical significance testst-test, fisher’s test, and chi-square. 2.7. Data analysis plan Data collected was entered into Statistical Package for Social Sciences (SPSS) version 29.0 software for analysis. Descriptive analysis of the data included absolute and relative frequencies for categorical variables while numerical variables were summarized using means and standard deviations. Chi-square or Fisher’s exact test was used to compare differences in proportions of categorical dependent or outcome variables and categorical independent or predictor variables. The cut-off point for the univariate logistic regression (bivariate) analysis was set at a 5% significance level. World Journal of Advanced Research and Reviews, 2025, 26(02), 494-508 497 2.8. Ethical Considerations Ethical approval was obtained from the Ethics and Research Committee of the Federal Neuropsychiatric Hospital, Maiduguri. Permission and approval for the research were also obtained from the medical emergency department of the State Ministry of Health. Prior to data collection, the Borno State Emergency Management Agency (SEMA) was made to be aware of the research, via official notification of their country office and appropriate representative(s) at the IDP camps in Maiduguri, North East Nigeria 3. Results Data was obtained from three hundred (300) respondents comprising one hundred and fifty (150) each from the IDP camp and their host communities. In Table 1, in both study groups, there were more males than females, with a maleto-female ratio of 1:0.85 (host) and 1:0.67 (IDP). However, the difference in proportions was not statistically significant. The mean age was 21.9 ± 4.58 years (15-29 years), with significantly younger respondents in IDP than in host communities (47% vs. 24%, p<0.001)”. Primary education or lower level was more common among IDP (82.6% vs 18.0%), while secondary education or higher was common among the host group (82.0% vs 17.4%, p<0.05). Most subjects (215, 71.7%) were single, with no significant difference in marital status comparing study groups. There was a significantly higher proportion of artisans among IDP (54.7% vs. 22.0% p<0.001) and students among host groups (46.0 vs.14.0 p<0.001). Salaried work or a job was the most typical source of income (65.3%), though this was significantly more common among IDP (74.0% vs 56.7 p<0.001), while the parental source was more common among the host group (39.3% vs 13.3%, p<0.001) Table 1 Socio-demographic Characteristics of the Respondents (n=300) Variable Host n (%) IDP n (%) Total n (%) Test Statistics Gender Male 81 (54.0) 90 (60.0) 171 (57.0) Female 69 (46.0) 60 (40.0) 129 (43.0) 0.29 Age groups (in years) 15-19 36 (24.0) 71 (47.3) 107 (35.7) 20-24 56 (37.3) 36 (24.0) 92 (30.7) 0.001* 25-29 58 (38.7) 43 (28.7) 101 (33.6) Mean ± SD 22.9 ± 4.05 20.9 ± 4.88 21.9 ± 4.58 <0.001* Educational level None 3 (2.0) 24 (16.0) 27 (9.0) Quaranic 18 (12.0) 44 (29.3) 62 (20.7) Primary 6 (4.0) 56 (37.3) 62 (20.7) <0.001⸸* Secondary 57 (38.0) 22 (14.7) 79 (26.3) Tertiary 66 (44.0) 4 (2.7) 70 (23.3) Marital status Single 109 (72.7) 106 (70.7) 215 (71.7) Married 35 (23.3) 40 (26.7) 75 (25.0) Divorced/separated 5 (3.3) 2 (1.3) 7 (2.3) 0.57⸸ Widowed 1 (0.7) 2 (1.3) 3 (1.0) Occupation Artisan 33 (22.0) 82 (54.7) 115 (38.3) World Journal of Advanced Research and Reviews, 2025, 26(02), 494-508 498 Student 69 (46.0) 21 (14.0) 90 (30.0) Petty trader 25 (16.6) 27 (18.0) 52 (17.3) <0.001⸸* Driver 10 (6.7) 8 (5.3) 18 (6.0) Housewife 9 (6.0) 1 (0.7) 10 (3.3) Farmer 0 (0.0) 9 (6.0) 9 (3.1) White collar job 3 (2.0) 0 (0.0) 3 (1.0) Others 1 (0.7) 2 (1.3) 3 (1.0) Main source of income Salary/Job 85 (56.7) 111 (74.0) 196 (65.3) Parents 59 (39.3) 20 (13.3) 79 (26.3) Charities 3 (2.0) 17 (11.3) 20 (6.7) <0.001⸸* Friends 2 (1.3) 1 (0.7) 3 (1.0) Others 1 (0.7) 1 (0.7) 2 (0.7) ⸸ Fisher’s exact test *Statistically significant One hundred and thirty-eight (46%) respondents abused substances with 49(33%) among IDPs and 89 (59%) among host communities. Figure 1 Prevalence of Substance Abuse among youths in IDP and Host community Substances that were commonly reported as ever used were tobacco (24.0%), opioids (19.3%) cannabis (17.0%) and alcohol (Table 2). Five per cent or less of respondents reported ever using other substances, including alcohol (5.0%), cocaine (2.0%) and sedatives (2.0%), Compared with respondents in IDP camps, those in host communities had a significantly higher prevalence of reporting ever using opioids (26.7% vs. 12.0% p<0.001), alcohol and (8.7% vs. 1.3% p<0.001), cocaine (4.0% vs. 0.0% p<0.010). World Journal of Advanced Research and Reviews, 2025, 26(02), 494-508 499 Table 2 Ever abuse of substances by Respondents Substances IDP n (%) Host n (%) Total n(%) Test Statistics Tobacco Yes 34 (22.7) 38 (25.3) 72 (24.0) 0.590 No 116 (77.3) 112 (74.7) 228 (76.0) Alcohol Yes 2 (1.3) 13 (8.7) 15 (5.0) <0.001⸸* No 148 (98.7) 137 (91.3) 285 (95.0) Cannabis Yes 20 (13.3) 31 (20.7) 51 (17.0) 0.090 No 130 (86.7) 119 (79.3) 249 (83.0) Cocaine Yes 0 (0.0) 6 (4.0) 6 (2.0) 0.010⸸* No 150 (100) 144 (96.0) 294 (98.0) Sedatives Yes 3 (2.0) 3 (2.0) 6 (2.0) 1.000⸸ No 147 (98.0) 147 (98.0) 294 (98.0) Opioids Yes 18 (12.0) 40 (26.7) 58 (19.3) <0.001* No 132 (88.0) 110 (73.3) 242 (80.7) ⸸ Fisher’s exact test *Statistically significant Within the last three months for all respondents, the most frequently used substances taken daily or almost daily were tobacco (47.8%), cannabis (15.9%) and opioids (10.1%) (Table 3). This sequence is similar, considering respondents in the host (tobacco:37%; cannabis:11.2%; opioids:10.1%) and IDP (tobacco:67.3%; cannabis:24.5%; opioids:10.2%) groups. Also, there was significantly more frequent abuse of tobacco and cannabis among respondents in IDP compared with host groups (p<0.05). There was no significant difference in the frequency of abuse of other substances (p>0.05). The daily or almost daily use of tobacco (63% vs 37%, p=0.010) and cannabis (25% vs 11%, p=0.030) was significantly higher among IDPs than people in the host communities. However, there were no significant differences in the frequency of use of alcohol (p=0.150), cocaine (p=0.460), sedatives (p=0.110) and opioids (p=0.120). Table 3 Frequency of Substance abuse in the last three months by Substance abusers (n=138) Substance IDP n (%) Host n (%) Total n (%) Test Statistics Tobacco Never 15(30.6) 51(57.3) 66 (47.8) Once/Twice 1(2.0) 1 (1.1) 2 (1.4) Weekly 1(2.0) 2 (2.2) 3 (2.2) 0.010⸸* Daily/Almost daily 32 (65.4) 35 (39.4) 67(48.6) Total 49 (100) 89 (100) 138(100) Alcohol Never 47(95.9) 76(85.4) 123(89.1) World Journal of Advanced Research and Reviews, 2025, 26(02), 494-508 500 Once/Twice 2 (4.1) 2 (2.2) 4(3.0) Monthly 0(0.0) 2(2.2) 2 (1.4) 0.150⸸ Weekly 0(0.0) 7 (8.0) 7 (5.1) Daily/Almost daily 0(0.0) 2(2.2) 2 (1.4) Total 49(100) 89 (100) 138 (100) Cannabis (C) Never 29(59.2) 58(65.2) 87 (63.0) Once/Twice 1(2.0) 3(3.4) 4 (2.9) Monthly 3(6.1) 7(7.8) 10 (7.2) 0.030⸸* Weekly 4(8.2) 11(12.4) 15 11.0) Daily/Almost daily 12(24.5) 10(11.2) 22 (15.9) Total 49(100) 89(100) 138 (100) Cocaine (D) Never 49 (100) 83(93.3) 132 (95.7) Once/Twice0 0(0.0) 5(5.6) 5 (3.6) Monthly 0 (0.0) 1 (1.1) 1 (0.7) 0.46⸸ Total 49 (100) 89 (100) 138 (100) Sedatives (G) Never 46 (93.9) 86 (96.7) 132 (95.7) Monthly 2 (4.1) 2 (2.2) 4 (2.9) Weekly 1 (2.0) 0 (0.0) 1 (0.7) 0.11⸸ Daily/Almost daily 0 (0.0) 1 (1.1) 1 (0.7) Total 49 (100) 89 (100) 138 (100) Opioids (I) Never 31 (63.3) 49 (55.1) 80 (58.0) Once/Twice 3 (6.1) 2 (2.2) 5 (3.6) Monthly 6(12.2) 9(10.1) 15 (10.9) 0.12⸸ Weekly 4 (8.2) 20 (22.5) 24(17.4) Daily/Almost daily 5 (10.2) 9 (10.1) 14 (10.1) Total 49 (100) 89 (100) 138 (100) ⸸ Fisher’s exact test *Statistically significant Table 4 shows the pattern of substance abuse among substance abusers. The mean age at onset of substance abuse was 17.9 ± 3.6 years p = 0.090, with significantly earlier onset among IDP compared with host groups (16.7 ± 4.0 years vs 18.7 ± 3.2 years p<0.001). Also, the mean duration of substance abuse was 5.39 ± 3.3 years, but with a significantly longer duration of abuse among IDP compared with host groups (6.3 ± 3.6 years vs 4.9 ± 3.0 years p=0.020). In both groups, the most common social means of taking substances was with friends (57.1% vs 56.2%) who were also the most common introducers of substances to respondents in both study groups (71.4% vs 59.6%). World Journal of Advanced Research and Reviews, 2025, 26(02), 494-508 501 Table 4 Pattern of Substance abuse among Substance abusers (n=138) Variable IDP n (%) Host n (%) Total n (%) Test Statistics Age at substance abuse (years.) <10 3 (6.1) 1(1.1) 4 (2.9) 11-20 41 (83.7) 70 (78.7) 111 (80.4) 0.090⸸ >20 5 (10.2) 18 (20.2) 23 (16.7) Total 49 (100) 89 (100) 138 (100) Mean ± SD 16.7 ± 4.0 18.7 ± 3.2 17.9 ± 3.6 0.001* Duration of substance abuse (years.) <5 23 (46.9) 58 (65.2) 81 (58.7) 6-10 20 (40.8) 27 (30.3) 47 (34.1) >10 6 (12.) 4(4.5) 10 (7.2) 0.070⸸ Total 49 (100) 89 (100) 138 (100) Mean ± SD 6.3 ± 3.6 4.9 ± 3.0 5.39 ± 3.3 0.020⸸* Means of taking substance Individually 10 (20.4) 25 (28.1) 35 (25.4) With friends 28 (57.1) 50 (56.2) 78 (56.5) 0.222⸸ In group 11 (22.4) 11 (12.4) 22 (15.9) Others 0 (0.0) 3 (3.4) 3 (2.2) Total 49 (100) 89 (100) 138 (100) Substance introducer Friends 53 (59.6) 35 (71.4) 88 (63.8) Curiosity 13 (14.6) 7 (14.3) 20 (14.5) Relative 15 (16.9) 4 (8.2) 19 (13.8) 0.45⸸ Father 1 (1.1) 0 (0.0) 1 (0.7) Brother 4 (4.5) 0 (0.0) 4 (2.9) Drug pusher 1 (1.1) 1 (2.0) 2 (1.4) Others 2 (2.2) 2 (4.1) 4 (2.9) Total 89 (100) 49 (100) 138 (100) ⸸ Fisher’s exact test *Statistically significant Table 5 shows that most subjects had low levels of recognition (94.9%), ambivalence (62.0%) and taking steps (72.3%). Compared with respondents in the host group, those in the IDP group had a significantly higher proportion of high degree for taking steps (20.4% vs. 4.5%, p<0.001), the mean score was significantly higher among respondents in IDP compared with host group for recognition (21.14 vs. 18.35, p=0.040) ambivalence (12.7 vs. 11.2 p=0.040) and taking steps (22.9 vs. 18.1 p= 0.010). World Journal of Advanced Research and Reviews, 2025, 26(02), 494-508 502 Table 5 Degree of Willingness to Stop Substance Abuse using SOCRATES Scores (n=138) Substance IDP n (%) Host n (%) Total n (%) Test Statistics Recognition Low (7-30) 46 (93.8) 84 (94.4) 130 (94.2) Medium (31-33) 1 (2.0) 1 (1.1) 2 (1.4) High (>34) 2 (4.2) 4 (4.5) 6 (4.4) 0.420⸸ Total 49 (100) 89 (100) 138 (100) Mean ± SD 21.14 ± 7.2 18.35 ± 7.5 19.35 ± 7.5 0.040* Ambivalence Low (4-13) 25 (51.1) 61 (68.5) 86 (62.3) Medium (14-15) 7 (14.3) 12 (13.5) 19 (13.7) High (16-20) 17 (34.6) 16 (18.0) 33 (24.0) 0.070 Total 49 (100) 89 (100) 138 (100) Mean ± SD 12.7 ± 4.0 11.19 ± 4.2 11.74 ± 4.1 0.040* Taking steps Low (8-30) 29 (59.2) 71(79.8) 100 (72.5) Medium (31-33) 10 (20.4) 14(15.7) 24 (17.4) High (>34) 10 (20.4) 4(4.5) 14 (10.1) 0.001⸸* Total 49 (100) 89 (100) 138 (100) Mean ± SD 22.90 ± 10.8 18.07 ± 9.5 19.80 ± 10.2 0.010* ⸸ Fisher’s exact test *Statistically significant Table 6 shows the binary logistic regression analysis was done to assess factors associated with substance abuse. Every unit increase in age by 1 year, yielded 11% and 20% increase in the likelihood of substance abuse among respondents in host (OR=1.11) and IDP (OR=1.20) groups, respectively (p = 0.001). Compared with females, males had at least threeand five-fold increased likelihood of substance abuse among respondents in host and IDP groups, respectively (p<0.001). Compared with respondents from Kanuri tribe, those from Babur-bura and other tribes, had 3.02 and 2.40 increased likelihood of substance abuse (p<0.05). Table 6 Binary logistic regression of association of factors with Substance Abuse (n=300) Variable Host Community IDP camp OR 95% CI P-value OR 95% CI P-value Age 1.11 0.97-1.94 0.001 1.20 0.87-2.04 <0.001 Gender Females* 0.32 0.16-0.64 <0.001 0.05 0.02-0.17 <0.001 Males 3.09 1.57-6.08 <0.001 19.70 5.79-68.12 <0.001 Duration in comm./camp 0.95 0.90-0.99 0.04 1.02 0.85-1.23 0.80 Tribe Kanuri* Babur-bura 1.12 0.42-3.00 0.82 3.02 1.35-6.76 0.01