Substance Use and Psychosocial Predictors of High School Dropout in Cape Town, South Africa Alan J. Flisher University of Cape Town and University of Bergen Loraine Townsend and Perpetual Chikobvu University of Cape Town Carl F. Lombard Medical Research Council, South Africa Gary King The Pennsylvania State University The aims of this study were to examine whether use of tobacco, alcohol, and illicit drugs predicts dropout among secondary school students in Cape Town, South Africa. A self-report instrument was administered to 1,470 Grade 8 students. The proportion of students that dropped out of school between the onset of the study and 4 years later was 54.9%. After adjusting for a range of confounders, dropout was significantly predicted by absenteeism, poverty (as assessed by a possession index), and past month cigarette use, but not by past month alcohol use and lifetime illicit drug use. Contrary to findings from developed countries, alcohol and illicit drug use did not predict dropout. It is possible that predictors of dropout documented elsewhere may not be pertinent in developing countries. School attrition represents a major educational and social challenge, partic- ularly in the developing world, where over 40% of children enrolled in pri- mary schools fail to progress to secondary education (United Nations Educational, Scientific and Cultural Organisation, 2003/4). In South Africa, 60% of children who enroll in Grade 1 drop out before completing high school (Department of Education, 2003). This may be related to relatively high rates JOURNAL OF RESEARCH ON ADOLESCENCE, 20(1), 237–255 r 2010, Copyright the Author(s) Journal Compilation r 2010, Society for Research on Adolescence DOI: 10.1111/j.1532-7795.2009.00634.x Requests for reprints should be sent to Alan J. Flisher, Division of Child and Adolescent Psychiatry, University of Cape Town, Red Cross Children’s Hospital, Klipfontein Road, Rondebosch 7700, Republic of South Africa. E-mail: alan.flisher@uct.ac.za