JHAS Vol. 10, No. 1, 2020 Free Full Text Articles are Available at www.jhas.org.np 71 Original Article JHAS 2020; 10(1):71-76 doi:https://doi.org/10.37107/jhas.142 Correspondence: Dr. Hari Prasad Kaphle, School of Health and Allied Sciences, Pokhara University, Pokhara-30, Kaski, Nepal E-mail- harikafe07@gmail.com Contributing Factors of Substance Abuse among Secondary Level School Students in Bharatpur Metropolitan Alisha Gurung 1 , Hari Prasad Kaphle 1 1 School of Health and Allied Sciences, Pokhara University, Pokhara-30, Kaski, Nepal ABSTRACT Introduction: Substance abuse is harmful or hazardous use of psychoactive substance including alcohol, tobacco and illicit drugs. This study aimed to assess the prevalence and contributing factors for substance abuse among secondary level school students in Bharatpur Metropolitan. Methods: A cross sectional study was carried out among 495 students of grade 11 and 12 of secondary schools in Bharatpur metropolitan from June to December, 2019. Data were collected using self-administered anonymous questionnaire. Chi-square test was performed to fnd out the association between dependent and independent variables and crude odd ratio was obtained to measure the strength of association. Results: The study showed that 18.8% participants were involving in substance abuse. Alcohol was found to be most commonly abused substance by participants. Substance abuse was signifcantly associated with boys (OR=11.903, 95% CI: 6.395-22.157), high monthly household income (OR=1.709, 95% CI: 1.085-2.691), time spent on internet more than one hour per day (OR=2.401, 95% CI: 1.388-4.153), no control over internet by others (OR= 2.578, 95% CI:1.574-4.224), management students (OR= 1.678, 95% CI: 1.011-2.286), absence in school for more than 4 days in a month (OR= 2.401, 95% CI:1.338-4.153), students living with others than family members (OR= 2.577, 95% CI:1.339- 4.958), presence of substance abuser in family (OR= 2.701, 95% CI:1.667-4.377), sibling abuse substances (OR= 4.757, 95% CI:1.467-15.248), substance abuser in close friend circle (OR= 11.204, 95% CI: 6.693-4.18.755), friends insisted/ enforced to take substances (OR= 2.978, 95% CI: 1.409-6.294), substance abuser in neighborhood (OR= 2.866, 95% CI:1.777-4.621) and stressful events (OR= 2.434, 95% CI: 1.130-5.243). Conclusion: Various socio-demographic, socio-economic, technological, educational, environmental and psychological factors play signifcant role in substance abuse among secondary school students. It is recommended to observe and monitor activities of adolescents regularly, provide a suitable and supportive environment to adolescents and provide school, community and health facility based awareness, counseling and services to solve the problem of substance abuse among adolescents. Keywords: Substance abuse, secondary school students and factors associated. INTRODUCTION According to World Health Organization (WHO), “substance abuse is harmful or hazardous use of psychoactive substance including alcohol and illicit drugs”. 1 Some of the abused substance includes alcohol, cigarette/tobacco, cannabis, amphetamines, marijuana, ecstasy, opioids, cocaine etc. Likewise, it also includes khat, inhalants and volatile substances like glue, petrol and also synthetic drugs like barbiturates. Substance abuse has become a major public health problem in global context and it has been increasing drastically in developing countries. 23 Adolescence substance abuse holds a number of negative health consequences and has also negative impact on wellbeing of individual. It also increases risk of injury, suicidal ideations, decreased academic performance, risk of acquiring STDs and psychiatric disorders. 2,4 Similarly, it also leads to social consequences as well as poverty which affect economic status of country. 5 There is also a link between substance abuse and getting involved in a crime. 4 Adolescence are vulnerable to substance abuse and have greater problems regarding substance abuse. It is a common public health risk that peaks in age of 18-25 years and are highly prevalent in school students. 6 Factors affecting substance abuse among adolescents are numerous and complex in different context. 7 Adolescent substance abuse has been associated with low academic performance, declining grades, absenteeism, and school drop-out. 4 Different study showed different prevalence of substance abuse