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Journal of Child & Adolescent Substance Abuse

ISSN: 1067-828X (Print) 1547-0652 (Online) Journal homepage: http://www.tandfonline.com/loi/wcas20

Prevalence of Substance Use in a Sample ofGhanaian Adolescents Experiencing ParentalDivorce

Bright Addo, George Oheneba Mainoo, Jonathan Mensah Dapaah & MichaelN K Babayara

To cite this article: Bright Addo, George Oheneba Mainoo, Jonathan Mensah Dapaah& Michael N K Babayara (2016): Prevalence of Substance Use in a Sample of GhanaianAdolescents Experiencing Parental Divorce, Journal of Child & Adolescent Substance Abuse,DOI: 10.1080/1067828X.2015.1056867

To link to this article: http://dx.doi.org/10.1080/1067828X.2015.1056867

Published online: 05 May 2016.

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Prevalence of Substance Use in a Sample of Ghanaian Adolescents ExperiencingParental Divorce

Bright Addoa, George Oheneba Mainooa, Jonathan Mensah Dapaaha, and Michael N K Babayarab

aKwame Nkrumah University of Science and Technology, Kumasi-Ghana; bGhana College of Physicians and Surgeons, Accra-Ghana

ABSTRACTUsing a cross-sectional nonexperimental design and a convenience sample of 240 adolescentsbetween the ages of 14 and 19 years, this study investigated the prevalence of substance useamong adolescents experiencing parental divorce in Ghana. The relative influence of factors such asadolescents' sex, class level, age at parental divorce, and years of experience with parental divorceon the use of substances were also examined. The Adolescent Substance Use Checklist (ASUC) wasadministered during class hours. Descriptive, bivariate and multivariate analyses were conducted.The results obtained showed that lifetime ever use of substances was 48.8% (ND117), with alcoholbeing the common used substance by adolescents. Adolescent males were as likely as females touse substances (ORD1.37, CID.807 –2.325). A significant relationship was found between class level,age at parental divorce, and substance use (p < .05 for both relationships). These two risk factorsalso proved to be significant predictors of substance use.

KEYWORDSadolescence; parentaldivorce; prevalence; riskfactors; substance use

Introduction

Several studies (e.g., Amato, 2000; Barrett & Turner,2005; Sun, 2001) have shown parental divorce to be neg-atively related to various measures of cognitive functionand social well-being among adolescents, and positivelyrelated to the acquisition of risky health behaviors suchas substance use. Specifically, parental divorce has beenshown to increase the risk for alcohol use (Griesbach,Amos, & Currie., 2003; Kristjansson, Sigfusdottir, Alle-grante, & Helgason, 2008; Menning, 2006) and cigarettesmoking (Jeyness, 2001; Kristjansson et al., 2008; Men-ning, 2006). The patterns are also found across a rangeof measures, such as lifetime use (Barrett & Turner,2005; Burke, McIntosh, & Gridley, 2009; Epstein, Bang,& Botvin, 2007; Turner, Irwin, & Millstein, 1991), initia-tion of drug use (Donovan, 2004; Gil, Vega, & Biafora1998), use in the past month (Kristjansson et al., 2008),and problematic substance use (Fischer & Lyness, 2005;Needle, Su, & Doherty, 1990).

Studies focusing on delinquency and adolescent sub-stance use (drinking alcohol, smoking cigarettes, and useof other drugs) have also shown that variables reflectingfamily structure and family relations are significant pre-cursors of youth problem behaviors, including drinking,smoking, and illicit drug use. Although findings fromthese studies are not always consistent, most generallyagree that living in an intact family (with both biological

parents) has a protective value against adolescent sub-stance use and delinquency (Barrett & Turner, 2006).Conversely, living in one-parent families (with motheror father only) is found to be an important risk factor forvarious problem behaviors including drug use; with therisk of using drugs reported to be highest among father-custody families (father-only and father-stepmotherfamilies), even after controlling for the effects of age, sex,race, ethnicity, family income, and residential mobility.The risk is lowest in mother-headed divorced families(Barrett & Turner, 2006).

Efforts to account for these patterns and variations inadolescent drug use with regards to family structure dif-ferences have generated several theoretical explanations.One explanation focuses on differences across familytypes in the dynamics operating within families, such asthe quality of parent-child interaction (Amato, 2005;Burke et al., 2009; McIntosh, 2006). These explanationsdraw on several theoretical perspectives, including sociallearning (Bandura, 1977) and social control theories(Hirschi, 1969). The social learning theory argues thatindividuals acquire social behavior by modeling or imi-tating others’ behavior (Bandura, 1977). Family membersin this regard play a central role in shaping behavior,including deviant behavior. Parental use of drugs is asso-ciated consistently with greater use by their offspring(Bahr, Hoffmann & Yang, 2005; Friedman, Terras, &

CONTACT Bright Addo addobright1@gmail.com University of Ghana School of Public Health, P.O. Box LG 13, Legon-Accra, Ghana.© 2016 Taylor & Francis Group, LLC

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Glassman, 2000; Gunnarsson, 2012), and parents’ choiceof drugs is connected closely with adolescents’ drugselection (Barrett & Turner, 2006). Also supportingsocial learning theory, research finds that adolescentsimitate the drug use behavior of older siblings moreclosely than that of parents (Bahr, Hoffmann & Yang,2005; Gunnarsson, 2012; Hemovich & Crano, 2011). Asecond set of explanations centers on the theories of dif-ferential association (Sutherland, 1947), social stress(Pearlin, Menaghan, Lieberman, & Mullan 1981), andstrain (Merton, 1968). Each perspective has receivedsome empirical support; however, determining the rela-tive importance of each is difficult because studies typi-cally focus on single explanations (Barrett & Turner,2006).

Studies also have tended to examine lifetime or recentuse of drugs (Hemovich & Crano, 2011; Kirby, 2002;Kristjansson et al., 2008), as opposed to problematic sub-stance use (Fischer & Lyness, 2005). As a result, weknow more about variation by family structure in thelikelihood of experimenting with alcohol and drugs butlittle about the risk factors for drug use among adoles-cents of divorced families.

Concern about alcohol consumption among adoles-cents has led to a mushrooming of literature thatseeks to understand the correlates of drug use andmostly abuse among youths (Kabiru, Beguy, Crichton,& Ezeh, 2010). Although there is now ample literatureon drug and alcohol consumption in sub-SaharanAfrica, much of it focuses on the links between con-sumption and sexual behavior and sexually transmit-ted diseases (in particular HIV) among adult andadolescent populations Adu-Mireku, 2003; (Morojele& Brook, 2006). There is, however, a paucity of stud-ies documenting the prevalence and risk factors forsubstance use among adolescents following parentaldivorce in the Ghanaian context. Given this gap inthe literature, social workers, other social serviceprofessionals, and government officials largely dependon the wholesale import and reception of foreign,especially American, literature and recommendedpractice for Ghanaian practice and policy formulation(Oheneba Mainoo & Ow, 2008). Also, given the dif-ferences in the marital cultures of Western and non-Western countries like Ghana, there is the need toidentify the risk factors that predisposed adolescentsto drug use following parental divorce as a basis tofacilitate the design of specific social intervention pro-grams for Ghanaian youths.

Although several non-Ghanaian studies have identi-fied one or more correlates of divorce and drug useamong high school- and college-age adolescents, fewstudies to date have examined the risk factors for drug

use among adolescents of divorced families. Built on thepremise that identifying the specific characteristics ofsubstance use is important in designing specific and ade-quate social interventions to control or decrease the con-tinuing use of drugs, this study investigated theprevalence of substance use among adolescents ofdivorced families and further determined the relativeinfluence of predictor variables such as sex, class level,age at time of parental divorce, and adolescents’ years ofexperience with parental divorce on the use ofsubstances.

Methods

Design

This study was a cross-sectional nonexperimental surveydesign which utilized a non-probability, conveniencesample with a structured questionnaire for the collectionof quantitative data involving multiple variables thatwere examined to detect patterns of relationship andassociation.

Population

Students between the ages of 14 and 19 years who haveexperienced parental divorce for at least two-years andwere living with their divorced parents at the time of thesurvey and who consented to participate were includedin the study. The 14-to-19-year age range of participantswas based on development theories (Erikson, 1963;Piaget, 1967) which indicate that adolescents attain cog-nitive competence and measurement of intelligence dueto their age progression and as such have the capacity toretrieve past experiences and can participate effectivelyin a survey exercise. The two-year baseline experience ofparental divorce is also consistent with several studies(e.g., Amato & Keith, 1991; Oheneba Mainoo & Ow,2008; Wallerstein & Kelly, 1980) which indicate that chil-dren and adolescents experience decrements in psycho-social well-being within the first couple of yearsfollowing parental divorce.

Sample size and technique

The multistage sampling technique was employed toobtain the sample of study participants. This was done inthree stages. In the first stage of sampling, whichinvolved the selection of the educational districts,13 educational districts in the Ashanti Region weregrouped into three clusters, A, B, and C. Clusters A andB each consisted of four educational districts and Cluster

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C had five. One educational district was then randomlysampled from each of the three clusters.

In the second stage of sampling, three public coeduca-tional senior high schools with students in SHS 1 to SHS4 (10th-13th grades) in the three selected educationaldistricts were randomly sampled. Public senior highschools were sampled because of their large student pop-ulation and national character. The choice of coeduca-tional institutions was informed by the assessment ofgender as a predictor of adolescent drug use.

The third and final stage of sampling consisted of asystematic equal probability sampling. Classes (SHS 1 toSHS 4) were randomly sampled within the schools andall the students who met the inclusion criteria were sub-sequently selected for the study.

To avoid stigmatization of and psychological effectson adolescents who experienced parental divorce,600 students from both intact and divorced families weresampled. A filter question (which measured the maritalstatus of adolescents’ parents) was used to separate theresponses of participants into intact and divorced fami-lies. Upon filtering, 240 students (119 males and121 females) between the ages of 14 years and 19 yearswho have experienced parental divorce for at least twoyears and were living with their divorced parent at thetime of the survey were identified.

Variables

The dependent variable (DV) of the study was substanceuse. The independent variables were sex, class level, ado-lescent age at time of parental divorce, and adolescent’syears of experience with parental divorce.

Measurement of variables

Dependent variableVariables of the study were operationally defined toafford their measurement. Adolescent substance use as adependent variable of the study was measured by twostandard epidemiological items regarding lifetime andcurrent alcohol, tobacco, or marijuana use. These itemsincluded “Have you ever tried using alcohol, tobacco, ormarijuana before?” and “During the past 30 days, onhow many days did you use the substance (s) indicated?”For the purpose of further statistical analysis, the threetypes of substances reported to have ever been used werecollapsed into one “ever drug use.” Adolescents whoreported they had ever used substances were further sub-divided into those who were current users (those whohad used a substance or substances on five or more dayswithin the past 30 days) and those who were not. Asthere is no consensus in the published literature on the

most acceptable definition of adolescent current druguse, a relatively stringent definition was applied(Tercyak, 2003).

Independent variablesAs numerous studies have repeatedly demonstrated thatgender predisposes adolescents to varying behavior out-comes including substance use (e.g., Gullone & Moore,2000; Gunnarsson, 2012), one item was developed tomeasure the gender (sex) of adolescents as a risk factor.Respondents assessed this item by indicating whetherthey were male or female.

Class level of adolescents was measured by one item.The questionnaire item requested adolescents to indicatetheir level of study. The response categories of SHS 1 toSHS 4 applied for this item.

Adolescents’ age at time of parental divorce as anindependent variable was measured by one questionnaireitem. The question asked, “At what age range did yourparents divorce?” Respondents were expected to chooseby circling the appropriate age range at which theirparents got divorced.

One questionnaire item with four response categorieswhich indicated the years of experience adolescents hadwith their parents divorced was also developed to mea-sure adolescents’ years of experience with parentaldivorce. Specifically, the question asked was, “How manyyears have your parents been divorced?” Like age at timeof parental divorce, adolescents were instructed to circlethe response code that corresponded to their years ofexperience with parents’ divorce.

Description of research instrument

The independent variables selected to determine theirrelative importance or predictive ability on the use ofsubstances among adolescents of divorced families wasbased on the the Adolescent Substance Use Checklist(ASUC). The ASUC is a 24-item self-reporting researchinstrument utilizing closed-ended questions and mutu-ally exhaustive response categories. The entire instru-ment was arranged into content subsections A and B.Section A consisted of 11 demographic and backgroundsurvey items. The first set of questions (nine) asked inthis section mainly measured sex, age, class level, ethnic-ity, religious identity, marital status of parents, currentliving arrangement of adolescents, age range of adoles-cent at parental divorce, and adolescent’s years of experi-ence with parental divorce. The last two questions on thebackground characteristics of adolescents determinedthe type(s) of substances ever used (alcohol, tobacco, ormarijuana) and the frequency of use, which was furtherused to distinguish between adolescents who were

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current substance users and those who were not. Partici-pants were to respond by writing the number of daysthey had used the drug, which was later coded as 0 Dnon-current user and 1 D current user. Thus, Section Aof the ASUC identified measures that distinguishedbetween adolescents either in terms of demographic vari-ables such as sex, age, class level, ethnic background, reli-gious identification, current living arrangement, age atparental divorce and years of post-parental divorce expe-rience, or their use of substances. Coding for the 11 itemswas mutually exclusive and exhaustive.

Section B consisted of 13 carefully developed itemsgenerated through prior research. A 5-point scale (1 Dnot true at all to 5 D always true) measured four items(nervousness, impulsivity, temperament, and attentiondisorder) to assess adolescent externalizing problembehaviors. A computed Cronbach’s alpha coefficientvalue of .65 indicated that the externalizing problembehavior subscale with its four items was reliable. TheASUC also consisted of an internalizing problem sub-scale constructed from three (1 D not true at all to 5 Dalways true) items. Items measured included unhappi-ness, loneliness, and hurt feelings. The Cronbach’s coeffi-cient alpha of .67 for the internalizing problem behaviorsubscale was also considered reliable.

Six items of the ASUC measured adolescents’ ofdivorced families association with drug-using peers andwith drug-peddling peers; peer use engagement; recrea-tional drug use attitude; social boredom; and peer-induced confidence. Respondents graded items on a scaleof 1 (strongly disagree) to 5 (strongly agree). The internalconsistency reliability (Cronbach’s coefficient alpha) ofthe peer use association subscale was .75.

Pilot test of draft questionnaireWe contacted the principal of a public coeducationalsenior high school in the Kumasi Metropolis to recruitstudents for the purpose of conducting a pilot test of theresearch instrument. The rationale for the pilot test wasto identify ambiguity in the survey questionnaire or theprocedures of survey administration, as well as in theinstructions for the study participants. Overall, the pilottest explored means to improve research items, format,and scales. With permission granted, 40 test participantswere recruited and briefed on the objectives of the study,after which they were administered a consent form tosign. The aim of the study and ethical considerations ofanonymity, confidentiality, and voluntary withdrawalwere again explained before administering the instru-ment. Forty completed self-report questionnaires werecollected, thoroughly reviewed, and analyzed. Overall,the participants indicated that items and instructionswere easy to understand. An average of 15 minutes was

used by each student to complete the surveyquestionnaire.

Test-retest proceduresPermission was also sought from another educationaldistrict to conduct the pretest-posttest exercise. Withpermission granted, 30 participants were recruited forthe pretest exercise and were given brief information onthe aims and objectives of the study and consent formsthat explained the relevant ethical issues of voluntaryparticipation, anonymity, and confidentiality.

The test was conducted for the next day and retest wasconducted after a two-week period. Investigator ensuredthat the test conditions were the same in both test exer-cises. Basically, the test-retest exercise was used to evalu-ate the adequacy of the questionnaire, to try outsystematically all procedures for the main study, to estab-lish and evaluate codes for questionnaire responses, andto gauge the length of the survey (Oheneba Mainoo &Ow, 2008). It was also used to establish reliability for theresearch instruments. A Pearson correlation coefficientwas computed to assess the test-retest reliability of indi-vidual scores for the ASUC for 30 participants within atwo-week interval between administrations; r (30) D .75.Although, there are no concrete rules for determininghow strong the test-retest coefficient of stability needs tobe, a correlation coefficient of .75 and above for a periodof two weeks between administrations was considered areasonable degree of stability.

Data collection

Formal written letters to request permission to conductthe main study in selected schools were given to threeprincipals. With permission granted by the principals,assistance was solicited from three teachers in each ofthe three schools. These teachers were trained to serve asresearch assistants for the study. It was explained to theteachers that the study was designed to determine therisk factors for substance use among adolescents ofdivorced families. It was emphasized that only studentswho had experienced parental divorce for at least twoyears were required to participate. However, in order toavoid stigmatization and possible psychological effectson test performance and participants’ self-esteem duringand after the exercise, we emphasized the need to allowall conveniently selected students to participate in thestudy with the intention of using a filter question (mari-tal status of parents question) to separate the responsesof participants of intact families from participants ofdivorced families. Data were collected over a three-weekperiod, with one week allotted to each study area aftertest-retest of the research instrument had been

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conducted. The collection process was the same through-out the three schools. In each school, 200 participantswere divided into four clusters and settled into variousclassrooms under the supervision of the research assis-tants. Issues of ethical concerns on voluntary participa-tion, anonymity, and confidentiality were discussedfollowed by reading aloud the standard code of instruc-tions on the research instrument. The investigators werepresent in each cluster to inform participants of the aimof the study and to address concerns from participantsbefore administering the research instruments. Each par-ticipating cluster of participants received the standardcode of instructions in the same format before respond-ing to the questionnaire.

The research assistants assisted in the administrationof questionnaires to participants, ensured proper lightingof the sites, and maintained silence to ensure participantsconcentration. The use of participants’ class teachers asresearch assistants in the same school venue and duringclass periods minimized participants’ anxieties andensured a conducive and more relaxed atmosphere thatmanifested in the non-withdrawal rate. Participantsresponded to all items in the survey. The non-discrimi-natory, generally inclusive participation of respondentsof intact and divorced family backgrounds ensured fam-ily background anonymity, which essentially boosted testparticipation of all participants irrespective of the type offamily backgrounds they came from.

Data management and analysis

Upon collection, the data were coded, entered, andcleaned. The coding process aimed at simplifying thedata entry and analysis process. In the exercise of trans-lating words into numbers, a coding scheme or instruc-tion was prepared to direct the process. The scheme wasthen used to translate the responses in the questionnaireinto numbers. Coding was straightforward since closed-ended types of questions with mutually exhaustiveresponses were utilized.

Once coded, data were entered into the StatisticalPackage for the Social Sciences (SPSS) software(Version 20). Variables were defined in the variable viewphase of the SPSS program, while data were subsequentlyentered into the data view of the software program tocreate a data file.

After being entered, the data were thoroughly checkedfor errors or mistakes. Data cleaning at this stageinvolved eliminating errors in coding. Since data proc-essing errors are inevitable, particular attention was paidto the entry of data. The validation tool in the SPSS pro-gram, which gives information about missing values withtheir identification numbers and wrong entries made,

was also utilized to further confirm that the data wereclean and error-free. There were no missing values in thedata.

The cleaned data were analyzed using SPSS(Version 20). Descriptive analysis was conducted onsociodemographic and primary variables. To determinethe relationship between selected risk factors (indepen-dent variables) and substance use (dependent variable), achi-square test for independence was conducted. The rel-ative influence and predictive ability of the selected riskfactors were also determined through the multivariateanalysis technique, binary logistic regression.

Ethical consideration

Permission was sought from the headmasters of the threesenior high schools sampled for the study. Permissionwas also sought from the teachers who had a class withthe students at the time permission was given to admin-ister the survey instrument. Individual informed consentwas obtained from respondents by requesting them tosign an assent form attached to the questionnaire. Toensure anonymity of the study participants, they wereinstructed not to provide any form of personal identifica-tion. They were, however, asked to indicate their pro-gram of study and date of completing the questionnaire.A debriefing session was organized for participants whowere thought to have been psychologically stressedthrough their participation in the exercise, but no partici-pant showed up to utilize the service, an indication thatthere was no emotional or psychological effect of the sur-vey exercise on participants.

Results

Sociodemographic characteristics of the sample

Study participants for this study consisted of 240 adoles-cent-students who had experienced parental divorce forat least two years at the time of the survey. Participants’ages ranged from 14 to 19 years, and participants weredrawn from three public coeducational senior highschools in the Ashanti Region of Ghana.

The sample of the study was almost evenly distributedwith respect to gender (49.6% males, 50.4% females).Age distribution of the sample revealed the majority ofthe adolescents sampled were between the ages of 18 and19 years (N D 101; 42.1%). The distribution of respond-ents with respect to their level of study was also almostevenly distributed; however, a relatively high numberwas recorded for students belonging to SHS 2 and 3.Seven ethnic groups of adolescents were identified, withthe Akan group (N D 215; 89.6%) constituting the

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highest number. Three main religious groups were iden-tified (seeTable 1), with adolescent Christians (N D 235;97.9%) constituting the highest number. AdolescentMuslims (N D 3; 1.2%) and adolescent freethinkers(N D 2; 0.8%) were the least represented in this study.Adolescents who reported that they were living withtheir mothers after parental divorce constituted themajority (67.9%). The age of respondents at the time ofparental divorce revealed adolescents who reported thattheir parents divorced during their latency years (six to10 years old) constituted the majority (N D 128; 53.3%).Only 48 adolescents sampled (20.0%) reported that theywere in preschool (one to five years old) at the time theirparents divorced. Most of the adolescents sampled forthis study (N D 99; 41.3%) reported that their parentshad divorced barely within six 10 years at the time of thestudy.

Prevalence of substance use

The total number of adolescents who reported not usingany drugs (N D 123; 51.2%) were more than adolescentswho reported ever using a substance (N D 117; 48.8%),as seen in Table 2. We found that more males reportedlifetime ever use of substances than females (52.9% ver-sus 44.6%). This difference was, however, not statistically

significant. Use of substances in the past 30 days alsoshowed variations within the sexes, with more adolescentmales’ reporting use of substances. Table 2, which alsoshows the types of substances mostly used by the adoles-cents, indicates that compared to tobacco and marijuana,alcohol was the most used substance (82% of adolescentsreporting use). The dominant use of alcohol by the ado-lescents could be attributed to its availability on the mar-ket. The low use of tobacco and marijuana reportedcould be a result of the known adverse effects associatedwith the use of these substances. In all the measures ofsubstance use, we found a non-significant difference inthe use of substances among adolescent males andfemales. This result indicates that the use of substances islargely not dependent on sex.

Relationship between adolescent characteristicsand substance use

The bivariate analysis conducted to determine the rela-tionship between adolescents’ background characteristicsand lifetime ever use of substances is presented inTable 3. It revealed statistically significant relationshipsbetween the independent variables; class level and age atparental divorce and the dependent variable ever use ofsubstance (p D .003 for both tests).

A high percentage of adolescents whose parentsdivorced when they were between the ages of six and10 years and those whose parents did so when they wereolder than 15 years indicated ever using a substance. Themajority of the adolescents who were in the early stagesof their secondary education (i.e., SHS 1 and SHS 2) alsoindicated ever using a substance. In spite of the relation-ship between the other measures of adolescents’ charac-teristics and substance use not attaining statisticalsignificance, it can be seen from Table 3 that a high per-centage of adolescents who were males; belonged to the16–17 age cohort; did not belong to a religious denomi-nation; lived with a sibling; and had experienced parentaldivorce for between six and 10 years reported lifetimeever use of a substance.

Risk factors for substance use

To determine the factors that influence the lifetime everuse of substances by adolescents (N D 117), a binarylogistic regression analysis was performed. The modelcontained four independent variables. These variableswere sex, class level, age at parental divorce, and years ofexperience with parental divorce. For each of the inde-pendent variables, dummy variables were created and acategory was chosen as the reference category to whichall other categories were compared. Table 4, which shows

Table 1. Background Characteristics of Respondents (N D 240).

Variable Category N (%)

Sex Male 119 (49.6)Female 121 (50.4)

Age (years) 14–15 3 (1.2)16–17 94 (39.2)18–19 101 (42.1)

Above 19 42 (17.5)Level of study SHS 1 57 (23.8)

SHS 2 62 (25.8)SHS 3 66 (27.5)SHS 4 55 (22.9)

Ethnicity Akan 215 (89.6)Ga 6 (2.5)Ewe 6 (2.5)Bono 5 (2.1)Nzema 2 (.8)Frafra 3 (1.3)

Dagomba 3 (1.3)Religious orientation Christian 235 (97.9)

Muslim 3 (1.3)Freethinker 2 (.8)

Living arrangement Father 50 (20.8)Mother 163 (67.9)

Grandparent 24 (10.0)Sibling 3 (1.3)

Age at parental divorce (years) 1–5 48 (20.0)6–10 128 (53.3)11–15 24 (10.0)

Above 15 40 (16.7)Years of experience with divorce 1–5 44 (18.3)

6–10 99 (41.3)11–15 50 (20.8)

Above 15 47 (19.6)

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the result of the regression analysis conducted, indicatesthat of the four factors entered into the model, only classlevel and age of adolescent at the time of parental divorceproved to be significant determinants or predictors ofsubstance use. The odds of using a substance was foundto be high among adolescents in the early stage of theirstudies (OR D 4.9 for SHS 1 and 2.2 for SHS 2).

Discussion

Confirming mainstream research findings, our studyrevealed that substance use is prevalent among adoles-cents experiencing parental divorce in Ghana. Out of the

240 adolescents of divorced families who participated inthe study, 117 (48.8%) indicated lifetime ever use of asubstance. It must be emphasized that prior to this studywe anticipated a relatively low prevalence of substanceuse due to the extended nature of families in Ghana.Unlike the family system in the Western world, which ispredominantly nuclear, the family system in Ghana isextended. The extended family system is noted to collec-tively offer support to its members in crisis situationssuch as death of a parent or divorce. Kinsmen of theextended family system usually deem it obligatory toassist in providing support for the custodial spouse andchildren, which serves as a buffer against the acquisition

Table 2. Substance Use Among Adolescents (N D 240).

Variable Category Male N (%) Female N (%) p-value

Lifetime ever use No 56 (47.1) 63 (52.9) .246Yes 67 (55.4) 54 (44.6)

Type of substances usedAlcohol No 56 (47.1) 63 (52.9) .246

Yes 67 (55.4) 54 (44.6)Tobacco No 110 (92.4) 115 (95.0) .571

Yes 9 (7.6) 6 (5.0)Marijuana No 113 (95.0) 116 (95.9) .736

Yes 6 (5.0) 5 (4.1)Current use (use in past 30 days) No 51 (42.9) 38 (31.4) .064

Yes 11 (9.2) 7 (5.8)NA� 57 (47.9) 76 (62.8)

Note.NA D Adolescents who reported not using any of the substances.� p < 0.05.

Table 3. Adolescents’ Characteristics and Lifetime Ever Use of Substances (N D 240).

Ever Use of Substances N (%)

Characteristics Categories No Yes p-value

Sex Male 56 (47.1) 63 (52.9) .245Female 67 (55.4) 54 (44.6)

Age (years) 14–15 2 (66.7) 1 (33.3) .87116–17 46 (48.9) 48 (51.1)18–19 54 (53.5) 57 (46.5)

Above 19 21 (50.0) 21 (50.0)Level of study SHS 1 18 (31.6) 39 (68.4) .003�

SHS 2 33 (53.2) 29 (46.8)SHS 3 36 (54.5) 30 (45.5)SHS 4 36 (65.5) 19 (34.4)

Religious orientation Christian 121 (51.5) 114 (48.5) .302Muslim 2 (66.7) 1 (33.3)

Freethinker – 2 (100.0)Living arrangement Father 28 (56.0) 22 (44.0) .290

Mother 82 (50.3) 81 (49.7)Grandparent 13 (54.2) 11 (45.8)

Sibling – 3 (100.0)Age at parental divorce (years) 1–5 32 (66.7) 16 (33.3) .003�

6–10 56 (43.8) 72 (56.2)11–15 18 (75.0) 6 (25.0)

Above 15 17 (42.5) 23 (57.5)Years of experience with divorce 1–5 24 (54.5) 20 (45.5) .304

6–10 44 (44.4) 55 (55.6)11–15 30 (60.0) 20 (40.0)

Above 15 25 (53.2) 22 (46.8)

�p < 0.05.

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of risky behaviors such as substance use. The gradualtransformation of the erstwhile extended family systemto a nuclear one over the years in Ghana might haveaccounted for the relatively high prevalence of substanceuse obtained in this study.

The predominant use of alcohol that we found is con-sistent with the findings of authors such as Doherty andNeedle (1991), and Epstein and colleagues (2007) in theextant literature. The ease with which adolescents haveaccess to alcoholic beverages and the numerous commer-cials on different brands of it on TV makes it the mostpreferred choice of substance to use.

Contrary to the finding of Needle and colleagues(1990), which indicated that adolescent boys are morelikely to engage in substance use than girls, the results ofour study revealed a non-significant relationship betweensex and lifetime use of substance. This result is indicativeof the fact that adolescent males are not significantly dif-ferent from their females regarding substance use. Con-sistent with the study of Doherty and Needle (1991),which showed that adolescents whose parents haverecently divorced are noted to abuse drugs and alcoholmuch more than adolescents whose parents divorcedduring their early childhood, our study also revealed asignificant relationship between age at parental divorceand substance use, with adolescents whose parentsdivorced in their preadolescence years being more likelyto use substances. In spite of the relationship betweenadolescents’ years of experience with divorce and sub-stance use not attaining statistical significance, adoles-cents with less years of experience of parental divorcewere found to be more likely to use substances than thosewith relatively more years of experience with divorce (seeTable 4). This finding also corroborates the findings ofAmato and Keith (1991), Wallerstein and Kelly (1980),and Oheneba Mainoo and Ow (2008), which indicate

that adolescents experience decrements in psychosocialwell-being within the first couple of years followingparental divorce.

Our results have implications for both future researchand practice. First, as with all works of original research,replication of this study would serve as a check on thereliability and generalizability of the present findings.Beyond mere replication, however, our findings suggestseveral promising directions for future research. First,researchers may wish to extend this study by undertak-ing more detailed analyses of the factors found to influ-ence the use of substances. Second, unlike the cross-sectional design employed, a longitudinal design wouldpermit inferences regarding causation. From a preven-tion point of view, the findings of this study could beused to educate or sensitize married couples on the nega-tive effects of parental divorce and the need to find betterways of solving their marital problems other than seek-ing divorce.

Existing community and school counseling centersshould be strengthened and well-resourced to providefree and quality counseling services to parents and ado-lescents of divorced families to enable them to developeffective coping strategies to deal with the adverseoutcomes of divorce other than resorting to substanceuse. Counseling sessions may address teaming socialproblems and engage adolescents into more proactiveactivities that facilitate positive well-being.

These implications notwithstanding, our study haslimitations and it is noteworthy to highlight its majorones. A primary limitation of this study is the use of aself-report questionnaire for the collection of data. Giventhe potential anxiety related to disclosing alcohol andother substances used or relationships with peers whouse substances, study participants might have felt pres-sured to respond in ways they considered socially

Table 4. Binary Logistic Regression of Independent Variables Predicting Likelihood of Substance Use.

Factor Category B p-value OR (95% CI)

Sex Male .039 .894 1.039 (.587–1.839)Female 1 –

Level of study .007��

SHS 1 1.587 .001 4.889 (1.974–12.108)SHS 2 .770 .084 2.159 (.903–5.164)SHS 3 .611 .144 1.842 (.811–4.185)SHS 4 1

Age at parental divorce (years) .008��

1–5 ¡1.178 .013 .308 (.121–.782)6–10 ¡.242 .587 .786 (.328–1.879)11–15 ¡1.543 .014 .214 (.062–.733)15C 1 –

Years of experience with divorce .6181–5 ¡.220 .644 1.247 (.490–3.173)6–10 .102 .819 .903(.377–2.161)11–15 ¡.409 .389 .664 (.262–1.686)15C 1

��p < 0.01.

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desirable, though they were assured of anonymity andconfidentiality. Second, the sample of the study was notnormal as there were disproportionate sociodemographicfactors. For instance, there were disproportionate ethnicand religious groups distributions, with Akans andChristians representing more than 90% of the entire dataset. Different results might have been observed if thesegroups were proportional in the sample distribution.

Finally, our findings to a large extent cannot be gener-alized to all adolescents of divorced families in Ghana.Geographically, the survey areas of the study were alllocated within the Ashanti Region and as such are closelyrelated in terms of students’ sociodemographic charac-teristics, their families’ socioeconomic status, students’residential state similarities, and effects of acculturation.These similarities do not subtend to the rich array of dif-ferent demographic, cultural, and social-economic con-ditions that would have been characteristics of a nationalrepresentative sample.

In conclusion, the results of our study provide evidencethat the use of substance use is prevalent among adoles-cents experiencing parental divorce in the Ghanaian con-text and suggests relationships between risk factors andsubstance use by adolescents experiencing parentaldivorce. Despite the longstanding interest in understand-ing the impact of parental divorce on youth psychosocialand emotional outcomes, research continues to overlookthe diverse nature of single-parent families and the etiol-ogy of alcohol and other illicit substance use in these fam-ilies. It is hoped that future research continuous todetermine whether the risk factors identified by this studyand others identified in the extant literature of adolescentsubstance use demonstrate the same predictive functionwhen measured in other ways in other samples in othergeographical areas. Only through the development of agreater understanding of these factors will there beimprovements in existing interventions and developmentof new and effective ones for use with adolescents.

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