Substance Use and the Associated Factors Among High School Students in Jimma Town, Jimma, Southwest Ethiopia

Background: High substance use among Ethiopian high school students has been reported in localized studies, yet key contributing factors such as parental substance use, school policies, and environmental influences remain under-researched, particularly in Jimma. Identifying the prevalence and contributing factors specific to this setting is essential for developing targeted prevention strategies and guiding school and community-level interventions. Methods: This cross-sectional study assessed substance use prevalence and the associated factors among 206 high school students (Grades 9–12) in Jimma Town, Jimma, Ethiopia. Participants were selected using multistage random sampling from two schools. Self-administered questionnaires, including an adapted Brief Screener for Tobacco, Alcohol, and other drugs, were used to screen participants. Data were entered in Epi-Data 3.1 and analyzed using SPSS 27; bivariate and multivariate logistic regression analyses identified associated factors, and statistical significance was determined at a 95% confidence level, P value (.05). Results: Among 202 participants, the prevalence of substance use was 27.2% (95% CI: 21.1–33.3). The most common substances used were Khat 48.5% (95% CI: 1.75–1.96), followed by alcohol 26.7% (95%CI: 1.27–1.56), and tobacco products 8.9% (95% CI: 1.23–1.52). Living with parents (AOR = 9.245, 95% CI: 0.96–88.94, P = .045), parents’ neutral opinion on substance use prevention (AOR = 2.762, 95% CI: 1.09, 6.94, P = .031), students’ lack of information on substance use (AOR = 0.343 95% CI: 0.15, 0.77, P = .010), and peer substance use especially chewing Khat (AOR = 16.512, 95% CI: 6.68–40.80, P < .001) significantly increased odds of substance use. Conclusions: The high prevalence of substance use among high school students necessitates a collaborative approach involving all stakeholders to foster a safer and more supportive educational environment. Schools should mandate comprehensive substance use prevention programs, establish clear prevention-focused policies, and engage parents and the community to build a cohesive support network.