Cluster analysis of conformity and social desirability: Association with use and problematic use of licit substances

Background: Problematic Use of Licit Substances is an increasing public health concern in Lebanon, where political and economic instability, alongside cultural and religious diversity, may intensify risk behaviors, while social desirability and conformity can influence their reporting. This study aims to assess the profiles of participants related to social desirability and conformity pressures and their association with licit substance use and problematic use. Methods: A cross-sectional online survey was conducted among 460 adults in Lebanon (February-March 2025). Data on cigarette, waterpipe, and alcohol use were collected alongside validated measures of social desirability and conformity. A two-step cluster analysis was first conducted to determine the optimal number of clusters, followed by K-means clustering to classify participants based on their social desirability and conformity scores, with subsequent regression analyses examining sociodemographic and cluster membership correlation with substance use behaviors. The risk of problematic substance use was higher in the detached/autonomous phenotype and increased with age and among male gender participants, while religious prohibition appeared strongly protective. Differential results were found for waterpipe and alcohol, in comparison with problematic cigarette use. Conclusion: Considering social desirability and conformity allows for more precise identification of problematic substance use clusters, guiding targeted prevention and intervention. This complex interplay of personality traits, cultural values, age, gender, and education highlights the need for culturally sensitive, gender-specific, and cluster-tailored public health and psychosocial interventions rather than universal approaches.