Substance use risk factors among high-risk urban youth in Chennai: an exploratory study and ecologically grounded intervention framework

Background Substance use among high-risk urban youth is a growing public health concern in India, particularly in rapidly urbanizing settings marked by socio-economic vulnerability. This study examined substance use patterns, risk awareness, and associated socio-ecological factors among high-risk urban youth in Chennai and developed an ecologically grounded psychosocial intervention framework.Methods An exploratory cross-sectional study was conducted among 116 high-risk urban youth aged 15–29 years recruited purposively from urban slum communities, Government Observation Homes, and rehabilitation centers in Chennai, India. Data were collected using a structured questionnaire in Tamil or English and analyzed using descriptive statistics and exploratory bivariate analysis.Results The findings indicated early initiation of substance use, with peer influence, family instability, school disruption, poor community resources, and poverty identified as key influences. Risk awareness and willingness to discontinue substance use differed significantly across age groups, with younger respondents showing greater readiness for behavioral change.Conclusions The findings highlight the need for context-sensitive, multi-level interventions addressing behavioral and structural determinants of substance use among marginalized urban youth. The study proposes an evidence-informed psychosocial intervention framework integrating micro-, mezzo-, and macro-level strategies for prevention, support, and rehabilitation.