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Second and third year medical students’ self-reported alcohol and substance use, smoking habits and academic performance at a South African medical school

Annelize Vorster
Anthonie M. Gerber
Lynette J. van der Merwe
Sanet van Zyl


Background: Health professional students frequently use alcohol and narcotics. The potential impact on academic performance and professional behaviour is concerning.
Aim: This study aimed to determine self-reported use of alcohol, illicit substances (e.g. cannabis, lysergic acid diethylamide [LSD], magic mushroom, cocaine, crack, ecstasy, methamphetamine and heroin), prescription medication and smoking habits, correlating academic performance.
Setting: Faculty of Health Sciences, University of the Free State.
Methods: An observational, descriptive, cross-sectional study design was used. Information was obtained using a self-administered questionnaire, capturing demographics, self-reported academic performance, drinking and smoking habits, and substance use. Coded responses were analysed using the Remark Office OMR 8 Software System. Descriptive statistics were calculated for categorical variables.
Results: Completed questionnaires comprised 171 students. A total of 78.4% of second year and 82.8% of third year students reported using alcohol. Twenty-two per cent of second year and 24.1% of third year students reported cannabis use. In the second year group, three (2.7%) students reported using magic mushroom, two (1.8%) reported cocaine, two (1.8%) reported ecstasy and one (0.9%) reported using  methamphetamine. Only third year students reported using LSD or ‘crack’. Cigarette smoking was common – 31.5% and 35.1% in both
groups, respectively. Smokeless tobacco devices were used by 8.5% of second year and 7.1% of third year students. Almost 40% of both groups reported that they had smoked a water pipe. Academic performance achieved was mostly 60% – 69% (38.9%) among second year students and 70% – 79% (46.6%) among third year students.
Conclusion: Self-reported use of alcohol and drugs and smoking among medical students is alarming. Additional student support, early  identification and referral for management and/or rehabilitation should be a priority at tertiary institutions responsible for training future
healthcare professionals.

Keywords: Alcohol; Drug abuse; Medical students; Smoking habits; Academic performance.