Substance use in the conscripts affiliated with the fort Ratchaburi Province

Background: Substance use problems impact both physical and mental health, spreading to many areas, including military forts, which represent the strength and stability of the nation. Objective: This study aimed to investigate the prevalence, behavior, attitudes, and factors related to substance use among the conscripts affiliated with the Fort Ratchaburi Province. Methods: A cross-sectional study collected data from 400 conscripts between July - September 2023 using questionnaires through individual interviews. The questionnaires included: 1) demographic information; 2) attitudes towards substance use; 3) The alcohol, smoking and substance involvement screening test; 4) The Thai substance use disorder screening test. A urine toxicology test was conducted for cannabis, opioid, and methamphetamine. The data were analyzed using descriptive and inferential statistics. Results: The prevalence of substance use, at least once in the lifetime and in the past three months, was 86.7% (n = 347) and 71.5% (n = 286), respectively. The five substances with the highest usage in the past three months were alcohol (54.0%), tobacco (53.3%), kratom leaves (33.3%), cannabis (30.8%), and mixtures of kratom leaf decoction (22.0%). Of 254 conscripts who used tobacco, 210 (82.7%) and 6 (2.4%) were found to be at moderate and high risk, respectively, of having tobacco problem. Substance use disorder (SUD) was found in 76.8%, 37.4%, 37.4%, 34.1%, 27.3, 26.7% of conscripts who used tobacco, alcohol, cannabis, kratom leaves, mixtures of kratom leaf decoction and amphetamine-type stimulants, respectively. The attitudes of the conscripts are mostly not aligned with substance use. Low educational level and income sufficiency were identified as factors associated with and predictors of substance use (P < 0.05). Conclusion: Most conscripts used substances. Although the majority of substances used in this study are legal, high prevalence of SUD was found, especially tobacco use disorder in conscripts who smoked cigarettes. Factors related to substance use include low level of education and income sufficiency.