Determining adverse childhood experiences and their association with substance use among young adults in universities and colleges in Mombasa County, Kenya

BACKGROUND: Substance use and adverse childhood experiences (ACEs) remain major risk factors for health, education, and social relationships, with the effects of ACEs persisting into adulthood. This study aimed to investigate the association between substance use (alcohol, tobacco and tobacco products, and illicit drugs) and ACEs among young adults in higher learning institutions in Mombasa County, Kenya. METHODS: The analytical cross-sectional study collected data on having ever experienced any form of ACEs and substance use (alcohol, tobacco and tobacco products, and illicit drugs). A total of 849 participants were randomly sampled from 11 higher leaning institutions in the county. Questionnaires collected information on ACEs and substance use, with ACEs scores used to assess association with the three substances. Descriptive statistics were used for exploratory data analysis, while Chi-square tests and logistic regression assessed the relationship between ACEs and the use of the three substances. RESULTS: The overall ACEs prevalence was 88.1% (95%CI: 86.0%-90.3%). Among the three substances, alcohol had the highest prevalence at 45.6% (95%CI: 42.4%-49.1%). Exposure to physical abuse (adjusted odds ratio (aOR) = 1.8 (95% CI: 1.0-3.1), p = 0.044), emotional neglect (aOR = 1.6 (95% CI: 1.2-2.2), p = 0.002), emotional abuse (aOR = 2.0 (95% CI: 1.1-3.5), p = 0.019), sexual abuse (aOR = 2.2 (95% CI: 1.3-3.8), p = 0.003) and parent/guardian alcoholic (aOR = 1.8 (95% CI: 1.3-2.5), p < 0.001) was significantly associated with higher prevalence of alcohol use. Exposure to emotional neglect (aOR = 1.5 (95% CI: 1.0-2.1), p = 0.039) and collective violence (aOR = 2.0 (95% CI: 1.3-3.2), p = 0.001) was significantly associated with higher prevalence of tobacco and tobacco products use. The use of illicit drugs was significantly associated among those who had experienced emotional abuse (aOR = 1.9 (95% CI: 1.1-3.3), p = 0.019) and those who had a household member imprisoned (aOR = 1.6 (95% CI: 1.1-2.3), p = 0.024). CONCLUSION: This study found that most young adults in colleges and universities had experienced at least one ACE and reported substance use, with prevalence higher among those exposed to ACEs. This emphasizes the need for targeted approaches within higher learning institutions supporting early detection and prevention of ACEs and their associated consequences such as adult substance use.