Mediators of the relationship between external and internal religiosity and protection against substance use among university Muslim students in Egypt

Substance use disorders (SUDs) pose major health and social risks for adolescents and young adults. Although religiosity has been linked to lower substance use, the mechanisms underlying this protective effect remain unclear. This study examined mediating factors influencing the relationship between religiosity and substance use among university students. A cross-sectional survey was conducted with 1,680 students at Zagazig University using validated measures of religiosity and substance use, alongside scales assessing coping, resilience, emotion regulation, self-efficacy, purpose in life, and family functioning. Overall, 7.6% reported drug use, with higher prevalence among males. Logistic regression showed that low internal and external religiosity and poor family functioning significantly increased substance use risk. Mediation analysis indicated that internal religiosity exerted both direct and indirect protective effects, partly through family functioning and self-efficacy. External religiosity demonstrated a direct but non-mediated protective influence. Findings highlight religiosity as a protective factor against substance use in university populations.