|Year : 2016 | Volume
| Issue : 1 | Page : 6-11
Sociodemographic correlates of substance use among long distance commercial vehicle drivers
Christopher Izehinosen Okpataku
Department of Psychiatry, Bingham University and Bingham University Teaching Hospital, Jos, Plateau State, Nigeria
|Date of Web Publication||1-Mar-2016|
Christopher Izehinosen Okpataku
Department of Psychiatry, Bingham University and Bingham University Teaching Hospital, Jos, Plateau State
Source of Support: None, Conflict of Interest: None
Background: Psychoactive substance use by vehicle drivers is a global problem. The identification of factors associated with their use among long-distance commercial drivers will provide information valuable to the interventions aimed at the control of this pattern of behavior.
Objective: To determine the sociodemographic factors associated with the use of psychoactive substances among long distance commercial vehicle drivers in Kaduna, a city in Northwest Nigeria.
Materials and Methods: Long distance drivers from selected motor parks in Kaduna metropolis were recruited. They were interviewed using a sociodemographic and a brief drug use questionnaire, two screening instruments which included the Alcohol Use Disorder Identification Test and the Drug Abuse Screening Test.
Results: All 274 subjects were males, with a mean age of 43.4 ± 10.2 years. 94.9% of the subjects were married, 78.5% of them were Muslims, and 67.5% had received a formal education of at least primary school level. Younger drivers were more likely to use cannabis, P < 0.0001, and tobacco P < 0.028, while those who had no spouse used more cannabis. A significant proportion of alcohol users was Christians with formal education, while Muslims were more likely to use cannabis and caffeinated substances. Significant predictors of alcohol use were being a Christian, odds ratio (OR) = 30.6, P < 0.0001 and above 45 years of age, OR = 3.3, P = 0.007, while significant predictors of cannabis use were not having a spouse, OR = 6.6, P = 0.004, and below 45 years of age, OR = 5.5, P = 0.03.
Conclusion: Sociodemographic factors influence substance use among long distance drivers, and these characteristics can be explored as the focus in directing drug use control intervention.
Keywords: Airway, cardiovascular system, chronic fluorosis, endocrine system, skeleton, spinal anaesthesia, teeth
|How to cite this article:|
Okpataku CI. Sociodemographic correlates of substance use among long distance commercial vehicle drivers. J Med Trop 2016;18:6-11
| Introduction|| |
Psychoactive substance use is increasing in most parts of the world, and there is a growing concern about this trend and its consequences., The use of these substances by vehicle drivers is a common finding globally.,,, Substance use impairs the skills necessary for driving and has been implicated for the cause of road traffic accidents which are often fatal leading to injuries and death. Long distance drivers are fatigue-prone and have to be awake while driving over several hours, a major reason for the use of drugs. They are, however, not spared the medical and psychosocial consequences of psychoactive drugs when used over these long periods of driving. Substance use is apparently seen among long distance drivers as a “status symbol” and they appear not to be aware of the consequences. Measures aimed at drug prevention and control in this subgroup of drivers need to appraise the sociodemographic risks associated with this pattern of behavior.
More attention has been drawn in recent years to substance use and driving as a result of road traffic accidents causally related to substance use.,,, However, most of these studies were among routine drivers and private car-owners. In this category of drivers, substance use may be found as a regular pattern of behavior which may occur in and out of the driving periods. Sociodemographic factors such as education and religion were not usually evaluated as the focus was mostly on the relationship between substance use and road traffic accidents. Factors such as age and sex of drivers in relation to substance use in day-to-day routine driving may not be characteristically different from what is found among the general population. In some parts of the developing world, including Nigeria, long distance commercial driving is a major means of transportation. Drivers engage the road for a long period of time and driving often occurs at night time. This subgroup of drivers by virtue of their job are fatigue-prone and require keeping awake, both of which has been attributed as the major reasons for substance use according to these drivers.,
In drug prevention and control among drivers, programs may be designed and implemented to specifically focus on the sociodemographic factors identified to promote or increase the risks for drugged-driving. Age, sex, religion, and education are variables known to influence behavior and may be relevant if true for long distance drivers. Aside a few,, there is a relative dearth of information on the sociodemographic factors associated with substance use among long-distance commercial drivers in Nigeria. To the best knowledge of the authors, those mentioned were the only existing ones with some perspective on sociodemographic factors and after a thorough search of the literature, none was found from other parts of the world. In this study, we determined the sociodemographic factors related to substance use among long-distance commercial drivers in an Urban city in Nigeria, which hopefully provides information for drug use control intervention.
| Materials and Methods|| |
Description of the Study Area
The study was done in Kaduna, a North-Western city of Nigeria and the third most populous state with a population of more than 6 million.
It was carried out among all long distance commercial vehicle drivers who consist mostly of young and middle-aged men of diverse ethnocultural origin with a slight Hausa–Fulani predominance. All licensed drivers who have been driving a minimum distance of 500 km from Kaduna for at least 1 year and were registered members of the National Union of Road Transport Workers (NURTW) Kaduna branch were eligible to participate. The NURTW among other roles regulates the activities of the motor parks and exercises authorities on its members.
It was a cross-sectional descriptive study of the drivers.
Sample Size Calculation
Eligible drivers were identified by their vehicle numbers and a list of them created. The number of drivers to be selected from each motor park was determined by the proportional allocation of a calculated sample size of 270. The total number of drivers was 1153. The sampling interval is 270/1153 = 0.23, 1/0.23 = 4.3.
The sample size required was calculated using the formula for calculating sample size in cross-sectional studies when the population is <10,000.
nf= n/1 + (n/N), where:
nf = Final sample size.
n = The desired sample size when the population is more than 10,000.
n = 1000 (an estimate of population of long distance drivers in Kaduna city as given by the NURTW).
N = Z 2 pq/d 2, where:
Z = The standard normal deviate, set at 1.96 to the 95% confidence level.
p = The proportion of the target population estimated to have a particular characteristic, in this case 0.40. This was based on the prevalence of psychoactive substance use in a similar study.
q = 1-p.
d = Degree of precision desired, set at 0.05.
n = 1.962 × 0.4 × 0.6/0.52 = 369, nf = 369/1.369 = 270.
An estimated minimum sample of 270 was therefore obtained. However, 274 drivers were recruited.
For each of the motor parks the proportionate sample taken was given by x = xp/X × nf. Where, x = sample fraction for the park, xp = total number of drivers the park, X = total population of drivers in all the parks, and nf = sample size. Beginning with the first driver who was to load his vehicle on an interview day at each of the -ten designated motor parks, each consecutive forth driver was interviewed until the sampling fraction for that park was attained. This process was repeated at the various motor parks until the sample size was attained.
Data Collecting Tools
Drivers responded to a sociodemographic questionnaire requesting information such as age, sex, religion, and the highest level of education; a drug use questionnaire and two drug screening instruments: The Alcohol Use Disorder Identification Test  and the Drug Abuse Screening Test.
Ethical clearance was sought and approved for the study by the Health Ethics Research Committee of the Ahmadu Bello University Teaching Hospital Zaria and the Kaduna state ministry of health. In addition, written informed consents were sought from the respondents, and they were assured of confidentiality for participation in the study.
The data obtained were analyzed by means of descriptive statistics including frequencies, percentages, means, standard deviation, and cross tabulation using the Statistical Package for Social Sciences (SPSS for Windows, version 16.0. Chicago, SPSS Inc). Chi-square and t-test were used to test for differences in categorical and numerical variables, respectively. Where conditions for Chi-square analysis were not met, exact test was applied where appropriate. A value of P < 0.05 was taken as statistically significant.
| Results|| |
All the respondents were males. There was no statistically significant difference in the mean age of substance users and nonusers. The current prevalence for the use of at least one psychoactive substance in this study was 76%. Drugs were used in combination including caffeinated substances, kola nuts, nicotine, alcohol, and cannabis. For drug users and nondrug users, no significant association was found between the sociodemographic factors of age, marital status, highest level of education attained, religious affiliation, and the use of psychoactive substance [Table 1]. However, on the basis of the individual psychoactive substances found to be mostly used by the respondents, there were sociodemographic differences in the specific drug of use. A statistically significant association was found between age group and cannabis, as well as tobacco use. No statistically significant difference was found for the other age groups and drug use. For the current conjugal status of the subjects, there was a significant association between cannabis use and conjugal status. A significant proportion of respondents with formal education were found to use alcohol. However, no statistically significant relationship was found between educational status and the use of cannabis, tobacco, kola nut, and other caffeinated substances. Religion had an influence on the substance of choice as a significant proportion of the subjects who used alcohol were Christians, while a significant proportion of Muslims used caffeinated substances Only Muslims reported cannabis use [Table 2].
|Table 1: Sociodemographic distribution of substance and nonsubstance users of the respondents|
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|Table 2: The relationship between sociodemographic factors and the major substances currently used by the respondents|
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For alcohol users, where a significant association was found between educational status and religion, and cannabis users where a significant association was also found between age, conjugal status and religion, and logistic regression analysis shows that significant predictors of alcohol use were being a Christian, odds ratio (OR) = 30.6, P < 0.0001 and above 45 years of age, OR = 3.3, P = 0.007, while significant predictors of cannabis use were not having a spouse, OR = 6.6, P = 0.004, and below 45 years of age, OR = 5.5, P = 0.03 [Table 3].
| Discussion|| |
This study found all long distance drivers to be males. A similar report had been documented by studies done among long distance commercial vehicle drivers in Nigeria., Empirical evidence further shows that long distance commercial driving in Nigeria is essentially dominated by males, partly resulting from economic reasons. Those of the male sex engage in income generating activities such as commercial driving for the benefit of themselves and their families. This is more likely in this part of the country where commercial driving has evolved and is perceived as a male's job. In other parts of the world, females have been found and assessed for drug driving. These were however based on samples drawn from day to day intracity vehicle drivers who are noncommercial and expectedly are part of this pattern of driving globally.,,
The mean age of subject in this study was close to the findings from other studies., Although these studies were not done among long distance drivers, it is a reflection of the age characteristics of commercial vehicle drivers in general. To be licensed to drive, one ought to meet some conditions which include a minimum age of 18 years. He or she needs to gain some experience on driving and acquire the necessary resources such as a suitable vehicle before engaging in commercial driving. This may partly account for why young people in their second decade of life were largely not found among drivers in this study. In addition, drivers in their seventh decade were expected to retire from active commercial driving due to the effects of aging which makes it difficult for the elderly to continue this energy-demanding and competitive job. This leaves drivers who are mostly in their third to fifth decade being the majority of those involved in this pattern of driving.
In this study, subjects between the age ranges of 41–50 years were found to constitute a significantly higher proportion of current users of alcohol, which was similarly documented by other investigators., A significant proportion of younger subjects within the age group of 21–30 years were found to use cannabis and tobacco, and being below 45 years of age a significant predictor of cannabis use. This report is similar to the findings among drivers in some other parts of the world. A study done in France on drugs and driving found younger drivers more likely to be users of cannabis with a mean age of 28 ± 6.1 years while alcohol users had a mean age of 41.1 ± 8.5 years. A Canadian study was done to determine driving under the influence of cannabis also reported the prevalence of driving after using cannabis to be considerably higher in young people with an average age of 28.7 years. Similarly, in an American national survey on drinking and driving, cannabis use was found to be the highest of the drugs detected in younger drivers aged 18–24 years while drivers who used alcohol were mostly in their fourth and fifth decade.
Most of the subjects were married and had no formal or primary education. This finding is similar to studies done in other parts of this country.,,, Commercial driving in Nigeria is done as a means of earning a livelihood, and marriage is often accompanied by increased financial obligation which could partly account for this finding. The use of cannabis had a significant association with the conjugal status as drivers who had no spouse used more cannabis. The single drivers were more likely to have been younger than their married counterparts, and young people have been found globally to use cannabis more. Marriage confers dignity and attracts some respect in the culture of the study population. It is possible that the older drivers most of whom were married refrained from cannabis use due to cultural perceptions of the marital status or because older people are not likely to experiment with such substances compared to younger people. But this is difficult to determine as this study was cross-sectional.
Most of the subjects had received a formal education. This is similar to the findings of another study, and possibly reflects pursuance of an alternative vocation in long distance commercial driving to formal education by these drivers to earn a means of livelihood. A significantly higher proportion of drivers with formal education was using alcohol. Formal education and knowledge of psychoactive substances are related, but what determines whether an educated or uneducated person do not take or take substances, (including the type taken) may be complex. For instance, in the analysis of prospectively gathered data, individuals who had dropped out of high school were 6.34 times more likely to develop alcohol abuse or dependence than were individuals with a college degree.
Islam is the major religion among the indigenous people of our study community. Religious affiliations significantly influenced drug choices in this study. Its effect was more on the use of alcohol, with being a Christian a significant predictor. A similar finding was recorded in Ile-Ife South-Western Nigeria. This is likely the effect of religious permissiveness or prohibition on the use of substances. Islam does not permit the use of alcohol. Various forms of alcohol are abundant in Southern Nigeria, which is indigenous to most Christians who in some cases are introduced to alcohol ingestion at childhood. Alcohol is an important aspect of social events, pleasure, and recreation. On the other hand, cannabis and caffeinated substances were found to be more commonly used by the adherents of Islam. Muslims may use drugs they consider not strictly prohibited by religion or which will not attract criticism by other adherents. These preferences may also be a reflection of the choices for the drug as similarly obtained in the general population. Perhaps it could also be the result of shared ethnic group activity and cultural modeling in which case people use and identify with certain psychoactive substances on the basis of whether or not people of his ethnoreligious background uses same. Empirical evidence point to this possibility as during the study subjects responded with elements of disdain and resentfulness when they were asked whether or not they used drugs such as alcohol or cannabis depending on what ethnoreligious group they belong.
In this study, there was no statistically significant sociodemographic difference in the use of psychoactive substance on the basis of their grouping into substance users and nonusers. However, following analysis for the individual drugs, sociodemographic factors influenced the preference for a drug. This study has indicated that the generalization of a relationship between sociodemographic factors and substance use may not be applicable in the subpopulation of long distance commercial vehicle drivers as there is specific drug whose preferences are partly determined by these factors.
Most studies found on drugs and driving in some parts of the world did not assess religious affiliations of their respondents to allow comparisons on this variable. Some drug abuse prevention programs done among young people to evaluate its influence on their future driving behavior did not consider the impact of their sociodemographic factors., This may understandably be so if these factors were not perceived as relevant in the settings where these studies were done. The influence of sociodemographic parameters may vary from one community to another. It is quite relevant and important in Nigeria. The socio- and bio-demographic differences in drug use can be explored in directing the focus for drug intervention programs. Since some drugs may be more commonly preferred by drivers based on education, religious, or age group, drug prevention program could be designed and tailored to address specific drugs considered to be of choice rather than the nonspecific approach as commonly practiced. Sociodemographic variables are a crucial aspect of the social determinants of drug use and a potential area needing further investigation.
| Conclusion|| |
This study was done among long distance commercial vehicle drivers; a high-risk group for drugged-driving, with an association found between sociodemographic factors and substance use. Preventive measures against drug use by drivers which has been the favored focus aimed at control may consider the role played by sociodemographic factors in the design of the strategies for identifying those at risk and their implementation. In order to curtail this societal menace as it will go a long way in reducing the rate of accidents on our roads.
My sincere gratitude goes to the officials and the entire members of the National Union of Road Transport Workers, Kaduna chapter for their cooperation and assistance during the period of data collection.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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[Table 1], [Table 2], [Table 3]
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