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“Alcohol will never run out”: Socio-ecological drivers of adolescent boys’ alcohol use in Kilimanjaro Region, Tanzania

Seekles, Maaike ORCID: https://orcid.org/0000-0002-7000-3624, Mwita, Winfrida, Andongolile, Alice, Kihange, Abdulrahaman, Owen, Gilbert, Hudda, Aliza, Mmbaga, Blandina T. and Obasi, Angela ORCID: https://orcid.org/0000-0001-6801-8889 (2024) '“Alcohol will never run out”: Socio-ecological drivers of adolescent boys’ alcohol use in Kilimanjaro Region, Tanzania'. PLOS Global Public Health, Vol 4, Issue 6, e0002443.

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Abstract

Heavy alcohol use amongst adolescent boys is a major public health concern in many countries. It is associated with a range of negative physical and mental health outcomes and predicts alcohol-related problems in adulthood. In Kilimanjaro Region, adolescent boys’ alcohol use is widespread, and higher than other regions in Tanzania. An understanding of causal and contextual factors that influence the use of alcohol is needed to inform the development and implementation of effective alcohol prevention interventions. This study aimed to explore these socio-ecological factors in-depth amongst adolescent boys, young men and key stakeholders in Kilimanjaro Region, Tanzania. Between August 2022 and June 2023, multi-method, participatory, qualitative methods including: ethnographic observations (8 weeks), 37 in-depth interviews, 14 focus group discussions and participatory adolescent activities were used to elicit perceptions on factors driving adolescent boys’ alcohol use in two (rural/urban) settings. Data were triangulated and deductively analysed, guided by Bronfenbrenner’s socio-ecological framework. This study found many dynamic and inter-related factors linked to alcohol use within adolescents’ social, cultural, economic, regulatory, and physical environments. In a context of widespread availability of alcohol, low enforcement of alcohol regulation and (mis)conceptions around the benefits of alcohol use (e.g. curative and/or nutritional properties), parental and cultural influences largely determined the initiation of use in childhood and younger adolescence; employment status, peers, lack of alternative recreational activity and social norms around independence appeared to drive continued and increased use in older adolescence. Factors and their impact varied between rural and urban settings. In conclusion, a wide range of determinants and drivers of alcohol use among ABYM work at multiple socio-ecological levels especially parental, cultural and socioeconomic factors. This suggests that effective prevention requires a systems approach intervening across these levels. For example, incorporating education/awareness raising, increased law enforcement, parent-child communication and problem-solving, and income generation activities.

Item Type: Article
Subjects: WA Public Health > WA 30 Socioeconomic factors in public health (General)
WS Pediatrics > WS 20 Research (General)
WS Pediatrics > By Age Groups > WS 460 Adolescence (General)
Faculty: Department: Clinical Sciences & International Health > International Public Health Department
Digital Object Identifer (DOI): https://doi.org/10.1371/journal.pgph.0002443
SWORD Depositor: JISC Pubrouter
Depositing User: JISC Pubrouter
Date Deposited: 20 Jun 2024 09:36
Last Modified: 20 Jun 2024 09:36
URI: https://archive.lstmed.ac.uk/id/eprint/24735

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