1. INTRODUCTION:

Drug abuse is a social problem, not in India alone, but the entire world. Drinking, smoking, and drug use by adolescents affect general health, physical growth, emotional development, and school performance.¹ Cannabis, heroin, and Indian-produced drugs are the most frequently abused drugs in India. There are many problems associated with drug abuse, such as drug tolerance, dependence and addiction.²

The problem of consumption of illicit psychoactive substances by students in higher education is not new, since it is in this age group that the highest prevalence of consumption of these substances continues to occur³. Substances abuse is dangerous not only for health but also in the view of economic and social values. The habit of substance abuse becomes the cause of purposeless waste of money and affects health⁵.

Adolescents between the ages of 12 and 17 demonstrate alcohol use disorders (AUDs) and drug use disorders (DUDs) in fairly similar past–year prevalence rates, and the overall prevalence of these disorders has decreased slightly since 2002, from approximately 6% to approximately 3%. Adolescents and young adults 18-25 demonstrate much higher rates of alcohol use disorders (AUDs) than drug use disorders (DUDs). However, the rate of alcohol use disorders prevalence has decreased since 2002, from approximately 18% to just over 12%. Drug use disorders remained somewhat consistent, hovering between 6% and 8%.⁴

These are the most commonly seen substance (drug) abuse products: alcohol, heroin, cocaine, tobacco (cigarette smoking) like; cigars, Zarda, and gutkha.⁶ The causes for this bad habit of drugs are poor parental role, peer group influence, low socioeconomic status, and media through advertisements of the products.⁷ The commonly seen effects of substance abuse are physical (poor self-care, body organ damage, respiratory distress, and loss of weight), mental (poor cognitive, memory loss, poor judgment, depression, stress, and brain damage), and social problems (poor quality of life, self-withdrawal from family and friends).⁸

Tobacco use is a major preventable cause of death in many parts of the world today (WHO, 2004) most regular smokers initiate the smoking habit in their adolescent period of life. The National Household Survey of Drugs and alcohol abuse in India (2002) reported that 55.8% of tobacco users belonged to the age group of 12-18. It was observed that the prevalence of tobacco use increased as the age advanced and more than 50% of smokers began to smoke during their adolescent period. This finding is supported by the global growth tobacco survey fact sheet which showed that 25% of students of 13-14 years experienced one or other form of tobacco.⁹

A non-experimental study was conducted to assess the knowledge regarding substance abuse among adolescents from selected PUC Colleges in Belgaum City, Karnataka. Samples were selected using a purposive, snowball sampling technique. Samples of 50 adolescent students 23 females and 27 males were selected. A self-administered questionnaire was used for data collection developed by the investigator which comprised of two parts. Part-I Semi a structured questionnaire on demographic data, and Part -II self-reporting knowledge questionnaire on substance abuse among adolescents. The findings revealed that the majority (50%) of adolescents had a moderate level of knowledge of substance abuse 30% had an inadequate level of knowledge and 20% had an adequate level of knowledge of substance abuse. The mean score was 11.48. There was a significant association between the level of knowledge and gender (sex) on substance (drug) among the adolescents in the selected PUC colleges in Belgaum City. Based on the findings, the investigator concluded that the professionals will have mild levels of stress and selected health problems.¹⁰

2. NEED FOR THE STUDY:

Substance abuse has become a global phenomenon. It has affected almost every country, although its extent and characteristics differ from region to region. The problems of drug abuse are localized especially in the urban, semi-urban, and along the border areas of India. The period of adolescence is vulnerable in the life of an individual. The increased vulnerability in this period is related to psychological factors like curiosity, poor impulse control, running away from reality, psychological distress, and so forth. Social factors like peer influence, lack of clear identity, and self or intra-familial conflict also expose the adolescent to substance abuse.¹¹

The use of tobacco, alcohol, and other substances is a worldwide problem that affects many children and adolescents. Early initiation of substance abuse is usually associated with a poor prognosis and a lifelong pattern of irresponsible behavior.¹² The hope that simple information given through educational programs will be sufficient to prevent drug dependence is frequently expressed, however, there is no evidence to support it. Knowledge with regards to the consequences of substance use among adolescents will be helpful to prevent them from initiating and continuing its use. Therefore, keeping in focus, the research question- the present study aims to find what is the level of knowledge regarding substance abuse among adolescents.¹³Some teens face personal challenges that compound their risk of substance use and addiction. These include a genetic predisposition toward developing an addiction or a family history of substance use disorders, adverse childhood events, such as abuse, neglect, or other trauma, co-occurring mental health problems, peer victimization, or bullying.¹⁴

A cross-sectional study was conducted to assess the knowledge and demographic factors associated with drug abuse among male pharmacy and nursing students at King Saud University, Riyadh, Saudi Arabia. This study used a design targeting male entry-level pharmacy and nursing students in their first and second years of Bachelor of Nursing and Doctor of Pharmacy courses. Of them, 85.3% of the pharmacy and% of nursing students thought that cocaine causes drug addiction, followed by heroin (pharmacy 80.7%; nursing students 71%), and morphine (pharmacy 75.2%; nursing students 59.1%). In this study, 52% (n = 105) claimed low awareness, whereas 48% (n = 97) indicated good understanding regarding drug addictions. Furthermore, the mean knowledge score among pharmacy students was higher (7.073±2.570) in comparison to nursing (5.806±2.494) (t = 3.540; p = 0. 0001). In addition, the father’s occupation was found to be significantly associated with the mean knowledge score of drug addiction (F = 2.667; p = 0.034). According to the findings, 52% of male students had insufficient knowledge about drugs that cause addiction. Age, course of study, and father's occupation all had a substantial impact on knowledge scores. The knowledge score on the complications of addictive substances was not significantly associated with the characteristics of the students (p = 0.05). As a result, we advocate for the introduction of educational initiatives that educate students about the harmful consequences of drug addiction and how to avoid issues.¹⁵

3. CONCEPTUAL FRAMEWORK:

The concepts are taken from the general system model by Ludwig Von Bertalanffy. A conceptual framework is a theoretical approach to the study of problems that are scientifically based, which emphasizes the selection, arrangement, and Objectives 12 classification of its concepts. The conceptual framework states the functional relationship between events and is not limited to statistical relationship.¹⁶

Figure 1: Conceptual Framework of Open System Theory By Bertalanffy And J.W Kenny

A pre-experimental study was conducted to determine the effectiveness of a structured teaching program on knowledge regarding substance abuse in terms of gain in knowledge score among adolescents in government schools, in Aherwan, Fatehabad (Haryana). A pre-experimental one-group pre-test post-test research approach was used to conduct this research study. A sample of 100 adolescents as subjects was selected from a government school, in Aherwan, Fatehabad (Haryana). Using a Simple random Sampling technique. The Study articulated that the overall post-test mean with SD (13.05±3.43) was higher than the pre-test mean with SD (9.67±2.98) with a mean difference of 3.38. ‘t’ value was computed to find the level of significance between the means and it was observed highly significant (‘t’99=13.55) at p<0.05. The study concludes that the planned teaching program was effective in increasing the knowledge among regarding substance abuse adolescents in government schools, in Aherwan, Fatehabad (Haryana).¹⁷

A study to assess the effectiveness of structured teaching program on knowledge regarding substance abuse among adolescents in selected nursing schools, Bangalore. An evaluative approach and quasi-experimental design that is one group pre-test and post-test design. A total number of 60 adolescents were selected by non-probability convenience sampling technique. A structured knowledge questionnaire was used to assess the knowledge in the pre-test which was followed by the implementation of the structured teaching programme. The post-test was conducted after 7 days using the same structured knowledge questionnaire to find out the effectiveness of STP. The results were described by using descriptive and inferential statistics. The result showed that the average pre-test score of 9.16±2.54 but after administration of STP, the result showed the average post-test score of 21.11±3.41. STP was found to be effective in improving the knowledge of nursing students regarding substance abuse with a paired t value of 48.79 which is above the table value of 2.6 at P=0.05 level of significance. Thus, the study concluded that STP was significantly effective in improving the knowledge of adolescents regarding substance abuse and ways to prevent it which in turn contributes to improving their lifestyle, well-being, education, and good citizens. ¹⁸

4. MATERIALS AND METHODS:

Pre-experimental group Pre-test Post-test design with a quantitative approach was used to assess the effectiveness of the planned teaching program on knowledge regarding drug abuse among the nursing students of selected colleges of the Udupi district. Purposive sampling technique was used to collect the data. Data was collected from 20/05/2024 to 27/05/2024 after obtaining permission from the principal, vidya college of nursing, Kapu, Udupi district.

Inclusion criteria for the study:

1) Nursing students who are willing to participate the study and who are present on the day.

2) Both male and female students. Participants were excluded if.

1) Nursing students who are physically ill

2) Students other than second year BSc. Nursing.

The self-administered questionnaire tool was made which consists of two parts, section-A consists of selected socio-demographic variables such as age in years, gender, religion, type of family, family income, educational qualification of mother and father, previous information, and source of information. This section consists of 9 items consists of a structured knowledge questionnaire on drug abuse. Section: B, This section consists of 26 items on introduction, definition, different forms of drug abuse, factors contributing to drug abuse, types of drug abuse, consequences of drug abuse, management of drug abuse, nursing management of drug abuse, and prevention and intervention strategies of drug abuse. Each item had only one correct response was scored one. The total possible score of the structured knowledge questionnaire was 26. The same questionnaire was used for the assessment of pre and post-tests.

The prepared tool along with objectives, blueprint, and criteria checklist was submitted to five experts comprised of nurse educators in Mental Health Nursing, psychologists, social workers, Psychiatrists, and statisticians for establishing the content validity. The experts were requested to judge the items for relevance, clarity, and appropriateness of the content area. The final tool is tested for reliability. The structured self-administered questionnaire was administered to 10, nursing students studying in Udupi College of Nursing, Manipal. The reliability of the tool was found by testing stability using the test-retest method and internal consistency was assessed by using the split-half technique. The internal consistency of the tool is assessed by split half method and is found to be 0.84. It indicates that the tool is reliable.

5. STATISTICAL ANALYSIS:

Paired t test was used to analyse the significant difference within the group and chi-square was used to find out association between knowledge with the demographic variables.

6. RESULT:

A total of 50 nursing students were participated in the study.

Table 1: Demographic characteristics of study participants

Sl. No	Variables	Categories	f	%
1.	Age in years	a. 18-25 years	43	86%
1.	Age in years	b. 26-32 years	07	14%
2.	Gender	a) Male	09	18%
2.	Gender	b) Female	41	82%
3.	Religion	a. Hindu	31	62%
		b. Christian	14	28%
		c. Muslim	05	10%
4.	Type of family	· Nuclear	39	78%
		· Joint	09	18%
		· Extended	02	4%
5.	Family income per month	a. Less than Rs.10000/-	08	16%
		b. Rs.10001 to Rs.25000/-	22	44%
		c. Rs.25,001 to Rs. 40000	09	18%
		d. More than RS. 40001 and more	11	22%
6.	Mother’s educational status	a. No formal education	07	14%
		b. Primary education (up to 4^th std)	08	16%
		c. Secondary education (5^th to 10^th)	13	26%
		d. PUC (11^th to 12^th)	05	10%
		e. Diploma	13	26%
		f. Graduation and above	04	08%
7.	Father’s educational status	a. No formal education	05	10%
		b. Primary education (up to 4^th std)	09	18%
		c. Secondary education (5^th to 10^th	13	26%
		e. PUC (11^th to 12^th)	08	16%
		f. Diploma	11	22%
		g. Graduation and above	04	8%
8.	Previous knowledge	a. Yes	19	38%
8.	Previous knowledge	b. No	31	62%
9.	Source of information	a. Teachers	00	0%%
		b. Family members	02	4%
		c. Peer group	05	10%
		d. Mass media	07	14%
		e. Health care provider	05	10%
		f. None	31	62%
Total			50	100%

The table 1 shows Age the majority of subjects 43(86 %) belong to the age group of 18-25 years and 7 (14 %) are 26-32 years. Gender: Regarding gender, the majority of subjects 41(82%) were females and 9(18%) were males. Majority 31(62%) of the samples were Hindu, 14(28%) were Christian, and the remaining 5(10%) were Muslim. Most of the 39(78%) were residing in nuclear family, 9 (18%) were residing in joint family, and 2 (4%) were residing in extended family. In the distribution of family income, 22(44%) had Rs. 10,001-25,000/- monthly income, 11(22%) more than. 40,001/- rupees, 9 (18%) had Rs. 25,001 to 40,000/- and 8(16%) had less than 10,000/- rupees. Majority of the 13(26%) had secondary education and diploma, 8(16%) had primary education, 7 (14%) had no formal education, 5(10%) had PUC and 4 (8%) had graduation and above. Father’s educational status showed that majority of them 13(26%) had secondary education, 11(22%) had diploma, 9 (18%) had primary education, 8(16%) had PUC, 5(10%) had no formal education and 4(8%) had graduation and above. Most of them 31(62%) did not have information and 19 (38%) had information about drug abuse. A good number of them 31(62%) did have any information about drug abuse, 7(14%) got it through mass media, 5(10%) got it through peer groups and health care providers, and 2(4%) through family members.

Table 2: Distribution of knowledge scores regarding Drug Abuse

Sl. No	Area	Max score	Mean		Mean percentage
Sl. No	Area	Max score	Pre	Post	Pre	Post
1	Meaning and Definition	03	1.06	2.92	35%	97%
2	Forms and Types	06	2.12	5.44	35%	91%
3	Consequences	08	3.6	6.62	45%	83%
4	Management	05	1.4	4.82	28%	96%
5	Prevention	04	1.2	3.2	30%	80%
Total		26	9.38	23	35%	90%

Table 2 shows an area-wise analysis of the pretest and post-test knowledge of nursing students regarding drug abuse. It shows that the overall pretest knowledge mean was 9.38 with a mean percentage of 35% and the post-test knowledge mean was 23 with a percentage of 90%.

Table 3: Comparison of pre and posttest knowledge score

Knowledge

assessment

Mean

Difference

of mean

Paired ‘t’ value

p-value

Pre-test

9.38

13.62

4.37

23.41

P<0.05

Post-test

2.91

The data in Table 4 illustrates that the mean post-test knowledge score 23, is higher than the mean pre-test knowledge score 9.38. The computed value 23.41 (p< 0.05) showed that there is a highly significant difference between the pre- test and post- test mean knowledge scores of 13.62.

Table 4: Distribution of the samples on the association between knowledge score and demographic variables

S.N	Demographic variables	Chi- square Value	df	P - value	Significance
1.	Age	0.0013	1	0.971	NS
2.	Gender	2.1126	1	0.146	NS
3.	Religion	1.0619	1	0.588	NS
4.	Type of family	0.5182	1	0.5182	NS
5.	Family income	0.202	1	0.977	NS
6.	Mother’s educational status	3.267	1	0.514	NS
7.	Father’s educational status	2.123	1	0.937	NS
8.	Previous knowledge	0.219	1	0.639	NS
9.	Source of information	1.123	1	0.890	NS

*NS- Not significant

Chi-square test was used to analyse association between knowledge with the demographic variables. Table 4 shows the association of the pretest level of knowledge score with selected demographic variables. The variables such as age, gender, religion, type of family, family income, mother’s educational status, father's educational status, previous information, and source of information at 0.05 level of significance do not show any significant association

7. DISCUSSION:

The study aimed to assess the effectiveness of planned teaching programme on knowledge regarding drug abuse among the nursing students of selected colleges of Udupi district.

Area-wise analysis of pretest and posttest knowledge of drug abuse among the nursing students of selected colleges of Udupi district. It shows that the overall pretest knowledge mean was 9.38 with a mean percentage of 35% and the posttest knowledge mean was 23 with a mean percentage of 90%.

The above findings of the first object were supported by A population-based crosssectional study conducted to assess the knowledge regarding harm of use and to obtain information about attitudes among high school students, in West Bengal, India, among 416 students, in classes VIII, IX, and X, with no interventions. Among the 416 students surveyed, 52(12.5%) used or abused substances at least once in their lifetime regardless of frequency; 26(15.1%) were urban students while 26 (10.7%) were from rural areas. Over 73% of participants stated they wanted to stop using substances, with 57.69% having made attempts to do so. The most common reasons for continuing substance use were 'easily accessible' and 'relief from stress.' Students' awareness of the dangers of substance use was significantly higher in urban areas at 84.6% compared to 61.5% in rural areas, with the majority attributing their knowledge to the media. Users were able to convince their peers to adopt this habit, with urban areas at 15.4% and rural areas at 26.9%. Despite knowing the negative consequences of substance abuse, teenagers still choose to engage in this behavior. The research determines that it is necessary to implement successful strategies to promote the development of self-assurance and competence in school children, as well as to deter risky behavior in adolescents.¹⁹

The mean post-test knowledge score 23, is higher than the mean pre-test knowledge score of 9.38. The computed value 23.41(p <0.05) showed that there is a highly significant difference between the pre-test and post-test mean knowledge scores of 13.62. Hence, hypothesis H1 is accepted. This indicates that the planned teaching program is effective in increasing the knowledge scores on drug abuse.

The above findings of the first object were supported by a A pre-experimental study with one group pre-test and post-test design was conducted to assess the effectiveness of a structured teaching program regarding substance abuse and its prevention among late adolescence non-medical undergraduate students at selected colleges of Surat. The study was conducted at the Industrial Training Institute, Majura Gate, Surat. The sample of 60 ITI students was selected through a nonprobability convenient sampling technique. A structured knowledge questionnaire was prepared to assess the knowledge of the sample. Content validity of the developed tools and structured teaching program was established by 5 experts and necessary modifications were made as suggested by them. The reliability of the tool was ascertained by Karl Pearson’s coefficient correlation method. The mean pre-test score was 9.95 and the mean post-test knowledge score was 17.13. The significance of the difference between the pre-test and post-test was statistically tested using a paired ‘t’ test and it was found significant at 0.05 level. There was a significant increase in the knowledge of the sample after administration of the structured teaching program regarding substance abuse and its prevention among late adolescent non-medical undergraduate students. Hence it is concluded that a structured teaching program was effective in improving the knowledge of the students.²⁰

The chi-square value of a variable such as age, gender, religion, type of family, family income, mother’s educational status, previous information, and source of information at 0.05 level of significance does not show any significant association.

A descriptive study was conducted to assess the knowledge of drug abuse among nursing students at a selected college. The research design adopted for this study was descriptive. 50 nursing students of III Year BSc Nursing Basic who fulfilled the inclusion criteria were selected as a sample through a nonprobability convenience sampling method. The study revealed that 5 (16%) had inadequate knowledge, 14(47%) had moderate knowledge and 11(37%) had adequate knowledge of drug abuse. It was found that the mean knowledge score was 12.3 with a standard deviation of 3.25. There was no significant association between knowledge score and demographic variables. The study concluded that the majority of students had moderate knowledge of drug abuse and its effects.²¹

7.1 Implication of the study:

The study findings will help to create awareness and improve the knowledge regarding drug abuse among the nursing students, regarding the benefits of 'administration of PTP. Nurse administrators should plan to conduct programmes about PTP regarding drug abuse among the nursing students.

7.2 Limitations of the study:

1. The study is done only on 50, nursing students. Hence generalization is possible only for the selected participants.

2. The study was confined to nursing students studying in only one nursing college in Udupi district.

3. Only knowledge was considered in the present study.

4. The study was conducted in one area, which restricts the generalization.

7.4 Recommendation for future study:

· Similar study may be conducted on a larger sample spread over a community in different areas.

· A comparative study can be conducted among two different geographical locations of the district in urban and rural areas.

8. CONCLUSION:

The implementation of the planned teaching program on drug abuse among college students proved to be both timely and impactful. Through interactive sessions, real-life case discussions, and evidence-based content, students gained a deeper understanding of the physical, psychological, and social consequences of drug use. The initiative not only provided knowledge but also helped in reshaping attitudes and encouraging informed decision-making.

Post-program evaluations revealed significant improvement in students' awareness of various substances, risk factors, and available support systems. Many participants expressed that the sessions challenged their previous perceptions and motivated them to adopt healthier coping strategies. The inclusion of peer discussions and anonymous feedback mechanisms fostered a safe and open learning environment, making the subject matter more relatable and meaningful.

A noticeable shift was observed in the willingness of students to engage in preventive behaviors and seek help when needed. This behavioral change, supported by increased knowledge and enhanced self-efficacy, stands as a testament to the program’s success. Furthermore, the program opened avenues for dialogue among students, teachers, and counselors, laying the foundation for a more supportive academic environment.

In conclusion, the teaching program served not just as an educational tool but as a catalyst for change. It emphasized the importance of early intervention, community awareness, and the role of education in combating drug abuse. Future efforts should focus on sustaining these gains through follow-up sessions and expanding the program’s reach, ensuring that more young adults are equipped to lead drug-free, informed lives.

9. ETHICAL APPROVAL:

The study was approved by the institutional ethics committee (UGI/ IEC. 286/2023).

10. ACKNOWLEDGEMENT:

We acknowledge the institutions who gave permission to conduct the research and all the participants who participated in this study.

11. CONFLICT OF INTEREST:

The authors declare no conflict of interest.

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Received on 24.06.2025 Revised on 14.07.2025

Accepted on 30.07.2025 Published on 14.08.2025

Available online from August 23, 2025

Int. J. of Advances in Nursing Management. 2025;13(3):158-164.

DOI: 10.52711/2454-2652.2025.00031

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