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Cross-sectional study on influence of the family environment on the lifetime non-medical use of prescription drugs among Chinese adolescents in Guangdong: an analysis of sex differences
  1. Wanxin Wang1,
  2. Min Luo1,
  3. Chuhao Xi1,
  4. Yiling Lei1,
  5. Siyuan Pan1,
  6. Xue Gao2,
  7. Yan Xu2,
  8. Guoliang Huang2,
  9. Xueqing Deng1,
  10. Lan Guo1,
  11. CiYong Lu1
  1. 1 Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
  2. 2 Department of Drug Abuse Control, Center for ADR Monitoring of Guangdong, Guangzhou, China
  1. Correspondence to Dr. Lan Guo; guolan3{at} and Dr CiYong Lu; luciyong{at}


Objectives This study aimed to assess if adolescents had used any prescription drugs non-medically, to explore the associations between the family environment and non-medical use of prescription drugs (NMUPD) and to investigate whether there are any sex differences in the aforementioned associations.

Design A population-based cross-sectional study.

Setting A secondary analysis of the cross-sectional data collected from high school students in Guangdong who were sampled using a multistage, stratified-cluster, random-sampling method in the 2015 School-based Chinese Adolescents Health Survey.

Participants A total of 21 774 students aged 12–20 years.

Data analysis Multilevel logistic regression models were used to explore the univariable and multivariable relationship between family environment and NMUPD among adolescents. Adjusted ORs and corresponding 95% CI were calculated.

Outcome measures Questions regarding to adolescent’ NMUPD (including sedative, opioid and stimulant) were surveyed in the study.

Results A total of 6.3% students reported lifetime NMUPD in this study. The most commonly used drugs were opioids (3.9%), followed by sedatives (3.2%) and stimulants (2.5%). Multilevel analyses indicated that living arrangements, family economic status, parental relationships, parental education levels, monthly pocket money, parental drinking and drug problems were significantly correlated to the NMUPD among all students. Among boys, living arrangements, family economic status, maternal education levels, monthly pocket money, parental drinking and drug problems were significantly related to different types of NMUPD. The same factors were related to girls’ NMUPD, except for maternal education levels. Parental relationships and paternal education levels were also associated with girls’ NMUPD.

Conclusion The family environment exerts an important influence on adolescents’ NMUPD. Interventions targeted at families are highly recommended considering the negative effects of NMUPD. In addition, the child’s sex might be taken into consideration when developing and implementing preventive strategies.

  • non-medical use
  • prescription drug
  • family environment
  • Chinese adolescent

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  • WW and ML contributed equally.

  • Contributors WW and ML participated in its design and coordination, performed the statistical analysis and drafted the manuscript. CX and YL participated in the design and interpretation of the data. SP participated in the design and coordination of the study and performed the measurement. XG, YX, GH and XD participated in data collection. LG and CL conceived of the study and participated in its design and coordination and helped to draft the manuscript. All authors read and approved the final manuscript.

  • Funding This study was supported by Centre for ADR monitoring of Guangdong (Grant number: GZSW11175FT4055).

  • Competing interests None declared.

  • Ethics approval The study received approval from the Sun Yat-sen University, School of Public Health Institutional Review Board. The research ethics number of approval is L2014076.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Data will be transferred if requested.

  • Patient consent for publication Obtained.

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