Substance use and associated psychosocial factors among street-connected children in Dhaka, Bangladesh: a cross-sectional study

Abstract

Substance abuse among street-connected children is a major public health concern worldwide, including in Bangladesh. Despite their heightened vulnerability, this population remains underrepresented in health research, and evidence regarding their substance use behaviours and associated psychosocial factors is limited. Therefore, this study aimed to assess the pattern of substance use and associated psychosocial factors among street-connected children in Dhaka, Bangladesh. This cross-sectional study included 100 street-connected children aged 10–18 years recruited from five major locations in Dhaka, the capital city of Bangladesh. Data were collected between January and December 2022 through face-to-face interviews using a pretested semi-structured questionnaire. The questionnaire covered socio-demographic characteristics, educational background, family circumstances, occupational activities, living conditions, street-life experiences, psychosocial vulnerabilities, substance use behaviours, and self-reported health problems. Substance use was assessed using the World Health Organization Alcohol, Smoking and Substance Involvement Screening Test (WHO-ASSIST Version 3.0). Following data collection, data were cleaned and analysed using SPSS version 24. Descriptive and inferential statistics were applied, and findings were presented using tables and figures. The mean age of the participants was 13.4 ± 2.34 (SD) years, and 75.0% were male. Nearly half of the children were illiterate (46.0%), while 53.0% had completed primary education. Slightly more than half (52.0%) were not living with their families. The overall prevalence of substance use was 73.0%. Among substance users, tobacco products were the most commonly used substances (94.5%), followed by cannabis (63.0%) and inhalants (58.9%). Sedatives (27.4%), alcohol (19.2%), amphetamine-type stimulants (16.4%), and opioids (4.1%) were less frequently reported. Polysubstance use was common, with 75.3% reporting the use of two or more substances. Peer pressure (83.6%), hunger (25.0%), and easy availability of substances (13.7%) were the leading reasons for substance use. Skin infections (65.8%), common cold/cough (41.1%), stomach ache (37.0%), and headache (28.8%) were the most commonly reported physical health problems. Experiences of abuse (86.3%), police harassment (61.6%), suicidal thoughts (20.5%), and sexual harassment (9.6%) were frequently reported. Older age (p=0.008), male gender (p<0.001), not living with family (p=0.002), and poor family relationships (p=0.033) were significantly associated with substance use. Approximately two-thirds of street-connected children were involved in substance use, with tobacco, cannabis, and inhalants being the most commonly used substances. Peer influence, psychosocial distress, and family-related vulnerabilities were important contributors to substance use behaviour. Comprehensive prevention, rehabilitation, mental health, and social support programmes are urgently needed to address the needs of this highly vulnerable population.

Bang J Psychiatry 2026;40(1): 1-9