Cannabis use in Sub-Saharan Africa: a systematic review and meta-analysis


Background and aims:

The most available data on the prevalence of cannabis use come from population surveys conducted in high-income countries in North America, Oceania, and Europe. Less is known about the prevalence of cannabis use in Africa. This systematic review aimed to summarize general population-level cannabis use in Sub-Saharan Africa since 2010.


Methods:

A comprehensive search was done in PubMed, EMBASE, PsycINFO, and AJOL databases in addition to Global Health Data Exchange and grey literature without language restriction. Search terms related to “substance”, “Substance-Related Disorders” and “Prevalence” and “Africa South of the Sahara” were used. Studies that reported cannabis use in the general population were selected while studies from clinical populations and high-risk groups were excluded. Prevalence data on cannabis use in the general population of adolescents (10-17 years) and adults (≥18 years) in Sub-Saharan Africa were extracted.


Results:

The study included 53 studies for the quantitative meta-analysis and included 13,239 participants. Among adolescents, the lifetime, 12 months, and 6 months prevalence of cannabis use were 7.9% (95% confidence interval [CI] CI 5.4-10.9%), 5.2% (95% CI 1.7-10.3%), and 4.5% (95% CI 3.3-5.8%), respectively. The corresponding lifetime, 12 months, and 6 months prevalence of cannabis use among adults were 12.6% (95% CI 6.1-21.2%), 2.2% (95% CI 1.7-2.7% with data only available from Tanzania and Uganda, and 4.7% (95% CI 3.3-6.4%), respectively. The male-to-female lifetime cannabis use relative risk was 1.90 (95% CI 1.25-2.98) among adolescents and 1.67 (0.63-4.39) among adults.


Conclusions:

Lifetime cannabis use prevalence in Sub-Saharan Africa appears to be about 12% for adults and just under 8% for adolescents.


Keywords:

Adolescent; Adult; Cannabis; Population; Prevalence; Relative risk; Sub-Saharan Africa.

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