{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T05:48:24Z","timestamp":1792820904950,"version":"4.5.0"},"reference-count":48,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,3,29]],"date-time":"2026-03-29T00:00:00Z","timestamp":1774742400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,3,29]],"date-time":"2026-03-29T00:00:00Z","timestamp":1774742400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100017974","name":"Child Mind Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100017974","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Drug and Alcohol Review"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Substance use among young people is a growing public health concern in South Africa (SA), with implications for short\u2010 and long\u2010term mental health, education and development. A lack of use data is among several challenges impeding progress to support young people. To address this gap, this study aimed to synthesise published prevalence data on substance use among adolescents under 19\u2009years of age in SA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a systematic review and meta\u2010analysis following PRISMA guidelines. Searches were run across PubMed, PsycINFO, Web of Science and Scielo. Studies reporting original SA prevalence data in community or school\u2010based samples were included. The Joanna Briggs Institute checklist for prevalence studies was used to assess study quality. Meta\u2010analyses were performed in R, using random effects models and heterogeneity was assessed using\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      statistics and meta\u2010regression.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thirty publications met inclusion criteria, and these reported 202 prevalence estimates (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009120,041, mean age 16.1\u2009years). The most commonly reported substances used were alcohol (35.09%, 95% CI 23.83\u201348.30), tobacco (25.47%, 95% CI 14.56\u201333.01) and cannabis (10.47%, 95% CI 5.98\u201317.71) with lifetime prevalence of any substance use of 13.05%, 95% CI 9.65\u201317.42. Similarly, 12\u2010month data indicated high exposure levels: alcohol 17.45% (95% CI 11.39\u201325.78), tobacco 11.57% (95% CI 8.92\u201314.88) and cannabis 6.66% (95% CI 4.82\u20139.13). However, substantial heterogeneity across studies was detected.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion and Conclusions<\/jats:title>\n                    <jats:p>High exposure to substances in SA, especially alcohol, tobacco and cannabis, underscores the urgent need for nationally representative surveillance and evidence\u2010based prevention efforts tailored to adolescents, to avoid progression of substance use into substance use disorder.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dar.70143","type":"journal-article","created":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T04:32:32Z","timestamp":1774845152000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Systematic Review and Meta\u2010Analysis of the Prevalence of Substance Use Among Adolescents in South Africa"],"prefix":"10.1111","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9489-8717","authenticated-orcid":false,"given":"Carrie","family":"Brooke\u2010Sumner","sequence":"first","affiliation":[{"name":"Mental Health, Alcohol, Substance Use and Tobacco Research Unit South African Medical Research Council  Cape Town and Pretoria South Africa"},{"name":"School of Nursing and Public Health (Public Health Medicine), Faculty of Health Sciences University of KwaZulu\u2010Natal  Durban South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauro Estivalete","family":"Marchionatti","sequence":"additional","affiliation":[{"name":"Child Mind Institute  New York New York USA"},{"name":"Stavros Niarchos Foundation Global Center for Child and Adolescent Mental Health at the Child Mind Institute  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zeina","family":"Mneimneh","sequence":"additional","affiliation":[{"name":"Child Mind Institute  New York New York USA"},{"name":"Stavros Niarchos Foundation Global Center for Child and Adolescent Mental Health at the Child Mind Institute  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadine","family":"Harker","sequence":"additional","affiliation":[{"name":"Mental Health, Alcohol, Substance Use and Tobacco Research Unit South African Medical Research Council  Cape Town and Pretoria South Africa"},{"name":"School of Public Health University of Cape Town  Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine O.","family":"Egbe","sequence":"additional","affiliation":[{"name":"Mental Health, Alcohol, Substance Use and Tobacco Research Unit South African Medical Research Council  Cape Town and Pretoria South Africa"},{"name":"School of Nursing and Public Health (Public Health Medicine), Faculty of Health Sciences University of KwaZulu\u2010Natal  Durban South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Jenkins","sequence":"additional","affiliation":[{"name":"Faculty of Philosophy University of Fribourg  Fribourg Switzerland"},{"name":"Faculty of Medicine and Health Sciences Stellenbosch University  Stellenbosch South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noluthando","family":"Mpisane","sequence":"additional","affiliation":[{"name":"Mental Health, Alcohol, Substance Use and Tobacco Research Unit South African Medical Research Council  Cape Town and Pretoria South Africa"},{"name":"Institute for Life Course Research Stellenbosch University  Stellenbosch South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meghan","family":"Mosalisa","sequence":"additional","affiliation":[{"name":"Mental Health, Alcohol, Substance Use 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