{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T07:59:05Z","timestamp":1790323145950,"version":"4.1.0"},"reference-count":28,"publisher":"AOSIS","license":[{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Background: Substance abuse in nursing raises ethical and legal concerns, with 10% \u2013 20% of students affected. Research indicates these behaviours often continue into professional practice and need to be addressed.\nAim: To explore and describe the perceptions of nurse educators and student nurses regarding substance abuse and to make recommendations to address substance abuse at a public nursing college in the Eastern Cape.\nSetting: A public nursing college education institution, comprising five main campuses and 18 sub-campuses in the Eastern Cape.\nMethods: A qualitative, exploratory and descriptive design was used. Purposive sampling was used to select participants, and data were collected through three nurse educator focus groups and three student nurse focus groups. Nurse educator focus groups consisted of four participants each, and student focus groups consisted of six participants each. The data were analysed using thematic analysis. Trustworthiness was established using Guba and Lincoln\u2019s criteria.\nResults: Three themes emerged: (1) Nurse educators and nursing students perceive substance abuse as a complex issue influenced by diverse personal and environmental factors, (2) Substance abuse impacts student nurses across three domains of their well-being and (3) The management of substance abuse within the education institution lacks comprehensive, structured and consistent strategies.\nConclusion: Substance use among nursing students is fundamentally a health and well-being issue that requires professional and structured interventions.\nContribution: Describing the perceptions of nurse educators and nursing students led to a set of recommendations to address substance abuse among student nurses.<\/jats:p>","DOI":"10.4102\/hsag.v31i0.3302","type":"journal-article","created":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T07:03:24Z","timestamp":1790319804000},"update-policy":"https:\/\/doi.org\/10.4102\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Perspectives on substance abuse among nursing students and educators in Eastern Cape, South Africa"],"prefix":"10.4102","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-5991-6133","authenticated-orcid":false,"given":"Nomthandazo M.","family":"Sululu","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03r1jm528","id-type":"ROR","asserted-by":"publisher"}],"name":"Nelson Mandela University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6596-2310","authenticated-orcid":false,"given":"Allison H.","family":"Du Plessis","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03r1jm528","id-type":"ROR","asserted-by":"publisher"}],"name":"Nelson Mandela University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2580","published-online":{"date-parts":[[2026,9,28]]},"reference":[{"key":"ref0","doi-asserted-by":"crossref","unstructured":"Bahji, A., Danilewitz, M., Maser, B., Guerin, E. & Frank, E., 2022, \u2018Association between substance use and professional outcomes among medical students: Findings from a Canadian cross-sectional survey\u2019, The Canadian Journal of Addiction 13(4), 32\u201343. https:\/\/doi.org\/10.1097\/CXA.0000000000000165","DOI":"10.1097\/CXA.0000000000000165"},{"key":"ref1","doi-asserted-by":"crossref","unstructured":"Barbayannis, G., Bandari, M., Zheng, X., Baquerizo, H., Pecor, K.W. & Ming, X., 2022, \u2018Academic stress and mental well-being in education institution students: Correlations, affected groups, and COVID-19\u2019, Frontiers in Psychology 13, 886344. https:\/\/doi.org\/10.3389\/fpsyg.2022.886344","DOI":"10.3389\/fpsyg.2022.886344"},{"key":"ref2","doi-asserted-by":"crossref","unstructured":"Brito, A.P.A., Lima, A.S., Rocha, \u00c1.C., Gon\u00e7alves, B.M., Freitas, D.M.C.B., Oliveira, G.J. et al., 2024, \u2018Alcohol consumption habits and their impact on academic performance: Analysis of ethanol patterns among health students: A cross-sectional study\u2019, S\u00e3o Paulo Medical Journal 142(6), e2023410. https:\/\/doi.org\/10.1590\/1516-3180.2023.0410.R1.05062024","DOI":"10.1590\/1516-3180.2023.0410.r1.05062024"},{"key":"ref3","unstructured":"Creswell, J.W., 2014, Qualitative inquiry and research design: Choosing among five approaches, 3rd edn., Sage, Los Angeles."},{"key":"ref4","unstructured":"Department of Trade and Industry, 2016, Final liquor policy paper: National liquor policy review (No. 1208), viewed 09 September 2026, from https:\/\/www.gov.za\/sites\/default\/files\/gcis_document\/201609\/40321gon1208.pdf."},{"key":"ref5","doi-asserted-by":"crossref","unstructured":"Duckworth, J.C., Graupensperger, S., Schultz, N.R., Gilson, M.S., Fairlie, A.M., Patrick, M.E. et al., 2023, \u2018Alcohol and marijuana use predicting next-day absenteeism and engagement at school and work: A daily study of young adults\u2019, Addictive Behaviors 142, Article 107670. https:\/\/doi.org\/10.1016\/j.addbeh.2023.107670","DOI":"10.1016\/j.addbeh.2023.107670"},{"key":"ref6","doi-asserted-by":"crossref","unstructured":"El Hayek, S., Foad, W., De Filippis, R., Ghosh, A., Koukach, N., Mahgoub Mohammed Khier, A. et al., 2024, \u2018Stigma toward substance use disorders: A multinational perspective and call for action\u2019, Frontiers in Psychiatry 15, 1295818. https:\/\/doi.org\/10.3389\/fpsyt.2024.1295818","DOI":"10.3389\/fpsyt.2024.1295818"},{"key":"ref7","unstructured":"Hennink, M., Hutter, I. & Bailey, A., 2020, Qualitative research methods, Sage, Los Angeles."},{"key":"ref8","doi-asserted-by":"crossref","unstructured":"Hirani, S., Tharani, A., Jetha, Z. & Khan, S., 2022, \u2018Insights from nursing students about factors affecting and strategies supporting their mental health\u2019, Journal of Wellness 4(1), Article 10.","DOI":"10.55504\/2578-9333.1101"},{"key":"ref9","doi-asserted-by":"crossref","unstructured":"Jiang, M.-M., Gao, K., Wu, Z.-Y. & Guo, P.-P., 2022, \u2018The influence of academic pressure on adolescents\u2019 problem behavior: Chain mediating effects of self-control, parent\u2013child conflict, and subjective well-being\u2019, Frontiers in Psychology 13, 954330. https:\/\/doi.org\/10.3389\/fpsyg.2022.954330","DOI":"10.3389\/fpsyg.2022.954330"},{"key":"ref10","doi-asserted-by":"crossref","unstructured":"Kong, L.N., Yao, Y., Chen, S.Z. & Zhu, J.L., 2023, \u2018Prevalence and associated factors of burnout among nursing students: A systematic review and meta-analysis\u2019, Nurse Education Today 121, 105706. https:\/\/doi.org\/10.1016\/j.nedt.2022.105706","DOI":"10.1016\/j.nedt.2022.105706"},{"key":"ref11","doi-asserted-by":"crossref","unstructured":"Lewis, Q.J., Smith, B.D., Offiong, A., Prioleau, M. & Powell, T.W., 2021, \u2018When a house is never a home: Housing instability among youth affected by parental drug abuse\u2019, Child Abuse & Neglect 118, 105131. https:\/\/doi.org\/10.1016\/j.chiabu.2021.105131","DOI":"10.1016\/j.chiabu.2021.105131"},{"key":"ref12","doi-asserted-by":"crossref","unstructured":"Mokwena, K.E. & Setshego, N.J., 2021, \u2018Substance abuse among high school learners in a rural education district in the Free State province, South Africa\u2019, South African Family Practice 63(1), a5302. https:\/\/doi.org\/10.4102\/safp.v63i1.5302","DOI":"10.4102\/safp.v63i1.5302"},{"key":"ref13","doi-asserted-by":"crossref","unstructured":"Morse, J.M., 2015, \u2018Critical analysis of strategies for determining rigor in qualitative inquiry\u2019, Qualitative Health Research 25(9), 1212\u20131222. https:\/\/doi.org\/10.1177\/1049732315588501","DOI":"10.1177\/1049732315588501"},{"key":"ref14","doi-asserted-by":"crossref","unstructured":"Netshiswinzhe, M.D., Ramathuba, D.U., Lebese, T.R. & Makhado, L., 2023, \u2018A model to prevent substance use\/abuse by nursing students at Limpopo College of Nursing, South Africa\u2019, Healthcare 11(16), 2285. https:\/\/doi.org\/10.3390\/healthcare11162285","DOI":"10.3390\/healthcare11162285"},{"key":"ref15","doi-asserted-by":"crossref","unstructured":"Peltzer, K. & Phaswana-Mafuya, N., 2018, \u2018Drug use among youth and adults in a population-based survey in South Africa\u2019, South African Journal of Psychiatry 24, a1139. https:\/\/doi.org\/10.4102\/sajpsychiatry.v24i0.1139","DOI":"10.4102\/sajpsychiatry.v24i0.1139"},{"key":"ref16","doi-asserted-by":"crossref","unstructured":"Rattner, I., 2021, \u2018A phenomenological study on substance use and misuse among nursing students\u2019, The Journal of Nursing Education 60(11), 607\u2013613. https:\/\/doi.org\/10.3928\/01484834-20210913-01","DOI":"10.3928\/01484834-20210913-01"},{"key":"ref17","unstructured":"Republic of South Africa, 2020, Explanatory summary of Bill and prior notice of its introduction published in Government Gazette No. 43595 of 7 August 2020, Government Printers, Pretoria."},{"key":"ref18","doi-asserted-by":"crossref","unstructured":"Rodr\u00edguez-S\u00e1ez, J.L., Mart\u00edn-Ant\u00f3n, L.J., Salgado-Ruiz, A. & Carbonero-Mart\u00edn, M.\u00c1., 2025, \u2018Academic performance, absenteeism, and drug use in emerging adulthood\u2019, Cureus 17(2), e78325. https:\/\/doi.org\/10.7759\/cureus.78325","DOI":"10.7759\/cureus.78325"},{"key":"ref19","unstructured":"Substance Abuse and Mental Health Services Administration, 2023, Key substance use and mental health indicators in the United States: Results from the 2022 National Survey on Drug Use and Health (HHS Publication No. PEP23-07-01-006, NSDUH Series H-58), Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration, Rockville, viewed 09 September 2026, from https:\/\/www.issup.net\/files\/2025-07\/SAMHSA%202022-nsduh.pdf."},{"key":"ref20","unstructured":"Tenny, S., Brannan, J.M. & Brannan, G.D., 2022, \u2018Qualitative study\u2019, in StatPearls [Internet], StatPearls Publishing, NCBI Bookshelf StatPearls, viewed 09 September 2026, from https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK470395\/."},{"key":"ref21","unstructured":"United Nations Office on Drugs and Crime, 2025a, World Drug Report 2025: Contemporary issues on drugs. UNODC World Drug Report 2025 Contemporary Issues, viewed 09 September 2026, from https:\/\/www.unodc.org\/unodc\/en\/data-and-analysis\/world-drug-report-2025.html."},{"key":"ref22","unstructured":"United Nations Office on Drugs and Crime, 2025b, World Drug Report 2025: Statistical annex. UNODC World Drug Report 2025 Statistical Annex, viewed 09 September 2026, from https:\/\/www.unodc.org\/unodc\/en\/data-and-analysis\/world-drug-report-2025.html."},{"key":"ref23","unstructured":"United States. National Commission for the Protection of Human Subjects of Biomedical and Behavioural Research, 1978 The Belmont report: Ethical principles and guidelines for the protection of human subjects of research, vol. 1, U.S. Department of Health, Education, and Welfare, Washington, DC."},{"key":"ref24","doi-asserted-by":"crossref","unstructured":"Veesart, A. & Cannon, S., 2022, \u2018The lived experience of nursing students who were unsuccessful in an undergraduate nursing program: A narrative inquiry\u2019, Nurse Education Today 118, 105517. https:\/\/doi.org\/10.1016\/j.nedt.2022.105517","DOI":"10.1016\/j.nedt.2022.105517"},{"key":"ref25","doi-asserted-by":"crossref","unstructured":"Volkow, N.D. & Blanco, C., 2023, \u2018Substance use disorders: A comprehensive update of classification, epidemiology, neurobiology, clinical aspects, treatment and prevention\u2019, World Psychiatry 22(2), 203\u2013229. https:\/\/doi.org\/10.1002\/wps.21073","DOI":"10.1002\/wps.21073"},{"key":"ref26","doi-asserted-by":"crossref","unstructured":"Vorster, A., Gerber, A.M., Van der Merwe, L.J. & Van Zyl, S., 2019, \u2018Second- and third-year medical students\u2019 self-reported alcohol and substance use, smoking habits, and academic performance at a South African medical school\u2019, Health SA Gesondheid 24, 1041. https:\/\/doi.org\/10.4102\/hsag.v24i0.1041","DOI":"10.4102\/hsag.v24i0.1041"},{"key":"ref27","doi-asserted-by":"crossref","unstructured":"Zolkefli, Y., 2024, \u2018Substance abuse and impaired practice in nursing\u2019, Journal of Client-Centered Nursing Care 10(4), 235\u2013238, viewed 09 September 2026, from https:\/\/jccnc.iums.ac.ir\/article-1-562-en.pdf.","DOI":"10.32598\/JCCNC.10.4.603.3"}],"container-title":["Health SA Gesondheid"],"original-title":[],"link":[{"URL":"https:\/\/hsag.co.za\/index.php\/hsag\/article\/view\/3302\/7334","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T07:03:38Z","timestamp":1790319818000},"score":1,"resource":{"primary":{"URL":"https:\/\/hsag.co.za\/index.php\/hsag\/article\/view\/3302"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,28]]},"references-count":28,"URL":"https:\/\/doi.org\/10.4102\/hsag.v31i0.3302","relation":{},"ISSN":["1025-9848","2071-9736"],"issn-type":[{"value":"1025-9848","type":"print"},{"value":"2071-9736","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,28]]},"article-number":"a3302"}}