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Table 3 Themes and examples of statements

From: Adolescents, parents and teachers’ perceptions of risk and protective factors of substance use in Moroccan adolescents: a qualitative study

Theme Example Illustrative Statements
Perceived Benefits of Substance Use Ex. 1 G1: “Sometimes adolescents consider smoking as one of the ways of imposing themselves and showing off in front of the others; they smoke at this very early age, which is why we wonder what these youngsters would do once they grow old.”
F1: “There are also those feelings of self-awareness from the part of those youngsters.”
F.T1: “According to me, those youngsters find that these behaviors and attitudes are complementary to their character and a way of confirming their manhood.”
Ex. 2 G2: “The reason behind the consumption of drugs sometimes is to look popular and to feel loved by their friends; sometimes the girl may start smoking only to get famous and well-known among her peers.”
F2: “…a kind of fashion and fame!?!”
F.T2: “Drug consumption and smoking can be sometimes an act of impressing others because it is highly regarded that smoking is part of the local tradition of displaying virility.”
Ex. 3 B1: “When you try it for the first time, it surely takes one to a different world; the use of drugs gradually increases day after day.”
F3: “Some adolescents strongly believe that the use of drugs makes one active, and it is the only source of the feeling of high ecstasy.”
M.T1: “When adolescents use drugs, they find himself in a state of indescribable pleasure, the feeling of euphoria; thus, the adolescent keeps on consuming drugs on a daily basis until they suddenly find themselves addicted, which makes it hard for them to let it go.”
Ex. 4 G3: “The period of adolescence plays a major role in creating all these problems and instills acts of carelessness within teenagers.”
M1: “There are also the effects of adolescence and natural motivations.”
M.T2: “In this period, students are exposed to smoking and even drug abuse; I think … the reason is the lack of awareness, and a teenager does not have enough sense of responsibility.”
Ex. 5 B2: Interviewer: (what was the factor that led you to smoke at first?)
“I just wanted to try it with friends … out of curiosity.”
F4: “This first experience with friends is extremely dangerous, the desire to experiment and explore at the beginning, and after that it becomes a habit.”
M.T3: “He just wants to taste these substances (try these taboos), and when he tries, he’s going to be at risk for addiction ... (although he just tried).”
Ex. 6 B3: “Some adolescents have psychological problems; they believe that the only solution to cope with their problems is to use different substances.”
F5: “What drives teens to use drugs are psychological problems like shyness, lack of self-confidence…”
F.T2: “Some psychological problems are behind adolescents’ substance use, like having a weak personality… or living in an uncomfortable atmosphere.”
Ex. 7 G2: “Some students suffer from poverty and compare themselves with other people who live in good homes and excellent conditions; they want to try drugs to forget their living reality.”
G4: “I know a poor girl who used to be my classmate whose parents decided to get divorced, so she was living with her grandmother ... all these problems prompted her to use drugs.”
F6: “Social factors such as poverty, unemployment and vulnerability, the housing crisis, such as shantytowns, and the labor crisis … lead some people to use substances in order to forget their problems.”
F6: “There are also many causes like domestic problems, including divorce of parents.”
F.T1: “Adolescents tend to escape and avoid their personal, economic, and social problems by using drugs.”
F.T3: “I believe that there are many family problems such as divorce that place adolescents in this situation.”
Ex. 8 G3: “The problem of dropping out of school can cause adolescents’ substance use.”
M2: “Study failure and dropping out of school may also be a cause of drug use in adolescents.”
F.T2: “School failure can lead students to drug use.”
Awareness and Beliefs Ex. 9 B4: “For example, my father used to smoke and my brother does so ... but I don’t smoke because it is very harmful.”
G5: “The media and schools also play an important role in health awareness through some awareness programs about the dangers of smoking and drugs. Unfortunately, this type of awareness is scarce in our context.”
F7: “The morals that I instill in my children keep them away from using drugs.”
M3: “Awareness through media, the Internet, and school sensitization campaigns against substances use for example.”
F.T2: “The school is working to reduce these risky behaviors such as smoking, drug taking. However, it is ineffective, given the widespread of the phenomenon or sometimes the lack of monitoring, especially outside of school.”
M.T4: “The curriculum must graduate a good citizen, and therefore these behaviors should be given great importance in terms of time and attention by the officials; nevertheless, such things are missing in our system.”
Ex. 10 G3: “Some adolescents are from families that are illiterate and unaware about the drug-related harms, in addition to the negative impact of the media.”
G6: “Even in the media, adolescents notice that the actors smoke and use drugs, so they tend to imitate them.”
F8: “The school no longer has a good impact because many other interests like the Internet have emerged, and the student has become uninterested in school, which led to a lack of awareness about drug-related harms.”
F3: “Some teenagers are influenced negatively by some bad models that exist in the media like an athlete, star, actor ... and they try to imitate them.”
F.T2: “They don’t care of the several harms caused by smoking and drug use.”
M.T4: “One reason for these behaviors is the absence of awareness among parents. Also, our curricula don’t give much importance to these risky behaviors in terms of time and consideration by the officials, which contributes to a degradation of the awareness.”
M.T5: “It is in fact the huge impact of the media outlets that misguides the adolescents by making them think that it is a form of social civilization!?!”
Ex. 11 B5: “ I think that drugs are not useful. For example, I like to see myself well-built and without diseases. If I use cigarettes or drugs, they will harm my health. So, I don’t use them and I will not use them.”
B6: “I have some friends who smoke but I don’t smoke. (Why?) I don’t want to because when you grow old you will lose all your money in addiction; I believe that cigarettes have no significance in solving or forgetting problems, and they only harm health and waste your money.”
B7: “Sometimes when an adolescent has a father who consumes drugs, he sees that he suffers from diseases, so he doesn’t want to be like him and undergo the same consequences.”
F3: “Some teenagers take lessons through one of the parent or the family member who used these substances and is in poor health because of these drugs.”
M.T2: “First, they may have convictions because of an education they have had from their parents. This is why you can find a teenager whose father is a smoker, but he does not smoke and always criticizes his father. Because he gave him a negative image and he shows himself in bad situation.”
Ex. 12 G3: “There are those who fill their free time with useful things to avoid bad behaviors. For example; sports, because someone who practices sports must follow a special diet and get away from drugs.”
M4 : “Some teens have a healthy adolescence and have a high interest in studying, which keeps them far from drug use and addiction.”
Family Influence Ex. 13 B3: “If the father smoked and there was pressure on the teenager, he would say why I do not smoke like my father to forget about these problems.”
M4 : “Parents don’t care about their children; they don’t give them time to talk to them about their problems. Consequently, they begin to use drugs to forget. In addition, you can find some parents using cigarettes in front of their children.”
M.T5: “In my opinion, the education at home and especially if it is free of religion, ethics, and communication between parents and children, will make adolescents vulnerable to being involved in such behavior.”
Ex. 14 G8: “We find that, for the girl who consumes drugs, her parents don’t care about her and don’t control her well. For example, she goes out at 8 in the morning, even if she doesn’t have a class or she isn’t going to go to class and stays out with addicted teenagers. So, she starts taking drugs.”
G9: “Parents don’t control the time schedule of their children when they enter school and when they come out.”
F10: “Absence of control by the family.”
F11: “When a child feels ignored by parents, he is encouraged to take these substances.”
M.T2: “I think bad parenting, when an adolescent sees that no person in his family gives him importance or controls him, he can do anything like smoking, consuming drugs, etc.
Ex. 15 B8: “One student in our class drinks alcohol; his father gives him everything, but he wants to deviate because he has money. Excessive and unchecked pocket money leads to risky behaviors.”
B3: “The other factor, I think, is the lack of parents’ control, especially when they give them money and don’t ask how they spend it.”
F12: “The reason for me is the availability of money in an excessive and uncontrolled way.”
F4: “Too much pocket money can be a cause of drug abuse, and its absence may lead to the same problems indirectly.”
F.T2: “Some teenagers get ample money to cover their needs without parental control.”
M.T5: “Giving children money without supervision or control.”
Ex. 16 G10: “As they say, my parents explained to me that drugs are bad and harmful.”
B2: “My parents know that I don’t smoke and they trust me. The money with which I could buy drugs I use it to buy something else healthy.”
G11: “The presence of control within the family as well as mutual trust between parents and children.”
M5 : “Parents should monitor their children and know who is accompanying them as friends.”
F3: “Education and control of children since childhood within the family represent a protective factor.”
F.T4: “Dialogue, understanding, and the attention given to an adolescent within the family, to know his problems and his needs, can keep adolescents away from this risk.”
Peer Influence Ex. 17 G12: “Bad company; sometimes the student who smokes begins to urge other teens to smoke and tell him you cannot smoke, you are not a man.”
B9: “What made you try? We played at night with each other, but after that we left playing and started meeting in the day to smoke. We were 6 people, now two people are not smokers and the others are addicts.”
M5 : “I think the cause is bad friends and free time.”
F13: “Adolescents learn from each other; the cause is the bad companions; they try to involve good boys and so on.”
M.T2: “All this is linked to the so-called bad companions. Parents, for example, do not pay attention to their children if they go with some bad teenagers who use these substances.”
Ex. 18 G4: “One girl was in relation with one boy who used all kinds of drugs ... she saw how relaxed he was when he smokes; thus, she began using drugs and becomes addicted like him.”
F.T2: “For female adolescents, emotional relationships and encounters with male adolescents have a significant impact on the use of cigarettes, drugs, and alcohol, especially in their talk about ecstasy.”
Ex. 19 B10: “I know how I choose my friends, and I had awareness before I reached this age because it is very dangerous.”
G13: “I choose my companions; they should be good and I do not accompany the bad girls. At the beginning of the year, you can spend a week with your friend to know if she has bad behavior or not.”
M3: “They choose friends who are smart and who understand things quickly, and those never used drugs.”
M.T6: “They don’t accompany friends who use drugs and they don’t go to the places where the drugs are used.”
Easy Accessibility of Substances Ex. 20 B11: “Do you feel that these substances are available? Ha, ha, ha, yeah, very easy to get; if you want, give me only 2 min to go out and I will buy chewing tobacco and return.”
B12: “Drugs are available and easy to obtain, and they exist everywhere. You should only have money.”
B2: “Alcohol is also used. They buy it from big shops, even though they are under the age of 18, but they are looking for someone over age to buy it for them.”
F14: “First, these substances are available, especially near to schools, such as cigarettes, snuff tobacco, edible cannabis, le, etc.
F13: “These substances are available everywhere. Cannabis and shisha cafes are spreading everywhere.”
M.T7: “Because the environment around the school has become promising for these behaviors. Also, drug dealers are present in abundance, and all kind of drugs can be found easily.”
M.T5: “There is also the availability of drugs and alcohol, which are easy to get by adolescents.”
Ex. 21 B10: “There are unsupervised places near the school where teenagers gather to use all kinds of drugs.”
B12: “You can find drug dealers sitting in cafes near the school. There are also places around the school that are not kept, for example, a cellar where students gather to use drugs.”
F15: “Lack of control by the authorities concerned with combating drugs and alcohol.”
F3: “Alcohol and drugs are sold to under-age teenagers because the law does not apply.”
M.T3: “There is a deficiency in security, not only the role of parents; we see that these phenomena happen in full view of the authorities; everything happens and they know about it and they have to punish these dealers.”
Social Norms Ex. 22 B2: “Some parents know that their children smoke, but they don’t do anything to them and consider that as normal.”
G4: “In addition, the environment where teens live influences them because they see that most people take drugs. So, they will try to use these substances because it has become usual.”
M2: “The society in which teens live is normalized with the use of drugs, and of course, in this case, they will be negatively affected.”
F15: “Normalization with these behaviors has an adverse effect on adolescent substance use.”
M.T1: “If these behaviors have become so frequent and habitual, the adolescent says he is not alone (a sort of normalization with these behaviors), so this is one of the main reasons for substance use by adolescents.”
Ex. 23 G14: “I think religious beliefs and practices protect against these behaviors; God Almighty has forbidden us all that destroy the mind.”
G11: “The absence of religious beliefs in adolescents is a major reason for their tendency toward drugs because the religious education has a crucial role in providing them with immunity from these dangerous behaviors.”
F14: “I know a teenager who lived without parents in bad circumstances; despite all this he did not deviate because his religious education was good. I consider that religious and moral education can deal with these problems experienced by adolescents in this period.”
F16: “The absence of religious beliefs is a reason for drug abuse.”
M.T7: “The causes of these behaviors are intertwined and varied, including the weakness of religious beliefs and the absence of faith and educational immunity of the student.”
  1. G girl, B boy, F father, M mother, M.T male teacher, F.T female teacher