# Cannabis use among Arab students: a systematic review

## TL;DR

This review examines cannabis use among Arab students, finding higher use among university students and highlighting factors like peer pressure and mental health.

## Contribution

The study provides the first comprehensive synthesis of cannabis use patterns and correlates among Arab school and university students.

## Key findings

- Cannabis use prevalence among university students ranged from 4.7% in Tunisia to 32% in Lebanon and Egypt.
- Key correlates of cannabis use included male gender, older age, and lower religiosity.
- The findings suggest a need for targeted prevention strategies in the Arab world.

## Abstract

The rising global prevalence and potential harms of cannabis use among adolescents and young adults are cause for concern. This systematic review focuses on the Arab world, compiling research on cannabis consumption among school and university students, where use has significantly increased but remains inadequately evaluated.

The review was registered in PROSPERO (CRD42021285103). Following PRISMA 2020 guidelines, two researchers searched PubMed, Embase, Scopus, and PsycInfo from inception to 9 May 2024, with no filters or language restrictions. Grey literature was identified through structured searches in Google Scholar and ProQuest Dissertations & Theses Global on 30 August 2024, as well as through reference list screening and citation tracking of the included articles. Keywords used included “cannabis”, “student”, and “Arab”.

From 5,820 potentially eligible records, 31 manuscripts were identified and 17 records were retrieved from the grey literature. A total of 48 cross-sectional studies from 13 Arab countries met the inclusion criteria and were included in the synthesis. Of these, 20 studies focused on school settings (sample sizes: 140–10,648), and 29 examined university students (sample sizes: 172–7,445). The most commonly used assessment tools were the Global School-Based Student Health Survey (GSHS) for school students and the WHO-based Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) for university students. Lifetime cannabis use prevalence ranged from 0.7% in Iraq to 9.4% in Morocco among school students, and from 4.7% in Tunisia to 32% in Lebanon and Egypt among university students. Cannabis use was more prevalent among university students. Key correlates included male gender, older age, family discordance, peer pressure, lower religiosity, and psychiatric symptoms.

These findings align with global patterns and emphasize the need for early intervention, psychoeducation, and targeted prevention strategies to mitigate cannabis-related risks among youth in the Arab world.