More than one in five school-going adolescents surveyed across six Indian districts were at moderate-to-high risk of substance use, according to a study published in The Lancet Regional Health - Southeast Asia.
The study, based on data collected during 2025-26, included 6,168 adolescents from 108 schools in Kamrup, Assam; Gorakhpur, Uttar Pradesh; Nagpur, Maharashtra; Rajkot, Gujarat; Deoghar, Jharkhand; and Puducherry. Researchers assessed substance-use risk using the World Health Organization's Alcohol, Smoking and Substance Involvement Screening Test (ASSIST).
Overall, 21.4% of the adolescents were classified as being at moderate-to-high risk. This included 10.3% at moderate risk and 11.1% at high risk. The study classified the remaining 78.6% as being at low risk.
The findings do not mean that one in five teenagers across India are at this level of risk. The research covered selected schools in six districts and examined differences between those settings. The researchers specifically noted substantial variation in substance-use risk across locations.
Guwahati recorded highest risk
Among the locations studied, selected schools in Guwahati recorded the highest substance-use risk, while Nagpur and Puducherry recorded the lowest.
The researchers found a 35.1 percentage-point gap between Guwahati and Nagpur. School characteristics, socioeconomic and demographic factors and personality traits accounted for part of this difference.
The study also identified several factors associated with higher substance-use risk. Adolescents who perceived substances as more accessible, had higher digital exposure or held more favourable attitudes towards substance use were more likely to fall into a higher-risk category.
High accessibility to substances was associated with 1.75 times higher odds of being in a higher-risk category, while high digital exposure was associated with 1.44 times higher odds.
CJI cites study on child substance abuse
Chief Justice of India Surya Kant cited the study on September 26 while delivering the Pataliputra Pragya Pravah lecture in Bihar on child protection and substance use.
Referring to the findings, Kant said that at least one in five teenagers in India were at moderate-to-high risk of substance abuse. He argued that substance use among children should be viewed not only as a public health concern but also as a child protection issue.
The Lancet study itself uses the term "substance-use risk", rather than saying that 21.4% of the adolescents had substance abuse. It was based on self-reported screening and was designed to identify risk levels, not establish a national prevalence of substance abuse.
The research was supported by an Indian Council of Medical Research extramural research grant.
Separately, a related study using data from the same 6,168 adolescents, published in BMC Psychology on September 25, found that 11.2% of the 4,848 adolescents for whom current-use data was available reported using at least one assessed psychoactive substance during the preceding three months. This measures reported current use and should not be confused with the 21.4% moderate-to-high risk figure.