4th Edition of Psychiatry and Addiction World Conference 2026

Abstract

Substance use among university students remains a growing public health concern in low-resource settings, contributing to adverse health outcomes and reduced academic performance, yet mobile health (mHealth) approaches for addressing it remain understudied in African university contexts. This quasi-experimental study examined the association between an mHealth cognitive behavioral therapy (CBT)-informed psychoeducational text messaging intervention and substance use frequency among undergraduate students at Jimma University, Ethiopia. A total of 140 students with substance use were allocated by campus into intervention (n=70) and control (n=70) groups. Substances assessed included tobacco, alcohol, cannabis, and khat, with use frequency (low/moderate/high) measured using the validated WHO Alcohol, Smoking and Substance Involvement Screening Test (ASSIST). The intervention group received three months of mHealth CBT-informed psychoeducational text messages addressing knowledge and skill-building, while the control group received no study-related text messages, follow-up calls, or mobile credit incentives. Endline assessment was conducted immediately after the intervention period, and ordinal logistic regression was used to assess associations, adjusting for baseline substance use frequency. After adjusting for baseline imbalance between groups (intervention: 82.9% high use vs. control: 45.7%; p<0.001), the intervention was associated with significantly lower odds of higher substance use frequency (OR=0.10, 95% CI 0.03-0.31, p<0.001). Higher self-esteem (OR=0.10, p=0.010) and lower monthly expenses (OR=0.06, p=0.013) were also associated with reduced odds of higher substance use frequency. These findings suggest that the mHealth CBT-informed psychoeducational text messaging intervention was associated with reduced substance use frequency among university students, indicating a feasible, low-cost strategy for addressing substance use in resource-limited university settings. However, given the non-randomized design and baseline imbalance between groups, causal inference is limited, and findings should be interpreted with caution pending confirmation through randomized controlled trials.