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The aim of this study was to investigate the prevalence rate and determinants of SU in adolescents based on the social development model (SDM). In 2018, applying a cross-sectional design, cluster multistage random sampling was employed to recruit 600 adolescents in Bam County, Iran, to participate in the study. A valid and reliable SDM-based instrument was used to collect data. The prevalence rate of using at least one substance was 42% (in girls 33.6% and in boys 50.3%). Adjusted for covariates, having close friends with SU was found as the factor with the highest risk. Higher scores in  involvement in prosocial activities and interactions  (OR: 0.47; 95% Confidence interval (CI): 0.33–0.66, p &lt; 0.001),  attachment and commitment to prosocial others (family and school)  (OR: 0.73; 95% CI: 0.58–0.93, p &lt; 0.05), and  skills for interaction/involvement  (OR: 0.51; 95%CI: 0.39–0.67, p &lt; 0.001) reduced the odds of ever use of SU among adolescents. Also, higher levels of  perceived rewards for antisocial interaction/involvement  (OR: 2.22; 95% Confidence interval (CI): 1.53–3.22, p &lt; 0.001) and  belief in antisocial values  (OR: 2.24; 95% CI: 1.67–2.94, p &lt; 0.001) increased the odds of ever use SU among the respondents. In community-based interventions to prevent SU among adolescents, a great focus should be firstly on identifying the probability of SU in close friends. Moreover, the involvement of adolescents in prosocial activities and interactions, attachment and commitment to prosocial others (family and school), and skills for interaction/involvement should be core categories while designing community-based interventional studies.

international journal of health promotion and education

Prevalence and determinants of substance use among a sample of Iranian adolescents with ease of access to drugs: an application of Social Development Model