Beyond Prevalence: Understanding Substance Use Behaviors and Associated Risks in Ethnic Minority Students at Primary-Secondary Transition

Research on substance use among ethnic minority students during the critical primary-to-secondary school transition in Northern Thailand remains limited. This study investigated substance use experiences, associated risks, and key demographic and behavioural factors in this vulnerable population. A cross-sectional study was conducted with 186 ethnic minority students (Grades 4–6) in Chiang Rai, Thailand, using the Alcohol, Smoking and Substance Involvement Screening Test-Youth (ASSIST-Y). Data were analysed using descriptive statistics and chi-square tests. Lifetime substance use prevalence was low (e.g., alcohol 8.6%, tobacco 5.9%), yet most users were classified at a moderate-risk level. Lifetime use was significantly associated with being male (χ²=12.545, p = .001), being in a higher grade level (χ²=7.840, p = .020), and exhibiting deviant behaviour (χ²=9.046, p = .003). Despite low prevalence, a concerning profile of moderate-to-high risk exists. The findings identify a vulnerable subgroup (males, older students, and those with behavioural issues), highlighting the need for targeted, gender-sensitive prevention programs during this critical school transition.