Perceptions of legal and illegal substances use: A nationwide cross-sectional study in Honduras

Context: Substance use adversely affects physical and mental health and imposes social and economic burdens in affected communities. Aims: To evaluate perceptions regarding the consumption of legal and illegal substances and associated factors in the general Honduran population. Methods: A cross-sectional analytical study was conducted using data from 3,309 informants aged ≥18 years. Data was obtained through interviews using a structured instrument based on the WHO's ASSIST 3.0 tool. Multivariate analysis was performed using generalized linear models. Results: Of the 3309 participants distributed nationally, perception of problematic drug use was observed among individuals with a history of violence (aPR=1.53), recent cannabis use (aPR=1.29), irresponsible behavior (aPR=7.05), or concerns raised by others (aPR=1.49). Conversely, university education was associated with a reduced perception of drug-related problems (aPR=0.70), adjusted for six variables. Conclusions: Tobacco was the most reported legal substance, followed by cannabis and cocaine among illegal substances. Problematic use perception was linked to specific behavioral and social indicators like violence, cannabis use, and academic attainment.