Introduction: School-based bullying, a global challenge, adversely contributes to psychological and physical development of adolescents. Existing evidence indicates an association between bully perpetration and substance use. Conversely, bully prevention interventions are linked to lower reports of substance use. This study examines the relationship between bullying perpetration and substance use among senior high school students in Ghana, West Africa.
Methods: Data from the 2012 Ghana Global School-based Student Health Survey (GSHS) were utilized. A total of 1,984 students participated in the 2012 GSHS. Complex sample frequencies and logistic regression analysis were utilized to calculate prevalence estimates and odds ratios respectively, focusing on bullying and substance use. Results: Overall, 23.4% of students reported bullying other students in the 30 days preceding survey. Among bullies, 9.8% smoke, 20.5% use alcohol, 16.1% had ever binge drunk and, 10.4% had used marijuana one of more times in lifetime. Students who smoke (OR 2.9; CI 1.6-5.5), use alcohol (OR 2.1; CI 1.5-2.8), binge drink (OR 1.8; CI 1.4-2.4), or ever used marijuana (OR 2.4; CI 1.5-3.9) were significantly more likely to report being involved in bullying other students compared to those who did not use aforementioned substances. Conclusion: The significant association between bullying and substance use (cigarette, alcohol, and marijuana) suggests the need to consider addressing substance use as part of bullying intervention efforts among senior high school students in Ghana.