Background
Substance use among youth is a significant public health concern worldwide. However, little is known in Rwanda about the prevalence of drug use among youth. The goal of the current study was to assess the prevalence and determinants of substance use among youth in Rwanda.

Methods
A cross-sectional home survey was carried out with 2479 Rwandan youth. Youth ranging, in age from 14–35 years, were randomly selected from 20 out of the 30 districts in the country. The youth were interviewed using a questionnaire that included socio-demographic information and self-reported substance use. Misuse and dependence on alcohol, marijuana and tobacco were respectively assessed by the Alcohol Use Disorders Identification Test (AUDIT), the Cannabis Abuse Screening Test (CAST), and the Hooked on Nicotine Checklist (HONC).

Results
Overall, the prevalence rate of substance use over the month prior to the survey was 34% for alcohol, 8.5% for tobacco smoking, 2.7% for cannabis, 0.2% for glue and 0.1% for drugs such as diazepam. 7.46% (one in thirteen) of the youth were alcohol dependent, 4.88% (one in twenty) were nicotine dependent, and 2.54% (one in forty) dependent on cannabis.

Conclusions
Our findings demonstrate that tobacco, alcohol, marijuana and other substance use are realities in the daily lives of youth in Rwanda. Further research is needed to monitor the evolution of this phenomenon and its determinants and in order to initiate evidenced-based interventions.