Guwahati: Nearly one in every two adolescents surveyed in selected schools in Guwahati faces a moderate or high risk of substance use, the highest among six Indian study sites.Researchers pointing to easy availability of addictive substances, rising digital exposure and risky social environments as the key drivers behind the alarming trend.The multicentre study supported by Indian Council of Medical Research and published in The Lancet Regional Health-Southeast Asia journal, found that 42.3% of students in selected Guwahati schools fell in the moderate or high-risk category for substance use, compared with 7.1% in Nagpur and 0.1% in Puducherry, exposing a sharp regional divide in adolescent vulnerability.The study surveyed 6,168 adolescents from 108 schools across six districts in India between 2025 and 2026. The participating sites included Kamrup (Guwahati) in Assam, Gorakhpur (Uttar Pradesh), Nagpur (Maharashtra), Rajkot (Gujarat), Deoghar (Jharkhand), and Puducherry, representing a diverse mix of urban, semi-urban, rural and tribal school setting.Far from attributing the disparity solely to individual behaviour, the researchers argue that the findings reflect the influence of the environment in which adolescents grow up.The widest gap—between Guwahati and Nagpur—was 35.1 percentage points, with only 37.9% of the difference explained by measurable factors such as school characteristics, socio-economic background and personality traits. The remaining gap points to deeper structural and contextual influences unique to local settings.The study identifies easy access to substances as the single strongest modifiable risk factor, followed by high digital exposure and risky behavioural environments. Conversely, stronger social engagement emerged as a protective factor, suggesting that family, school and community support can reduce vulnerability.The findings come amid growing concern over the spread of narcotics in Assam, where law enforcement agencies have intensified anti-drug drives in recent years, seizing large consignments and arresting traffickers. The study suggests that policing alone may not be enough if adolescents continue to face easy access to substances and increasing exposure to drug-related content online.Researchers said prevention strategies need to move beyond awareness campaigns and adopt context-specific interventions, including tighter regulation of substance availability around schools, digital and media literacy programmes, and peer-led initiatives under the School Health Programme. They cautioned, however, that the estimates are based on self-reported responses from students in selected schools and should not be interpreted as representative of the entire city.Even with that caveat, the findings underscore an uncomfortable reality: in Guwahati, the risks confronting adolescents may be shaped as much by their surroundings as by their individual choices, making the city’s social environment a critical front in the fight against substance use.GFXWHAT DRIVES THE RISK?Biggest contributors•Easy access to substances•High digital exposure•Risky peer/social environment•Personality traits•School & socio-economic factorsWhat stands out in Guwahati?– Easy access to substances, high digital exposure and risky behavioural environment put adolescents in selected Guwahati schools at the highest substance-use risk among six surveyed Indian sites.Key Takeaways· 82.3% of surveyed students in Guwahati were from government schools.· Only 17.8% were from private schools· highest proportion of female participants (59.2%) among the six study sites.· Highest anxiety sensitivity among all six study sites.· Highest impulsivity score.· Second-highest hopelessness score.· Second-highest sensation-seeking score.
