The health ministry has clarified that the high prevalence of tobacco and marijuana users in Bhutan as cited in the WHO report, is based on incidents of one or more time use and does not represent or reflect regular or problematic users.

Health secretary Dr Ugen Dophu said the information on Bhutan in the WHO report on mental health status among adolescents in South-East Asia was extracted from the ministry’s school health survey conducted in 2016.

Dr Ugen Dophu said that the figures published on tobacco, alcohol and marijuana use by the students are factual. However, the highlighted finding in the report and the article published in the media contains just the preliminary assessment of the data. The ministry pointed out that the indicators used were not reflected in the media report.

The country coordinator for the Global School-based Student Health Survey Bhutan 2016, Sangay Thinley, said that the second stage analysis of the data shows different frequencies of substance use.

“Readers would have been alarmed since clear definitions reflected in the report were not explained in the paper for reader’s clarity,” Sangay Thinley said.

He said that the prevalence of these substance use as reflected in the report is based on incidents of one or more time use and does not represent or reflect regular or problematic users.

The report states that 24.7 percent of the students aged 13 to 17-year-old are current smokers. Sangay Thinley said current smokers are defined as those who smoked cigarettes on one or more days in the past 30 days.

“Enquiring into the findings, 11.4 percent smoked for one to two days in the past 30 days while only 1.9 percent of the students smoked on all 30 days,” Sangay Thinley said.

It was found that only 9.5 percent are frequent smokers meaning they smoked cigarettes for six or more days in the past 30 days.

The second stage analysis also found that 75.3 percent of the students never smoked in the last 30 days while 78.5 percent never smoked in their lives.

Of the 29.3 percent of students reported to have used any tobacco products on one or more days in the past 30 days, 18.4 percent were current users of smokeless tobacco product, which is defined as those who used the product on one or more days in the past 30 days.

The report states that 24.2 percent of the students currently drank alcohol like ara, bangchang, changkoe, beer and wine on one or more days in the past 30 days, while only 17.4 percent of the students reported that they drank two or more drinks per day on the day they drank alcohol.

Sangay Thinley said the questionnaire stated that drinking alcohol does not include drinking few sips of wine for a religious purpose. “A drink was defined as a glass of wine, a bottle of beer, a small glass of liquor, or a mixed drink.”

Similarly, the current use of marijuana, defined as using marijuana one or more times in the past 30 days was found to be 12 percent. Of which, only 1.5 percent of students aged 13 to 17-year-old used it 20 or more times during the past 30 days.

Sangay Thinley said the recall period for most of the questions varied from a week, 30 days for substance use questions to 12 months for most of the mental health indicators. “There were no skip patterns used in the questionnaire which was conducted in a self-administered anonymous manner.”

The survey was conducted as part of the youth risk factor surveillance. “The next round of survey will be conducted in about four to five years times to access the trends of these risk factors.”

The first school health survey was conducted with support from WHO and Centres for Disease Control and Prevention.

Dechen Tshomo