Qom University of Medical Sciences Journal

Introduction
Addiction is one of the biggest public health and socio-economic problems worldwide, which has increased dramatically in developing countries. According to the latest report of the United Nations Office on Drugs and Crime in 2022, about 284 million people aged 15-64 used drugs in 2020, indicating an increase of 26% compared to the last decade. Iran has the largest number of people addicted to drugs compared to the world’s population. Students are among the groups in which drug use is prevalent. In many studies, academic life has been introduced as a stressful period and the academic environment is a stressful environment. Epidemiological studies have indicated an increasing trend of tobacco smoking, alcohol consumption and drug use among college students. Research has shown that social-cultural environment, biological factors, interpersonal and family factors, and psychological/behavioral factors such as religious orientation are predictors of drug addiction.
One of the important components of people’s health is the quality of life (QOL). It is a broad concept that includes all aspects of life, including mental, social and environmental aspects, and can be a predictor of drug addiction in people. Another component that affects people’s health is health literacy. Evidence suggests that low health literacy may be associated with risky behaviors such as smoking and alcohol or drug use. It can be said that health literacy is another predictor of drug addiction in people. considering that there are few studies on identifying the predictors of the drug addiction tendency, the present study aims to predict drug addiction tendency based on QOL and health literacy in Iranian male college students.
Methods
This is a descriptive-correlational study with a cross-sectional design. The study population consists of all male students of Islamic Azad University, Qom Branch in the academic year of 2022-2023. Of these, 358 eligible students were selected using a simple random sampling method. The inclusion criteria were willingness to participate in the study, no physical problems, and no history of mental illness. The exclusion criteria were incomplete response to the questionnaires and unwillingness to continue participation in the research.

To collect data, we used Weed et al.’s addiction potential scale [21], the World Health Organization (WHO) QOL scale with 26 items, and Montazeri et al.’s health literacy for Iranian adults (HELIA) . Data were analyzed in SPSS software, version 26 using multiple regression analysis and Pearson correlation test. The significance level was set at 0.05.
Results
The mean total scores of QOL, health literacy and addiction tendency were 80.42±6.89, 112.20±3.57 and 92.18±3.242, respectively. The Pearson correlation coefficients between QOL domains of physical health (r=-0.19, P=0.001), psychological health (r=-0.166, P=0.002) and social environment (r=-0.200, P=0.005) and addiction tendency showed a negative and significant correlation between them. Also, the Pearson correlation coefficients between health literacy domains of access (r=-0.133, P=0.035), reading (r=-0.175, P=0.006), understanding (r=-0.206, P=0.001), and decision (r=-0.119, P=0.036) and addiction tendency showed a negative and significant correlation between them.
In the regression model, the QOL domains of physical health (B=-0.165, P=0.001), psychological health (B=-0.12, P=0.001), social relations (B=-0.231, P=0.002), and social environment (B=-0.127, P=0.012) had a negative and significant correlation with addiction tendency. For every unit increase in physical health, psychological health, social relations, and social environment in college students, their addiction tendency decreases by 0.165, 0.120, 0.231 and 0.127, respectively.
In the regression model, health literacy domains of access (B=-0.238, P=0.021), reading (B=-0.28, P=0.008), understanding (B=-0.34, P=0.001) and decision (B=-0.211, P=0.040) had a negative and significant correlation with addiction tendency. For every one unit increase in access, reading, understanding, and decision-making abilities in college students, the addiction tendency decreases by 0.238, 0.28, 0.34 and 0.211, respectively. Among the study variables, the understanding domain of health literacy ranks first in predicting addiction tendency (β=-0.183).
Conclusion
QOL (physical health, psychological health, social relationships and social environment) and health literacy (access, reading, understanding and decision) can predict Iranian college students’ drug addiction tendency. Therefore, it is recommended that educational officials pay attention to the role of QOL and health literacy of college students in order to reduce their drug addiction tendency.
Ethical Considerations
Compliance with ethical guidelines
This study was approved by the Ethics Committee of Islamic Azad University, Qom Branch, Qom, Iran (Code: 162674702). After explaining the study objectives and methods to the participants, their informed consent was obtained. They were assured of the confidentiality of their information and was free leave the study at any time.
Funding
This article was extracted from the master's thesis of Saeedeh Rahimi Shawazi, approved by the Department of General Psychology, Faculty of Literature and Humanities, Islamic Azad University, Qom Branch, Qom, Iran. This research did not receive any grant from funding agencies in the public, commercial, or non-profit sectors.
Authors contributions
All authors equally contributed to preparing this article.
Conflicts of interest
The authors declared no conflict of interest.