Sense of coherence and substance use in adults: a systematic review and meta-analysis

This study systematically reviews the evidence on the association between sense of coherence (SOC) and substance use during adulthood. Two researchers conducted independent literature searches on the PubMed, LILACS, PsycINFO and Web of Science databases. Original articles assessing SOC and substance...

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Bibliographic Details
Authors: Freire Danigno, Julia; da Silva Dias, Mariane; Lessa Horta, Bernardo
Format: Article
Status:Published version
Publication date:2024
Country:Brasil
Institution:FIOCRUZ
Repository:Cadernos de Saúde Pública
Language:English
OAI Identifier:oai:ojs.teste-cadernos.ensp.fiocruz.br:article/8691
Online Access:https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8691
Access Level:Open access
Keyword:Senso de Coerência; Uso de Substâncias; Fumar; Droga Ilícita; Consumo de Bebidas Alcoólicas
Sentido de Coherencia; Uso de Sustancias; Fumar; Droga Ilícita; Consumo de Bebidas Alcohólicas
Sense of Coherence; Substance Use; Smoking; Illicit Drug; Alcohol Drinking
Description
Summary:This study systematically reviews the evidence on the association between sense of coherence (SOC) and substance use during adulthood. Two researchers conducted independent literature searches on the PubMed, LILACS, PsycINFO and Web of Science databases. Original articles assessing SOC and substance use in adults (age > 19 years) were included. Two reviewers independently assessed studies in two phases – initially by reading the title/abstract, then the full text. Discrepancies were resolved by a third reviewer. Estimates were pooled using random-effects models. Bibliographic search identified 21 studies on the association between SOC and substance use in adults. Studies (n = 11) that assessed the association with tobacco smoking found a 0.92 (95%CI: 0.82; 1.01, very low degree of certainty) odds of smoking among those with a high SOC; the association was not modified by age. Individuals with a strong SOC had lower odds of using alcohol (pooled effect: OR = 0.70, 95%CI: 0.50; 0.90, very low degree of certainty); adjustment for confounding variables decreased the magnitude of the association (pooled OR = 0.89, 95%CI: 0.80; 0.98). This systematic review and meta-analysis suggests that a strong SOC protects against substance use among adults regardless of age, with practical implications for preventive interventions and tailored strategies aimed at high-risk individuals. Longitudinal studies are needed to understand the impact of SOC on substance use. Examining interactions with socioeconomic factors and including diverse populations would enhance generalizability.