Bullying Victimization and Use of Substances in High School: Does Religiosity Moderate the Association?

  • Rima A. Afifi
  • Khalil El Asmar
  • Dima Bteddini
  • Moubadda Assi
  • Nasser Yassin
  • Sara Bitar
  • Lilian GhandourEmail author
Original Paper


Alcohol, tobacco and other drug use continue to pose serious public health concerns among youth. Bullying victimization has been identified as a risk factor and religiosity a protective factor for adolescent substance use. No previous research has examined the potential moderating role of religiosity. We explore the association between bullying victimization and substance use in adolescents with low and high levels of religiosity. A cross-sectional survey was conducted with a representative sample of high school students in greater Beirut. Binary and multinomial logistic models were used, adjusting for demographics, and stratified by level of religiosity. Of the 986 students responding to the survey, 65% were females; 48% had experienced some form of bullying; and 52% self-rated as low in religiosity. Between 10 and 30% were current users of alcohol or tobacco. Students of lower religiosity levels who had been bullied were more likely to use substances than those who self-rated as high religiosity. Religiosity may be a potential moderator of the association between being bullied and substance use, but the exact mechanisms and underlying reasons need further investigation.


Religiosity Bullying Substance use Youth Arab 



This study was supported through a Grant from the Swiss Agency for Development.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Rima A. Afifi
    • 1
    • 2
  • Khalil El Asmar
    • 3
  • Dima Bteddini
    • 1
  • Moubadda Assi
    • 4
  • Nasser Yassin
    • 5
    • 6
  • Sara Bitar
    • 7
  • Lilian Ghandour
    • 3
    Email author
  1. 1.Department of Health Promotion and Community Health, Faculty of Health SciencesAmerican University of BeirutBeirutLebanon
  2. 2.Department of Community and Behavioral Health, College of Public HealthUniversity of IowaIowa CityUSA
  3. 3.Department of Epidemiology and Population Health, Faculty of Health SciencesAmerican University of BeirutBeirutLebanon
  4. 4.Center for Research on Population and Health, Faculty of Health SciencesAmerican University of BeirutBeirutLebanon
  5. 5.Department of Health Management and Policy, Faculty of Health SciencesAmerican University of BeirutBeirutLebanon
  6. 6.Issam Fares Institute for Public PolicyAmerican University of BeirutBeirutLebanon
  7. 7.American University of BeirutBeirutLebanon

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