Objective: The present study was conducted to qualitatively examine the contexts and processes of substance use among dormitory students and to explore prevention strategies. Method: This was a qualitative study using grounded theory. After conducting interviews, the recorded data were transcribed and analyzed using the Strauss and Corbin approach in three stages: open, axial, and selective coding. The participants were 20 individuals, including social and cultural experts in sociology and psychology, senior experts from the anti-narcotics headquarters, university health officials, and dormitory students. Results: Socio-psychological factors and categories such as peer pressure, loneliness, normalization of use, adventurism, and value changes were identified as causal conditions for substance use. Additionally, concentrated cultural and social policies, flawed prevention programs, and weak supervision were found to be contextual conditions. Unfavorable economic conditions, insufficient income, and poor family economic status were also identified as intervening conditions. Finally, the consequences of substance use among dormitory students were discovered to be increased costs for the government and families, low academic self-efficacy, higher healthcare expenses, and adverse health outcomes. Developmental prevention, designing alternative activities, and creating a supportive environment should be considered as strategies for preventing substance use. Conclusion: Findings from this study indicate that substance use among dormitory students is the result of a complex interplay of individual, social, and psychological factors; highlighting the need for comprehensive and multidimensional prevention approaches that consider the micro, meso, and macro levels.
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