srjmdSRJMDSRJMD2788-9467https://doi.org/10.47310/srjcms.2025.v05i02.003Prevalence and Patterns of Substance Abuse among School-Going Adolescents: A Cross-Sectional Study from Kullu District, Himachal PradeshBackground: Adolescent substance abuse is a growing public health concern, often beginning at an early age and leading to adverse health, academic, and psychosocial outcomes. In Himachal Pradesh, especially Kullu district, cannabis cultivation and use have been frequently reported, yet systematic data among school-going adolescents remain limited. Objectives: To assess the prevalence, patterns, and awareness of substance abuse among school-going adolescents in Kullu district. Methods: A cross-sectional study was conducted from January to April 2016 among 300 students aged 14–19 years from senior secondary schools. Data were collected using a pretested, self-administered questionnaire. Students declining consent or submitting incomplete responses were excluded. Results: Of 300 participants, 169 (56.3%) were males and 131 (43.7%) females, with a mean age of 15.9 years. Prevalence of alcohol use was 13.7%, cigarette smoking 6.3%, and cannabis use 4.7%. Alcohol and cigarette use were higher among females (17.5% and 10.7%) compared to males (10.7% and 4.7%), whereas cannabis use was more common among males (6.5% vs. 2.3%). The mean age of initiation was 14 years. Awareness of harmful effects was highest for alcohol (84.3%) and smoking (88.3%) but lower for cannabis (58%), with 42% unaware of its risks. Despite awareness, disapproval rates were modest (smoking 58.3%, alcohol 51.7%, cannabis 46%). About 6% of users reported psychosocial or academic problems linked to substance use. Conclusion: Substance abuse among adolescents in Kullu district is notable, with alcohol most prevalent, followed by smoking and cannabis. Female predominance in alcohol and smoking contrasts with most Indian studies, while cannabis use shows male predominance. Early initiation, gender differences, and limited disapproval despite awareness highlight the urgent need for targeted preventive strategies in schools and stricter regulation of substance availability.