Introduction: Adolescent substance use in Nigeria is an escalating public health issue, with increasing abuse of cannabis, alcohol, prescription drugs, and inhalants. Adolescents represent about 60% of the country’s population, placing them at high risk for academic underperformance, psychological disorders, and social challenges. Although Cognitive Behavioural Therapy (CBT) is recognised as an effective treatment for substance use disorders, its adaptability and effectiveness within Nigeria’s cultural and resource-constrained settings require further investigation. This study aimed to assess the effectiveness of CBT in reducing substance use and improving behavioural outcomes among adolescents in Nigeria.
Methods: A systematic review was conducted following PRISMA 2020 guidelines. Databases searched included PubMed, African Journals Online, PsycINFO, Scopus, and institutional repositories. Eligible studies involved Nigerian adolescents aged 10–19 who received CBT or its core components compared with standard care, no treatment, or alternative therapies. Outcomes measured included changes in substance use and behavioural patterns. Risk of bias was assessed using the Cochrane Risk of Bias Tool for randomized controlled trials and the CASP checklist for non-randomised studies. Due to variations in study characteristics, a narrative synthesis was used.
Results: Nineteen studies involving about 1,960 adolescents showed that CBT, administered individually or in group settings over 4–12 weeks, significantly reduced substance use and improved self-esteem, coping skills, and depressive symptoms. However, study quality varied and long-term data was limited.
Conclusion: CBT demonstrates potential as an effective intervention for adolescent substance use in Nigeria. Further long-term research is essential to support broader implementation.