Alcohol use among adolescents can result in many health issues and is linked to future health and economic problems, motor vehicle crash involvement and interpersonal violence. This study aimed to determine the prevalence of alcohol use among in-school adolescents and factors associated with its use in a Municipality in Ghana. Methods: A school-based cross-sectional survey was conducted among 700 students. A stratified random sampling method was applied to select the participants. Structured

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... stionnaires were administered to collect information on demographic characteristics, students' behaviors, family, peer, school factors and engagement in economic activities. Univariate, bivariate and multivariate analysis were applied to determine prevalence and risk factors of alcohol use Results: The prevalence of lifetime alcohol use was 39% while current users were 27.6%. The odds of taking alcohol were highest among sexually active adolescent compared to those who were not sexually active (AOR=2.96, 95% CI: 1.56, 5.61, p=0.001). Adolescents who used other substances such as cigarette smoking (AOR=7.16 95% CI: 3.90, 13.17, p=<0.0001) and marijuana (AOR=3.57, 95% CI: 1.38, 9.26, p=0.009) had increased odds of using alcohol. Conclusion: Interventions aimed at addressing adolescents' alcohol use may help address the use of other substances.