Table 2 Qualitative themes and sample excerpts from participant narratives

Affective attitude

Perception of peer-provider

“I thought we get along more with a young person doing it as opposed to having an older person, and I’m young. With an older person, it will be more of a lecture and not counselling. [With the peer provider] it seemed like a talk, she was advising me, I respond. But if it was an older person I will just say yes or no. But with her I was talking.” (Male, 15 years).

Perception on session

“I enjoyed the advice and also it made me know of the effects of drugs and I realized that using these things is not good.” (Male, 15 years).

Burden

Cognitive effort

“The effects of drugs, causing ailments [was easy to understand]… that if you use drugs, you can’t do well in school.” (Male, 16 years).

Time

“It was around thirty minutes or twenty minutes…it was worth it.” (Male, 15 years).

Ethicality

“[The counselling session fit in with my goal of becoming a doctor.] When I sat down and asked myself, if I wanted to study medicine and use substances it would be difficult. It is either I leave one or the other. So, I decided that even if it is in small amounts, I should leave it to pursue medicine well. [The counselling session also fit in with my goal of helping my parents]…because, if you use substances, you cannot help your parents because all the money that you have you spend it on drugs. So, I saw that there was no way I could use alcohol and help my parents. One would have to fall.” (Male, 18 years).

Intervention coherence

“[The goal of the session]… was to educate the youths on the dangers and side effects of drug and substance abuse. So, most youths use drugs or anything, so it was to help, rehabilitate, teach the side effects and things that they should do and shouldn’t do.” (Male, 20 years).

Opportunity costs

“I had to sacrifice. On that day we were to go to…play football but I came here.” (Male, 15 years).

Perceived effectiveness

“…The day after the…session, I was called to go for a bash. I have declined some… bashes. You think like, what am I even going to do? Some cheap alcohol and then… I let it just slide. Must I attend there? I think that because the next morning, I’m going to wake up with a bad hangover. So at least it has helped me reduce. I don’t just go for anything.”

Self-efficacy

“I am confident I’ll be able to stop it. Because I don’t consider it a necessity. It’s not a must I use it. And I like functioning normal…Because you may use [a drug]… and you end up saying stupid things…you end up destroying friendships and relationships with your close people. All because you used alcohol, or you abused something… It goes to the head. Yeah… you’ll just not function normally.” (Male, 21 years).

Recommendations to improve acceptability

“Maybe after some time, you make another session to see the progress of the person. You know, sometimes you end up forgetting or maybe you have told me, you have explained, and I have understood then I get somewhere someone confuses me again, you see, when you give us, a period then call us again we can be like, I almost went back to this issue but at least I have been called and counselled again…. in the session, monitoring someone is nowhere. Especially for those who have been in several substance abuse, you see that this person is really addicted. So, they need several [sessions] for them to at least cut off.” (Male, 22 years).