There is such shortage of substance use (alcohol and drug) research across Africa. In this publication, a large team worked together to assess the prevalence and perceptions of substance abuse and related economic indicators and mental health disorders in a large cohort of Kenyan students in order to integrate public health approaches and clinical management. The findings highlight 4 key areas for interventions: 1. Starting interventions earlier in high schools; 2. Employing public health approach; 3. Increase public awareness and training of school counselors and other personnel; and 4. Enhance and enforce exiting policies restricting availability of cheap alcohol and cigarettes to young people.