This is a community-based data, case-control study conducted in five communities (three urban, two peri-urban) in Bo District, Southern Province, Sierra Leone, investigating the determinants of Kush (synthetic cannabinoid) use among youths aged 15–35 years. A total of 214 households were enrolled 107 case households with a current or recent Kush-using youth, and 107 neighbourhood-matched control households without a known Kush user. Using a structured, pilot-tested questionnaire, the study examined four domains of risk: household socio-demographic characteristics, socioeconomic status, family structure and parental presence, and psychosocial/environmental factors (peer influence, trauma, mental health, school engagement, and neighbourhood drug availability).