Changes in the socio-demographic patterning of late adolescent health risk behaviours during the 1990s: Analysis of two West of Scotland cohort studies

MRC Social and Public Health Sciences Unit, 4 Lilybank Gardens, Glasgow, G12 8RZ, UK.
BMC Public Health (Impact Factor: 2.26). 10/2011; 11(1):829. DOI: 10.1186/1471-2458-11-829
Source: PubMed


Substance use and sexual risk behaviour affect young people's current and future health and wellbeing in many high-income countries. Our understanding of time-trends in adolescent health-risk behaviour is largely based on routinely collected survey data in school-aged adolescents (aged 15 years or less). Less is known about changes in these behaviours among older adolescents.
We compared two cohorts from the same geographical area (West of Scotland), surveyed in 1990 and 2003, to: describe time-trends in measures of smoking, drinking, illicit drug use, early sexual initiation, number of opposite sex sexual partners and experience of pregnancy at age 18-19 years, both overall and stratified by gender and socioeconomic status (SES); and examine the effect of time-trends on the patterning of behaviours by gender and SES. Our analyses adjust for slight between-cohort age differences since age was positively associated with illicit drug use and pregnancy.
Rates of drinking, illicit drug use, early sexual initiation and experience of greater numbers of sexual partners all increased significantly between 1990 and 2003, especially among females, leading to attenuation and, for early sexual initiation, elimination, of gender differences. Most rates increased to a similar extent regardless of SES. However, rates of current smoking decreased only among those from higher SES groups. In addition, increases in 'cannabis-only' were greater among higher SES groups while use of illicit drugs other than cannabis increased more in lower SES groups.
Marked increases in female substance use and sexual risk behaviours have implications for the long-term health and wellbeing of young women. More effective preventive measures are needed to reduce risk behaviour uptake throughout adolescence and into early adulthood. Public health strategies should reflect both the widespread prevalence of risk behaviour in young people as well as the particular vulnerability to certain risk behaviours among those from lower SES groups.

Download full-text


Available from: Helen Sweeting, Oct 13, 2015
15 Reads
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Article summary Article focus Previous studies have reported clustering of risk behaviours during adolescence. Prior studies have not examined whether changes in risk behaviour rates affects relationships between these risk behaviours. We examined clustering in early and later adolescent risk behaviours to determine if clustering differed at two different time points, by gender and by socioeconomic status, the latter of which has also tended not to be addressed in previous studies. Key messages Despite changes in health risk behaviour rates, relationships between adolescent risk behaviours remain strong. Relationships generally did not vary by gender or social class. There is a need for improved risk behaviour prevention in young people, perhaps through a holistic approach that addresses the broad shared determinants of various risk behaviours. Strengths and limitations of this study We compared cohorts of young people from the same geographic area and life stage, surveyed using (near) identical questions, 13 years apart. To our knowledge, this is the first study to examine time trends in associations between substance use and sexual behaviour. We examined these associations in both early and late adolescence and by gender and social class, the latter of which has not been previously investigated. Although we accounted for loss to follow-up in the 1999/2003 study via weighted analyses, we may not have fully compensated for differential loss to follow-up of adolescents with more ‘risky’ patterns of behaviour. Questions on alcohol intake included a more detailed drinking grid in the 1999/2003 study, which possibly encouraging increased reporting in this later cohort, while use of interviewer-administered questionnaires may have led to under-reporting of behaviours.
    BMJ Open 01/2012; 2(1):e000661. DOI:10.1136/bmjopen-2011-000661 · 2.27 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Preventing smoking initiation among adolescents of lower socio-economic groups is crucial for the reduction of socio-economic inequalities in health. The aim of the present study was to examine whether effective smoking prevention interventions in Europe are equally effective among adolescents of low- and high-socio-economic status (SES). As part of the European Union-funded TEENAGE project, three school-based smoking prevention intervention studies in Europe were selected for secondary analyses: (i) a Dutch class competition intervention, (ii) the European Smoking Prevention Framework (ESFA) study and (iii) the A Stop Smoking in Schools Trial (ASSIST) intervention. All three studies differed in effectiveness by SES. The Dutch class competition study only had a significant effect among higher SES adolescents. The results for the ESFA study and ASSIST study were mixed and depended on which SES indicator was used. The conclusion of the study is that stratified analyses provide important insights in differential intervention effects for higher and lower socio-economic groups. Although findings from the different studies were mixed, interventions that use a social network approach in which youngsters are allowed to deliver the intervention themselves may be a successful strategy in targeting adolescents from lower socio-economic groups.
    Health Education Research 02/2012; 27(3):459-69. DOI:10.1093/her/cys017 · 1.66 Impact Factor
  • Health Education Research 02/2012; · 1.66 Impact Factor
Show more

Similar Publications