Multilevel analysis of health risk behaviour in Czech teenagers
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The health risk behaviour (HRB) of teenagers, especially substance abuse, is one of the most serious problems of today's public health arena. The aim of this paper is to assess the extent of the multiple health-risk behaviours within the teenage population and to analyses the role of the individual and family structure as well as educational and geographic factors in the combination of their risk behaviours (frequency of smoking, alcohol intoxication and lifetime cannabis use). The data for this paper come from an on-line survey among elementary school students in 19 selected schools in Prague and 18 other elementary schools throughout Czechia. Family composition and relationship with the adolescent's mother were confirmed as significant variables associated with risk behaviours. Adolescents coming from two-parental families had significantly lower prevalence rate of all three HRB than students living with only one parent or in zero-parent families. Respondents who declared the highest satisfaction with the relationship with their mother had the lowest prevalence of all there HRB characteristics. Regarding leisure time activities, going out with friends clearly increased the risk of HRB, and having specific hobbies, reduced the risk of HRB's. The strongest association revealed was the one between the co-occurrence of health risk behaviours and going out with friends. Significant associations with the aggregate municipality characteristics were confirmed only in the case of marijuana use. It is thus mainly the family and peer domain where the prevention and health policies have to focus.