College of Social Sciences, University of Glasgow, Glasgow, UK.
Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK.
J Prev Med Public Health. 2024 May;57(3):288-297. doi: 10.3961/jpmph.24.052. Epub 2024 May 9.
This study explored the prevalence and predictors of alcohol and cannabis co-use among 9263 Filipino adolescents, using data from the 2019 Global School-based Student Health Survey (GSHS).
We conducted a cross-sectional secondary analysis of the GSHS, targeting adolescents aged 13-17 years and excluding cases with incomplete data on alcohol and cannabis use. Our analysis employed the bivariate chi-square test of independence and multivariable logistic regression using Stata version 18 to identify significant predictors of co-use, with a p-value threshold set at 0.05.
The weighted prevalence of co-users was 4.2% (95% confidence interval [CI], 3.4 to 5.3). Significant predictors included male sex (adjusted odds ratio [aOR], 4.50; 95% CI, 3.31 to 6.10; p<0.001) and being in a lower academic year, specifically grade 7 (aOR, 4.08; 95% CI, 2.39 to 6.99; p<0.001) and grade 8 (aOR, 2.20; 95% CI, 1.30 to 3.72; p=0.003). Poor sleep quality was also a significant predictor (aOR, 1.77; 95% CI, 1.29 to 2.44; p<0.001), as was a history of attempted suicide (aOR, 5.31; 95% CI, 4.00 to 7.06; p<0.001). Physical inactivity was associated with lower odds of co-use (aOR, 0.45; 95% CI, 0.33 to 0.62; p<0.001). Additionally, non-attendance of physical education classes (aOR, 1.48; 95% CI, 1.06 to 2.05; p=0.021), infrequent unapproved parental checks (aOR, 1.37; 95% CI, 1.04 to 1.80; p=0.024), and lower parental awareness of free-time activities (aOR, 0.63; 95% CI, 0.45 to 0.87; p=0.005) were associated with higher odds of co-use. Factors not significantly linked to co-use included age group, being in grade 9, always feeling lonely, having no close friends, being bullied outside school, and whether a parent or guardian understood the adolescent's worries.
The findings highlight the critical need for comprehensive interventions in the Philippines, addressing not only physical inactivity and parental monitoring but also focusing on sex, academic grade, participation in physical education classes, sleep quality, and suicide attempt history, to effectively reduce alcohol and cannabis co-use among adolescents.
本研究利用 2019 年全球学校学生健康调查（GSHS）的数据，探讨了 9263 名菲律宾青少年中酒精和大麻共使用者的流行率和预测因素。
我们对 GSHS 进行了横断面二次分析，针对年龄在 13-17 岁的青少年，排除了酒精和大麻使用数据不完整的病例。我们的分析采用了独立双变量卡方检验和 Stata 版本 18 中的多变量逻辑回归，以确定共使用者的显著预测因素，p 值阈值设为 0.05。
共使用者的加权流行率为 4.2%（95%置信区间[CI]，3.4 至 5.3）。显著的预测因素包括男性（调整后的优势比[aOR]，4.50；95%CI，3.31 至 6.10；p<0.001）和较低的学业年级，具体为 7 年级（aOR，4.08；95%CI，2.39 至 6.99；p<0.001）和 8 年级（aOR，2.20；95%CI，1.30 至 3.72；p=0.003）。睡眠质量差也是一个显著的预测因素（aOR，1.77；95%CI，1.29 至 2.44；p<0.001），自杀未遂史也是如此（aOR，5.31；95%CI，4.00 至 7.06；p<0.001）。身体活动不足与共使用者的几率较低相关（aOR，0.45；95%CI，0.33 至 0.62；p<0.001）。此外，不上体育课（aOR，1.48；95%CI，1.06 至 2.05；p=0.021）、父母很少未经许可检查（aOR，1.37；95%CI，1.04 至 1.80；p=0.024）以及父母对青少年闲暇活动的认识较低（aOR，0.63；95%CI，0.45 至 0.87；p=0.005）与共使用者的几率较高有关。与共使用者无关的因素包括年龄组、9 年级、总是感到孤独、没有亲密朋友、在校外被欺负以及父母或监护人是否了解青少年的担忧。
研究结果强调了菲律宾迫切需要全面干预措施，不仅要解决身体活动不足和父母监督问题，还要关注性别、学业成绩、参加体育课、睡眠质量和自杀未遂史，以有效减少青少年的酒精和大麻共使用者。
