Document Type : Original Article

Authors

Department of Orthopedics, Faculty of Medicine, Mahasarakham University, Mahasarakham, Thailand

Abstract

BACKGROUND: Health literacy (HL) is an important role‑play in health risk behaviors such as
alcohol drinking and smoking. Inadequate HL in substance use (HLSU) is a barrier to reduce the
risk of alcohol and tobacco use. This study aims to investigate the association of HLSU with alcohol
consumption and tobacco use among Thai adolescents. Hence, the strengthening of HL program
intervention may applied to reduce substance abuse among Thai adolescents.
MATERIALS AND METHODS: This was a cross‑sectional study conducted on 1087 university
students studying in three universities located in northeastern area with multistage sampling methods
by geographical areas. The data were collected by self‑administered questionnaire. Multiple logistic
regression was applied to determine the effect of HLSU of alcohol consumption and tobacco use.
RESULTS: Most adolescents were drinkers (60.7%) and about 20.7% were smokers. Approximately
40% of them reported as inadequate HLSU. Adolescents with inadequate HLSU and a high level of
positive alcohol expectancies and smoking outcome expectancies (SOE) were more likely to drink
alcohol and smoke. Conversely, those who had a high level of negative alcohol drinking and SOE
were less likely to consume alcohol and tobacco.
CONCLUSION: Adolescents’ alcohol consumption and tobacco use were influenced by HL, hence
improving adolescents’ HLSU could help prevent or reduce the risk of drinking and smoking behaviors.

Keywords

1. Fleary SA, Joseph P, Pappagianopoulos JE. Adolescent health
literacy and health behaviors: A systematic review. J Adolesc 2018;62:116‑27.
2. World Health Organization. Global Status Report on Alcohol
and Health 2018: Executive Summary. Available from: https://
apps.who.int/iris/handle/10665/312318. [Last accessed
on 2019 Nov 23].
3. World Health Organization. WHO Report on the Global Tobacco
Epidemic, 2017 Monitoring Tobacco use and Prevention Policies:
Executive Summary. Available from: https://www.who.int/
tobacco/global_report/2017/executive‑summary/en/. [Last
accessed on 2019 Nov 23].
4. National Statistical Office. Annual Report 2018. Bangkok,
Thailand: National Statistical Office; 2018. p. 62.
5. MuhangaM, Malungo J. The what, why and how of health literacy:
A systematic review of literature. Int J Health 2017;5:107‑14.
6. Stewart DW, Adams CE, Cano MA, Correa‑Fernández V,
Li Y, Waters AJ, et al. Associations between health literacy and
established predictors of smoking cessation. Am J Public Health
2013;103:e43‑9.
7. Rundle‑Thiele S, Siemieniako D, Kubacki KK, Deshpande S.
Benchmarking alcohol literacy: A multi country study. Mod
Manag Rev 2013;18:99‑111.
8. Damari B, Azimi A, Shahrabi NS. Status of substance abuse
literacy in manufacturing and production sites in Iran: Results
from a nationwide survey. Med J Islam Repub Iran 2019;33:7.
9. Panahi R, Niknami S, Ramezankhani A, Tavousi M, Osmani F.
Is there a relationship between low health literacy and smoking?
Health Educ Health Promot 2015;3:43‑52.
10. Rolová G, Barták M, Rogalewicz V, Gavurová B. Health literacy
in people undergoing treatment for alcohol abuse – A pilot study.
Kontakt 2018;20:425‑31.
11. Hoover DS, Wetter DW, Vidrine DJ, Nguyen N, Frank SG, Li Y,
et al. Enhancing smoking risk communications: The influence
of health literacy and message content. Ann Behav Med
2018;52:204‑15.
12. Manganello JA. Health literacy and adolescents: A framework
and agenda for future research. Health Educ Res 2008;23:840‑7.
13. Wang JW, Cao SS, Hu RY. Smoking by family members and
friends and electronic‑cigarette use in adolescence: A systematic
review and meta‑analysis. Tob Induc Dis 2018;16:05.
14. Leshargie CT, Alebel A, Kibret GD, Birhanu MY, Mulugeta H,
Malloy P, et al. The impact of peer pressure on cigarette smoking
among high school and university students in Ethiopia:
A systemic review and meta‑analysis. PLoS One 2019;14:e0222572.
15. Urbán R, Kökönyei G, Demetrovics Z. Alcohol outcome
expectancies and drinking motives mediate the association
between sensation seeking and alcohol use among adolescents.
Addict Behav 2008;33:1344‑52.
16. Urbán R. Smoking outcome expectancies mediate the association
between sensation seeking, peer smoking, and smoking among
young adolescents. Nicotine Tob Res 2010;12:59‑68.
17. Javadzade SH, Sharifirad G, Radjati F, Mostafavi F, Reisi M,
Hasanzade A. Relationship between health literacy, health status,
and healthy behaviors among older adults in Isfahan, Iran. J Educ
Health Promot 2012;1:31.
18. Intarakamhang U, Intarakamhang P. Health literacy scale
and causal model of childhood overweight. J Res Health Sci
2017;17:e00368.
19. Thongnopakun S, Pumpaibool T, Somrongthong R. The
association of sociodemographic characteristics and sexual risk
behaviors with health literacy toward behaviors for preventing
unintended pregnancy among university students. J Multidiscip
Healthc 2018;11:149‑56.
20. Momen K, Kanato M. Developing a substance literacy scale for
Thai population. J Med Assoc Thai 2015;98 Suppl 6:S10‑6.
21. Ham LS, Stewart SH, Norton PJ, Hope DA. Psychometric
assessment of the comprehensive effects of alcohol questionnaire:
Comparing a brief version to the original full scale. J Psychopathol
Behav Assess 2005;27:141‑58.
22. Myers MG, McCarthy DM, MacPherson L, Brown SA.
Constructing a short form of the smoking consequences
questionnaire with adolescents and young adults. Psychol Assess
2003;15:163‑72.
23. Silapakit P, Kittirattanapaiboon P. AUDIT: Alcohol Use Disorders
Identification Test: Guidelines for Use in Primary Care. 2001 (Thai
Version). 2nd ed.. Bangkok, Thailand: Tantawanpaper; 2009.
24. Chisolm DJ, Manganello JA, Kelleher KJ, Marshal MP. Health
literacy, alcohol expectancies, and alcohol use behaviors in teens.
Patient Educ Couns 2014;97:291‑6.
25. Hamzaha SR, Ismail M, Nor ZM. Does attachment to parents and
peers influence health literacy among adolescents in Malaysia?
Kontakt 2018;20:376‑83.
26. Haghdoost AA, Hessari H, Baneshi MR, Rad M, Shahravan A.
The impact of mother’s literacy on child dental caries: Individual
data or aggregate data analysis? J Educ Health Promot 2017;6:5.
27. Brandt L, Schultes MT, Yanagida T, Maier G, Kollmayer M,
Spiel C. Differential associations of health literacy with Austrian
adolescents’ tobacco and alcohol use. Public Health 2019;174:74‑82.
28. Foo YC, Tam CL, Lee TH. Family factors and peer influence in
drug abuse: A study in rehabilitation centre. Int J Collab Res Intern
Med Public Health 2012;4:190‑201.
29. Dermota P, Wang J, Dey M, Gmel G, Studer J, Mohler‑Kuo M.
Health literacy and substance use in young Swiss men. Int J Public
Health 2013;58:939‑48.
30. Chen CY, Storr CL, Liu CY, Chen KH, Chen WJ, Lin KM.
Differential relationships of family drinking with alcohol
expectancy among urban school children. BMC Public Health
2011;11:87.
31. Leonardi‑Bee J, Jere ML, Britton J. Exposure to parental and
sibling smoking and the risk of smoking uptake in childhood
and adolescence: A systematic review and meta‑analysis. Thorax
2011;66:847‑55.
32. Kuther TL. Rational decision perspectives on alcohol consumption
by youth. Revising the theory of planned behavior. Addict Behav
2002;27:35‑47.