Document Type : Original Article


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


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.


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