Association of the COVID-19 lockdown with health risk behaviors in South Korean adolescents

Since there is no certainty about when the coronavirus disease 2019 (COVID-19) lockdown will be affected by health risk behaviors, so we investigate the effect of COVID-19-related health risk behavior changes using school-based self-reported data from a nationally representative South Korean adolescent population. We analyzed web-based self-reported data from the Korea Youth Risk Behavior Web-based Survey in 111,878 participants (57,069 in COVID-19 prepandemic); 54,809 in during the COVID-19 pandemic. This study included 12 to 18-year-olds. Self-report questionnaires were used to assess socioeconomic status, health risk behaviors, and psychological factors. Health risk behaviors such as alcohol consumption, substance use, and sexual experience significantly decreased in COVID-19 pandemic than in COVID-19 prepandemic. Psychosomatic changes such as stress levels, violence experience, depression, suicidal ideation, suicidal plans, and suicide attempts were significantly lower in COVID-19 pandemic compared to COVID-19 prepandemic ( P < .001). After adjusting for multiple confounding variables, less alcohol consumption (odds ratio OR = 0.98; 95% confidence interval CI = 0.88–0.93), less exercise (OR = 0.92; 95% CI = 0.89–0.94), less sexual experience (OR = 0.82; 95% CI = 0.77–0.86), less violence experience (OR = 0.61; 95% CI = 0.55–0.67), less stress (OR = 0.86; 95% CI = 0.84–0.88), less depression (OR = 0.85; 95% CI = 0.83–0.88), less suicidal ideation (OR = 0.93; 95% CI = 0.89–0.97), plans (OR = 0.82; 95% CI = 0.76–0.88), attempts (OR = 0.78; 95% CI = 0.71–0.85) were significantly associated with the COVID-19 pandemic compared to COVID-19 prepandemic. The COVID-19 pandemic was associated with changes in health risk behaviors among Korean adolescents, resulting in alcohol drinking, sexual experience, drug use, violence experience, and suicidal behaviors (idea, plan, and attempts) being decreased during the lockdown period.