Korea Youth Risk Behavior Survey: achievements in the last 20 years and future directions

The Korea Youth Risk Behavior Survey (KYRBS) has been conducted annually by the Korea Disease Control and Prevention Agency (KDCA) since 2005 to monitor trends in health behaviors among Korean adolescents, with the 20th survey completed in 2024.Each year, approximately 60,000 middle and high school students participate in an anonymous, selfadministered, web-based survey comprising approximately 110 health behavior items.Over the past 20 years, school-and student-level participation rates averaged 99.8% and 94.9%, respectively, with a cumulative total of 1,304,561 participants.The prevalence of current cigarette smoking decreased from 11.8% (male, 14.3%; female, 8.9%) in 2005 to 3.6% (male, 4.8%; female, 2.4%) in 2024, and the prevalence of current drinking decreased from 27.0% (male, 27.0%; female, 26.9%) to 9.7% (male, 11.8%; female, 7.5%).In contrast, the prevalence of skipping breakfast increased from 27.1% (male, 26.4%; female, 28.0%) to 42.4% (male, 40.2%; female, 44.7%), whereas the prevalence of depressive symptoms showed little overall change (29.9% [male, 25.6%; female, 34.7%] in 2005 and 27.7% [male, 23.1%; female, 32.5%] in 2024).Survey data are released within the same year of collection and have been used as key evidence for the development and evaluation of adolescent health policies, including the Master Plans for Student Health Promotion and the National Health Plan in Korea.The KYRBS will continue to develop new survey items reflecting emerging health issues, expand the target population to include children, and regularly produce regional-level adolescent health statistics, thereby maintaining its role as a key national health surveillance system.