Association Between Smoking, Alcohol Consumption, and Dietary Habits in Northern Thai Adolescents in Thailand, 2016 - 2017

Background: Smoking and alcohol consumption have been common among adolescents in recent years, both of which are risk factors of cardiovascular disease. They may be associated with unhealthy dietary habits that can add to cardiovascular risks in adults. Objectives: This study aimed to evaluate the association between smoking status, alcohol consumption, and dietary habits in adolescents. Methods: In this study, 4,372 adolescents (2,223 males and 2,149 females) aged 13 to 18 years were enrolled from randomly selected schools in Northern Thailand. They were asked to complete the Thai Youth Risk Behavior Survey regarding smoking, alcohol use, and dietary habits. Results: The mean age of the participants was 15.4 (1.7) years and 15.0 (1.6) years in males and females, respectively. The prevalence of smokers and alcohol drinkers was 21% and 28.3%, respectively. Among alcohol drinkers, 52.4% were also smokers. Besides, 11% of the participants were current smokers. The proportions of adolescents with healthy dietary habits, defined as drinking 100% fruit juice, drinking milk, fruit/vegetable consumption, and having regular breakfast, were significantly higher in the non-smoking/non-drinking group (P ≤ 0.05 to P ≤ 0.001). Conclusions: Adolescents who were smokers and alcohol drinkers were less likely to have healthy dietary habits. This can affect cardiovascular risks and associated diseases in the future. The proper advice for dietary and lifestyle modification among these high-risk groups may be needed from an early age.