Specific leisure activities and adolescent substance use: an activity-specific analysis of Czech adolescents

Introduction Leisure activities play an important role in adolescent development, yet associations between specific leisure activities and substance use may vary considerably across activities. This study examined associations between eight specific leisure activities and cigarette smoking, e-cigarette use, alcohol consumption, and drunkenness among Czech adolescents. Methods Data were drawn from the 2022 Czech Health Behaviour in School-aged Children (HBSC) study and included 14,588 adolescents aged 11–15 years. Survey-adjusted multivariable logistic regression models were used to examine associations between the eight leisure activities and four past-30-day substance-use outcomes, adjusting for gender, survey grade, and participation in the other leisure activities. Results Substantial heterogeneity was observed across activities. Regular reading and playing board or card games were consistently associated with lower odds of all four substance-use outcomes, whereas hanging out with friends, visiting shopping centres, and daytime sleeping were consistently associated with higher odds. Associations for playing a musical instrument, creative/craft activities, and relaxing or doing nothing were less consistent across outcomes. Discussion The findings indicate substantial heterogeneity in the associations between specific leisure activities and adolescent substance use. They support further activity-specific investigation of adolescent leisure contexts and suggest that broad leisure categories may obscure potentially important differences between individual activities.