National trends in alcohol and substance use among adolescents from 2005 to 2021: a Korean serial cross-sectional study of one million adolescents

Park, Sangil; Yon, Hyunju; Ban, Chae Yeon; Shin, Hyoin; Eum, Seounghyun; Lee, Seung Won; Shin, Youn Ho; Shin, Jung U; Koyanagi, Ai; Jacob, Louis; Smith, Lee S.; Min, Chanyang; Yeniova, Abdullah Özgür; Kim, So Young; Lee, Jinseok; Hadalin, Vlasta; Kwon, Rosie; Koo, Min Ji; Fond, Guillaume; Boyer, Laurent; Kim, Sunyoung; Hahn, Jong Woo; Kim, Namwoo; Lefkir, Eléa; Bondeville, Victoire; Rhee, Sang Youl; Shin, Jae Il; Yon, Dong Keon; Woo, Ho Geol

doi:10.1007/s12519-023-00715-9

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National trends in alcohol and substance use among adolescents from 2005 to 2021: a Korean serial cross-sectional study of one million adolescents

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Author(s): Sangil Park ¹ , Hyunju Yon ² , Chae Yeon Ban ² , Hyoin Shin ² , Seounghyun Eum ² , Seung Won Lee ³ , Youn Ho Shin ⁴ , Jung U. Shin ⁵ ^, ²⁵ , Ai Koyanagi ⁶ ^, ⁷ , Louis Jacob ⁶ ^, ⁸ , Lee Smith ⁹ , Chanyang Min ¹⁰ , Abdullah Özgür Yeniova ¹¹ , So Young Kim ¹² , Jinseok Lee ¹³ , Vlasta Hadalin ¹⁴ , Rosie Kwon ¹⁰ ^, ¹⁵ , Min Ji Koo ¹⁰ ^, ¹⁶ , Guillaume Fond ¹⁷ ^, ¹⁸ , Laurent Boyer ¹⁷ ^, ¹⁸ , Sunyoung Kim ¹⁹ , Jong Woo Hahn ²⁰ , Namwoo Kim ²¹ , Eléa Lefkir ²² , Victoire Bondeville ² , Sang Youl Rhee ¹⁰ ^, ²³ , Jae Il Shin ²⁴ ^, , Dong Keon Yon ¹⁰ ^, ²⁵ ^, , Ho Geol Woo ¹ ^,

Publication date (Electronic): 29 March 2023

Journal: World Journal of Pediatrics

Publisher: Springer Nature Singapore

Keywords: Alcohol, Adolescent, Corona virus disease 2019, South Korea, Substance use

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Abstract

Background

Although previous studies have provided data on early pandemic periods of alcohol and substance use in adolescents, more adequate studies are needed to predict the trends of alcohol and substance use during recent periods, including the mid-pandemic period. This study investigated the changes in alcohol and substance use, except tobacco use, throughout the pre-, early-, and mid-pandemic periods in adolescents using a nationwide serial cross-sectional survey from South Korea.

Methods

Data on 1,109,776 Korean adolescents aged 13–18 years from 2005 to 2021 were obtained in a survey operated by the Korea Disease Control and Prevention Agency. We evaluated adolescents’ alcohol and substance consumption prevalence and compared the slope of alcohol and substance prevalence before and during the COVID-19 pandemic to see the trend changes. We define the pre-COVID-19 period as consisting of four groups of consecutive years (2005–2008, 2009–2012, 2013–2015, and 2016–2019). The COVID-19 pandemic period is composed of 2020 (early-pandemic era) and 2021 (mid-pandemic era).

Results

More than a million adolescents successfully met the inclusion criteria. The weighted prevalence of current alcohol use was 26.8% [95% confidence interval (CI) 26.4–27.1] from 2005 to 2008 and 10.5% (95% CI 10.1–11.0) in 2020 and 2021. The weighted prevalence of substance use was 1.1% (95% CI 1.1–1.2) from 2005 to 2008 and 0.7% (95% CI 0.6–0.7) between 2020 and 2021. From 2005 to 2021, the overall trend of use of both alcohol and drugs was found to decrease, but the decline has slowed since COVID-19 epidemic (current alcohol use: β _diff 0.167; 95% CI 0.150–0.184; substance use: β ^diff 0.152; 95% CI 0.110–0.194). The changes in the slope of current alcohol and substance use showed a consistent slowdown with regard to sex, grade, residence area, and smoking status from 2005 to 2021.

Conclusion

The overall prevalence of alcohol consumption and substance use among over one million Korean adolescents from the early and mid-stage (2020–2021) of the COVID-19 pandemic showed a slower decline than expected given the increase during the prepandemic period (2005–2019).

Supplementary Information

The online version contains supplementary material available at 10.1007/s12519-023-00715-9.

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Youth Risk Behavior Surveillance — United States, 2017

Laura Kann, Tim McManus, William Harris … (2018)

Problem Health-risk behaviors contribute to the leading causes of morbidity and mortality among youth and adults in the United States. In addition, significant health disparities exist among demographic subgroups of youth defined by sex, race/ethnicity, and grade in school and between sexual minority and nonsexual minority youth. Population-based data on the most important health-related behaviors at the national, state, and local levels can be used to help monitor the effectiveness of public health interventions designed to protect and promote the health of youth at the national, state, and local levels. Reporting Period Covered September 2016–December 2017. Description of the System The Youth Risk Behavior Surveillance System (YRBSS) monitors six categories of priority health-related behaviors among youth and young adults: 1) behaviors that contribute to unintentional injuries and violence; 2) tobacco use; 3) alcohol and other drug use; 4) sexual behaviors related to unintended pregnancy and sexually transmitted infections (STIs), including human immunodeficiency virus (HIV) infection; 5) unhealthy dietary behaviors; and 6) physical inactivity. In addition, YRBSS monitors the prevalence of other health-related behaviors, obesity, and asthma. YRBSS includes a national school-based Youth Risk Behavior Survey (YRBS) conducted by CDC and state and large urban school district school-based YRBSs conducted by state and local education and health agencies. Starting with the 2015 YRBSS cycle, a question to ascertain sexual identity and a question to ascertain sex of sexual contacts were added to the national YRBS questionnaire and to the standard YRBS questionnaire used by the states and large urban school districts as a starting point for their questionnaires. This report summarizes results from the 2017 national YRBS for 121 health-related behaviors and for obesity, overweight, and asthma by demographic subgroups defined by sex, race/ethnicity, and grade in school and by sexual minority status; updates the numbers of sexual minority students nationwide; and describes overall trends in health-related behaviors during 1991–2017. This reports also summarizes results from 39 state and 21 large urban school district surveys with weighted data for the 2017 YRBSS cycle by sex and sexual minority status (where available). Results Results from the 2017 national YRBS indicated that many high school students are engaged in health-risk behaviors associated with the leading causes of death among persons aged 10–24 years in the United States. During the 30 days before the survey, 39.2% of high school students nationwide (among the 62.8% who drove a car or other vehicle during the 30 days before the survey) had texted or e-mailed while driving, 29.8% reported current alcohol use, and 19.8% reported current marijuana use. In addition, 14.0% of students had taken prescription pain medicine without a doctor’s prescription or differently than how a doctor told them to use it one or more times during their life. During the 12 months before the survey, 19.0% had been bullied on school property and 7.4% had attempted suicide. Many high school students are engaged in sexual risk behaviors that relate to unintended pregnancies and STIs, including HIV infection. Nationwide, 39.5% of students had ever had sexual intercourse and 9.7% had had sexual intercourse with four or more persons during their life. Among currently sexually active students, 53.8% reported that either they or their partner had used a condom during their last sexual intercourse. Results from the 2017 national YRBS also indicated many high school students are engaged in behaviors associated with chronic diseases, such as cardiovascular disease, cancer, and diabetes. Nationwide, 8.8% of high school students had smoked cigarettes and 13.2% had used an electronic vapor product on at least 1 day during the 30 days before the survey. Forty-three percent played video or computer games or used a computer for 3 or more hours per day on an average school day for something that was not school work and 15.4% had not been physically active for a total of at least 60 minutes on at least 1 day during the 7 days before the survey. Further, 14.8% had obesity and 15.6% were overweight. The prevalence of most health-related behaviors varies by sex, race/ethnicity, and, particularly, sexual identity and sex of sexual contacts. Specifically, the prevalence of many health-risk behaviors is significantly higher among sexual minority students compared with nonsexual minority students. Nonetheless, analysis of long-term temporal trends indicates that the overall prevalence of most health-risk behaviors has moved in the desired direction. Interpretation Most high school students cope with the transition from childhood through adolescence to adulthood successfully and become healthy and productive adults. However, this report documents that some subgroups of students defined by sex, race/ethnicity, grade in school, and especially sexual minority status have a higher prevalence of many health-risk behaviors that might place them at risk for unnecessary or premature mortality, morbidity, and social problems (e.g., academic failure, poverty, and crime). Public Health Action YRBSS data are used widely to compare the prevalence of health-related behaviors among subpopulations of students; assess trends in health-related behaviors over time; monitor progress toward achieving 21 national health objectives; provide comparable state and large urban school district data; and take public health actions to decrease health-risk behaviors and improve health outcomes among youth. Using this and other reports based on scientifically sound data is important for raising awareness about the prevalence of health-related behaviors among students in grades 9–12, especially sexual minority students, among decision makers, the public, and a wide variety of agencies and organizations that work with youth. These agencies and organizations, including schools and youth-friendly health care providers, can help facilitate access to critically important education, health care, and high-impact, evidence-based interventions.

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What Does Adolescent Substance Use Look Like During the COVID-19 Pandemic? Examining Changes in Frequency, Social Contexts, and Pandemic-Related Predictors

Tara Dumas, Wendy Danto Ellis, Dana M Litt (2020)

Purpose The overarching goal of this study was to provide key information on how adolescents' substance use has changed since the corona virus disease (COVID)-19 pandemic, in addition to key contexts and correlates of substance use during social distancing. Methods Canadian adolescents (n = 1,054, M age = 16.68, standard deviation = .78) completed an online survey, in which they reported on their frequency of alcohol use, binge drinking, cannabis use, and vaping in the 3 weeks before and directly after social distancing practices had taken effect. Results For most substances, the percentage of users decreased; however, the frequency of both alcohol and cannabis use increased. Although the greatest percentage of adolescents was engaging in solitary substance use (49.3%), many were still using substances with peers via technology (31.6%) and, shockingly, even face to face (23.6%). Concerns for how social distancing would affect peer reputation was a significant predictor of face-to-face substance use with friends among adolescents with low self-reported popularity, and a significant predictor of solitary substance use among average and high popularity teens. Finally, adjustment predictors, including depression and fear of the infectivity of COVID-19, predicted using solitary substance use during the pandemic. Conclusions Our results provide preliminary evidence that adolescent substance use, including that which occurs face to face with peers, thereby putting adolescents at risk for contracting COVID-19, may be of particular concern during the pandemic. Further, solitary adolescent substance use during the pandemic, which is associated with poorer mental health and coping, may also be a notable concern worthy of further investigation.

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Depressive symptoms, mental wellbeing, and substance use among adolescents before and during the COVID-19 pandemic in Iceland: a longitudinal, population-based study

Ingibjorg Eva Thorisdottir, Bryndis Asgeirsdottir, Alfgeir Logi Kristjánsson … (2021)

Adolescence represents a crucial developmental period in shaping mental health trajectories. In this study, we investigated the effect of the COVID-19 pandemic on mental health and substance use during this sensitive developmental stage.

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Author and article information

Contributors

Jae Il Shin: SHINJI@yuhs.ac

Dong Keon Yon:

ORCID: http://orcid.org/0000-0003-1628-9948

yonkkang@gmail.com

Ho Geol Woo: nr85plasma@naver.com

Journal

Journal ID (nlm-ta): World J Pediatr

Journal ID (iso-abbrev): World J Pediatr

Title: World Journal of Pediatrics

Publisher: Springer Nature Singapore (Singapore )

ISSN (Print): 1708-8569

ISSN (Electronic): 1867-0687

Publication date (Electronic): 29 March 2023

Pages: 1-11

Affiliations

[1 ]GRID grid.411231.4, ISNI 0000 0001 0357 1464, Department of Neurology, , Kyung Hee University Medical Center, ; 23 Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447 South Korea

[2 ]GRID grid.289247.2, ISNI 0000 0001 2171 7818, Department of Medicine, , Kyung Hee University College of Medicine, ; Seoul, South Korea

[3 ]GRID grid.264381.a, ISNI 0000 0001 2181 989X, Department of Precision Medicine, , Sungkyunkwan University School of Medicine, ; Suwon, South Korea

[4 ]GRID grid.413793.b, ISNI 0000 0004 0624 2588, Department of Pediatrics, , CHA Gangnam Medical Center, CHA University School of Medicine, ; Seoul, South Korea

[5 ]GRID grid.452398.1, ISNI 0000 0004 0570 1076, Department of Dermatology, , CHA Bundang Medical Center, CHA University School of Medicine, ; Seongnam, South Korea

[6 ]GRID grid.469673.9, ISNI 0000 0004 5901 7501, Research and Development Unit, , Parc Sanitari Sant Joan de Deu, CIBERSAM, ISCIII, ; Barcelona, Spain

[7 ]GRID grid.425902.8, ISNI 0000 0000 9601 989X, Catalan Institution for Research and Advanced Studies (ICREA), , Pg. Lluis Companys, ; Barcelona, Spain

[8 ]GRID grid.12832.3a, ISNI 0000 0001 2323 0229, Faculty of Medicine, , University of Versailles Saint-Quentin-en-Yvelines, ; Montigny-le-Bretonneux, France

[9 ]GRID grid.5115.0, ISNI 0000 0001 2299 5510, Centre for Health, Performance and Wellbeing, , Anglia Ruskin University, ; Cambridge, UK

[10 ]GRID grid.411231.4, ISNI 0000 0001 0357 1464, Center for Digital Health, Medical Science Research Institute, , Kyung Hee University Medical Center, Kyung Hee University College of Medicine, ; Seoul, South Korea

[11 ]GRID grid.411550.4, ISNI 0000 0001 0689 906X, Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, , Tokat Gaziosmanpaşa University, ; Tokat, Turkey

[12 ]GRID grid.452398.1, ISNI 0000 0004 0570 1076, Department of Otorhinolaryngology-Head & Neck Surgery, , CHA Bundang Medical Center, CHA University School of Medicine, ; Seongnam, South Korea

[13 ]GRID grid.289247.2, ISNI 0000 0001 2171 7818, Department of Biomedical Engineering, , Kyung Hee University, ; Yongin, South Korea

[14 ]GRID grid.8954.0, ISNI 0000 0001 0721 6013, Faculty of Medicine, , University of Ljubljana, ; Ljubljana, Slovenia

[15 ]GRID grid.214458.e, ISNI 0000000086837370, Department of Biomedical Engineering, , University of Michigan, ; Ann Arbor, MI USA

[16 ]GRID grid.17063.33, ISNI 0000 0001 2157 2938, Department of Human Biology, , University of Toronto, ; Toronto, ON Canada

[17 ]GRID grid.5399.6, ISNI 0000 0001 2176 4817, AP-HM, Aix-Marseille University, CEReSS-Health Service Research and Quality of Life Center, ; Marseille, France

[18 ]FondaMental Foundation, Creteil, France

[19 ]GRID grid.289247.2, ISNI 0000 0001 2171 7818, Department of Family Medicine, , Kyung Hee University College of Medicine, ; Seoul, South Korea

[20 ]GRID grid.412480.b, ISNI 0000 0004 0647 3378, Department of Pediatrics, , Seoul National University Bundang Hospital, ; Seongnam, South Korea

[21 ]GRID grid.412484.f, ISNI 0000 0001 0302 820X, Department of Neuropsychiatry, , Seoul National University Hospital, ; Seoul, South Korea

[22 ]GRID grid.410368.8, ISNI 0000 0001 2191 9284, Faculty of Medicine, , University of Rennes 1, ; Rennes, France

[23 ]GRID grid.289247.2, ISNI 0000 0001 2171 7818, Department of Endocrinology and Metabolism, , Kyung Hee University College of Medicine, ; Seoul, South Korea

[24 ]GRID grid.15444.30, ISNI 0000 0004 0470 5454, Department of Pediatrics, , Yonsei University College of Medicine, ; 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722 South Korea

[25 ]GRID grid.289247.2, ISNI 0000 0001 2171 7818, Department of Pediatrics, , Kyung Hee University College of Medicine, ; 23 Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447 South Korea

Author information

Dong Keon Yon http://orcid.org/0000-0003-1628-9948

Article

Publisher ID: 715

DOI: 10.1007/s12519-023-00715-9

PMC ID: 10049906

PubMed ID: 36977821

SO-VID: 9fafd7cd-e8d4-45d1-94db-c5a3b630bd4e

Copyright © © Children's Hospital, Zhejiang University School of Medicine 2023, Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

License:

This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.

History

Date received : 30 September 2022

Date accepted : 5 March 2023

Funding

Funded by: FundRef http://dx.doi.org/10.13039/501100003710, Korea Health Industry Development Institute;

National trends in alcohol and substance use among adolescents from 2005 to 2021: a Korean serial cross-sectional study of one million adolescents

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Novel Coronavirus Disease COVID-19

Most cited references 38

Youth Risk Behavior Surveillance — United States, 2017

What Does Adolescent Substance Use Look Like During the COVID-19 Pandemic? Examining Changes in Frequency, Social Contexts, and Pandemic-Related Predictors

Depressive symptoms, mental wellbeing, and substance use among adolescents before and during the COVID-19 pandemic in Iceland: a longitudinal, population-based study

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