Section 4: Healthy settings for young people in Canada – Health risk behaviours
4 Health Risk Behaviours
by Hana Saab and Matthew King
Why are health risk behaviours important?
Youth behaviour often involves taking some type of risk. Some experts regard engagement in risk behaviours as essential to maturation and to the ability of young people to develop meaningful relationships with their peers. Although engaging in health risk behaviours is a natural aspect of development, these behaviours can escalate into larger problems and lead to a risk-taking lifestyle. It is important to monitor trends in youth health risk behaviours to better inform harm reduction strategies and health promotion campaigns.
The four broad categories of risk behaviour examined in the HBSC study include smoking, drinking, substance use, and sexual activity. We asked all Grade 6 to 10 students about the first time they smoked a cigarette and how often they smoke at present. We also asked students about their first time drinking alcohol and getting drunk, types of alcohol consumed, and how often.
A survey with additional questions was administered to Grade 9 and 10 students. It asked questions about the frequency of cannabis use and other substance use, including: ecstasy; amphetamines; methamphetamines (e.g., crystal meth and meth); heroin, opium, or morphine; medical drugs (to get stoned, for example tranquilizers such as Valium and Ketamine and sedatives such as Seconal); cocaine (e.g., crack); glue or solvent sniffing; LSD (e.g., acid); magic mushrooms; Ritalin (to get high); and anabolic steroids (to enhance or improve appearance or athletic performance).
Grade 9 and 10 students were also asked whether they had had sexual intercourse and, if so, at what age. Regarding the last time they had sexual intercourse, students were also asked whether a condom was used and what methods of birth control, if any.
Ecstasy is a recreational drug which has long had a strong association with parts of youth culture. It is a synthetic, psychoactive (mind-altering) drug with hallucinogenic and amphetamine-like effects. Amphetamines and methamphetamines are stimulant drugs that act on the central nervous system, which is the reason why they are often referred to as “speed.” Hallucinogens are a class of drugs that can alter the senses and perceptions of people who use them. Some hallucinogens occur naturally in plants, such as “magic mushrooms,” while other hallucinogens, such as LSD, are prepared in laboratories. The active ingredient, Psilocybin, from magic mushrooms is similar in its effects and chemical structure to LSD. Anabolic steroids are generally popular among boys who use them to boost their physique.
In this chapter, we report on the ages at which students first tried smoking a cigarette (more than a puff), percentage of students who report smoking tobacco daily in 2006 and previous years, the age at which students first consumed alcohol (more than a small amount), percentage of students consuming different kinds of alcoholic drinks weekly compared to previous years, percentage of students who report ever getting “really drunk” at least twice across the survey years, first experimentation with cannabis and frequency of use, and trend information about percentage of students who report using other substances (with the exception of magic mushrooms, which are a new survey item for 2006).
Information on sexual activity includes age of first sexual intercourse, percentage of Grade 9 and 10 students who have had sexual intercourse from the two most recent survey years, condom use, and types of contraception used by young people.
This chapter examines risk behaviour in relation to protective factors that appear to buffer the progression of risk behaviours into problem behaviours later in life. Four risk behaviours – daily smoking, getting drunk at least twice, using cannabis in the past 30 days, and having sexual intercourse – are examined in relation to all seven contextual variables and measures: living with both parents, parent trust and communication, academic achievement, attitude towards school, communication with friends, pro-social attitudes of friends, and family affluence. The role of context is more pronounced for some risk behaviours than others.
Just under one-third of Canadian Grade 9 and 10 students indicate that they have smoked a cigarette (Figure 4.1). Five percent of both boys and girls report first trying smoking when they were aged 11 years or younger, 16% of boys and 18% of girls when they were between 12 and 14 years old, and 6% when they were 15 years of age or older.
The gender differences in daily smoking rates are not significant (Figure 4.2). In Grade 6, only 1% of students smoke daily with the rate reaching a high of 5% in Grade 9 boys and 6% in Grade 10 girls. These findings are corroborated by other studies such as the 2005 Canadian Community Health Survey that report the sharpest decline in smoking to be among young people aged 12 to 17.1
There is an encouraging downward trend in daily smoking for both genders since the last HBSC survey in 2002 (Figures 4.3 and 4.4). In 2006, only 4% of boys report smoking daily, compared to 15% in 2002, and 6% of girls report smoking daily, compared to 11% in 2002.
Alcohol remains popular among Canadian students, such that 70% report trying alcohol by the time they are 16 years old. More Grade 9 and 10 boys (11%) than girls (6%) report trying alcohol for the first time when they were 11 years or younger. Half of students (47% of boys and 53% of girls) report trying alcohol for the first time between the ages of 12 and 14. Eleven percent of boys and 13% of girls report trying alcohol for the first time when they were 15 years or older (Figure 4.5).
The proportion of girls and boys in Grades 6 and 8 who report drinking beer at least once a week has declined over the five Canadian HBSC surveys (Figure 4.6). The proportion of girls in Grade 10 who drink beer at least once a week has dropped steadily from 19% in 1990 to 8% in 2006. Although there was a similar downward trend for Grade 10 boys from 30% to 18% between 1990 and 1998, weekly beer drinking saw a surge in 2002 to drop by 9% in 2006 to 18%.
A different pattern emerges for wine drinking, which is more stable. On average, around 3% of girls report drinking wine at least once a week in Grades 8 and 10 since 1990, with no more than 6% of boys reporting drinking wine at least once a week over the same time period (Figure 4.7).
Drinking liquor and spirits at least once a week appears to be quite low (less than 2%) for students in Grade 6 over the five HBSC surveys (Figure 4.8). The downward trend in liquor and spirit weekly consumption for both boys and girls in Grades 8 and 10 between 1990 and 1998 rose significantly in 2002 to then drop sharply to 4% for both genders in Grade 8, and to an average of 10% for boys and girls in Grade 10 (or to 10% for boys and 9% for girls in Grade 10) in the 2006 cycle.
On the other hand, consumption of coolers by Canadian students might be replacing the traditional alcoholic drinks, given that 6% of boys and 8% of girls in Grade 10 report drinking coolers at least once a week (Figure 4.9). Trend data for this item is not, however, available to support this observation as the item is new for the 2006 survey.
Getting drunk increases steadily by grade, to the point where around two-fifths (39%) of Grade 10 boys and girls report being really drunk at least twice in their lifetime (Figure 4.10). In each of the grades, boys and girls are similar in this regard.
Drunkenness rates were highest in 1990, the first year of the study in Canada (Figure 4.11). For Grades 6 and 8, there is little change over time after 1994. For Grade 10 students, there has been a slight decline from 2002 to 2006 in the percentage of students who report getting “really drunk” twice or more in their lifetime.
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