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Using Multiple Tobacco Products and Binge Drinking among Adolescents during the COVID-19 Pandemic: A Cross-Sectional Study Using the Korea Youth Risk Behavior Survey for 2017–2021
J Korean Soc Res Nicotine Tob 2022; 13(2): 53-63
Published online June 30, 2022
© 2022 The Korean Society for Research on Nicotine and Tobacco.

Jinsol Jung1,2, Heejin Kimm2,3*

1Seoul Sungrye Elementary School, 2Graduate School of Public Health, Yonsei University, 3Institute for Health Promotion, Graduate School of Public Health, Yonsei University, Seoul, Korea
Correspondence to: 김희진
연세대 보건대학원 국민건강증진연구소
E-mail: HEEJINK@yuhs.ac
ORCID: https://orcid.org/0000-0003-4526-0570
Received May 30, 2022; Revised June 26, 2022; Accepted June 26, 2022.
This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, dis-tribution, and reproduction in any medium, provided the original work is properly cited.
 Abstract
Background: Previous studies have reported that adolescent dual users of tobacco products are at a high risk of binge drinking. However, changes in drinking and smoking behaviors during the COVID-19 pandemic, including the use of heated tobacco product (HTP), have remained unknown.
Methods: This study is cross-sectional in nature and uses self-reported survey data from 2017-2021 for individuals aged 13-18 years derived from the Korean Youth Risk Behavior Survey. For analysis, the study included 7,201 binge drinkers and 7,067 nonbinge drinkers. Single, dual, and triple use of tobacco products was defined as the number of products used such as cigarettes, e-cigarettes, and HTP. The study employed logistic regression with a complex sample design to compute for the adjusted odds ratios for binge drinking in 2019 and 2020.
Results: Among the current drinking youth, the total number of uses of tobacco product did not change significantly between 2017 and 2021, and the number of users of single products decreased, whereas multiple usage decreased in 2020 but returned to the level as 2019 or before. The number of dual users of tobacco products increased from 18.6% in 2017 to 23.2% in 2021. Being an exsmoker and a single/dual/triple user was associated with binge drinking in 2019 (Exsmoker aOR: 1.58, 95% CI: 1.30-1.91; Single user aOR: 2.98, 95% CI: 2.36-3.75; Dual user aOR: 2.53, 95% CI: 1.87-3.41; Triple user aOR: 2.66, 95% CI: 1.91-3.71), and the association was also significant in 2020 (Exsmoker aOR: 2.03, 95% CI: 1.64-2.51; Single user aOR: 2.78, 95% CI: 2.15-3.60; Dual user aOR: 3.13, 95% CI: 2.17-4.51; Triple user aOR: 4.02, 95% CI: 2.37-6.81).
Conclusion: Despite the decrease in smoking and drinking among adolescents during the COVID-19 pandemic, the number of dual, triple users of tobacco products among adolescents who engage in drinking has recently increased. Moreover, dual and triple users have displayed high risks of binge drinking. Thus, the study suggests that an integrated preventive approach and research are required to prevent the widening of the health risk behavior gap and multiple substance use among adolescents.
Keywords : Tobacco; Smoking; Alcohol; Binge drinking; Adolescents
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