{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T15:42:01Z","timestamp":1782488521918,"version":"3.54.5"},"reference-count":62,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2020,5,24]],"date-time":"2020-05-24T00:00:00Z","timestamp":1590278400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009061","name":"Thai Health Promotion Foundation","doi-asserted-by":"publisher","award":["NA"],"award-info":[{"award-number":["NA"]}],"id":[{"id":"10.13039\/501100009061","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>This study aimed to identify the prevalence of health-risk behaviours (alcohol use, tobacco smoking and gambling) and the associations between health-risk behaviours and injuries among youth (15\u201324 years) and young adults (25\u201339 years). A multi-stage cluster sampling survey was conducted in Chiang Mai, Thailand. The associations between health-risk behaviours and injuries were analysed using logistic regression and adjusted for potential confounders. Sample weights were applied in all analyses. Six-hundred-and-thirty participants were included. Fifty-three percent of males and 12.3% of females drank in the past three months. Smoking in the past three months was higher among males (38.5%) than females (0.7%). About a quarter of men and a fifth of the women had gambled in the past year. A total of 6.4% of males and 4.8% of females sought medical attention in the past year due to injuries. Compared to those without any of the three health-risk behaviours, the odds ratio for injuries requiring medical attention was 3.81 (95% CI: 1.33 to 10.90, p = 0.013) for those with two health-risk behaviours and 13.8 (95% CI: 4.24 to 45.10, p &lt; 0.001) for those with all three health-risk behaviours. Injury prevention policies may need to incorporate interventions designed to assess multiple health-risk behaviours.<\/jats:p>","DOI":"10.3390\/ijerph17103696","type":"journal-article","created":{"date-parts":[[2020,5,25]],"date-time":"2020-05-25T06:43:40Z","timestamp":1590389020000},"page":"3696","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Health-Risk Behaviours and Injuries among Youth and Young Adults in Chiang Mai, Thailand: A Population-Based Survey"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9537-8510","authenticated-orcid":false,"given":"Apichai","family":"Wattanapisit","sequence":"first","affiliation":[{"name":"School of Medicine, Walailak University, Nakhon Si Thammarat 80161, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wichuda","family":"Jiraporncharoen","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9068-3834","authenticated-orcid":false,"given":"Kanokporn","family":"Pinyopornpanish","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Surin","family":"Jiraniramai","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kanittha","family":"Thaikla","sequence":"additional","affiliation":[{"name":"Research Institute for Health Sciences, Chiang Mai University, Chiang Mai 50200, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4206-9164","authenticated-orcid":false,"given":"Chaisiri","family":"Angkurawaranon","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,5,24]]},"reference":[{"key":"ref_1","unstructured":"GBD 2017 Causes of Death Collaborators (2018). Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980\u20132017: A systematic analysis for the Global Burden of Disease Study 2017. Lancet, 392, 1736\u20131788."},{"key":"ref_2","unstructured":"GBD 2017 Disease and Injury Incidence and Prevalence Collaborators (2018). Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990\u20132017: A systematic analysis for the Global Burden of Disease Study 2017. Lancet, 392, 1789\u20131858."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/j.puhe.2011.09.027","article-title":"Risk factors for injury in a national cohort of 87,134 Thai adults","volume":"126","author":"Yiengprugsawan","year":"2012","journal-title":"Public Health"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1186\/1478-7954-9-2","article-title":"The national burden of road traffic injuries in Thailand","volume":"9","author":"Ditsuwan","year":"2011","journal-title":"Popul. Health Metr."},{"key":"ref_5","first-page":"S274","article-title":"Road traffic injuries in Thailand: Current situation","volume":"95","author":"Chadbunchachai","year":"2012","journal-title":"J. Med. Assoc. Thai."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e004668","DOI":"10.1136\/bmjopen-2013-004668","article-title":"Predictors of injury mortality: Findings from a large national cohort in Thailand","volume":"4","author":"Yiengprugsawan","year":"2014","journal-title":"BMJ Open"},{"key":"ref_7","first-page":"863918","article-title":"Factors associated with violent behavior among adolescents in northeastern Brazil","volume":"2014","author":"Soares","year":"2014","journal-title":"Sci. World J."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"786","DOI":"10.1001\/archpedi.156.8.786","article-title":"Multiple risk behavior and injury: An international analysis of young people","volume":"156","author":"Pickett","year":"2002","journal-title":"Arch. Pediatr. Adolesc. Med."},{"key":"ref_9","first-page":"1","article-title":"Youth Risk Behavior Surveillance\u2014United States, 2017","volume":"67","author":"Kann","year":"2018","journal-title":"Morb. Mortal. Wkly. Report Surveill. Summ."},{"key":"ref_10","first-page":"287","article-title":"Alcohol intake and risk of injury","volume":"74","author":"Cremonte","year":"2014","journal-title":"Medicina"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1016\/j.drugalcdep.2010.02.011","article-title":"The more you drink, the harder you fall: A systematic review and meta-analysis of how acute alcohol consumption and injury or collision risk increase together","volume":"110","author":"Taylor","year":"2010","journal-title":"Drug Alcohol Depend."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"184","DOI":"10.4068\/cmj.2018.54.3.184","article-title":"Association between Smoking and Unintentional Injuries among Korean Adults","volume":"54","author":"Choi","year":"2018","journal-title":"Chonnam Med. J."},{"key":"ref_13","first-page":"711","article-title":"Alcohol-related aggression-social and neurobiological factors","volume":"110","author":"Beck","year":"2013","journal-title":"Dtsch. Arztebl. Int."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1346","DOI":"10.1111\/j.1530-0277.2010.01218.x","article-title":"Acute alcohol effects on inhibitory control and implicit cognition: Implications for loss of control over drinking","volume":"34","author":"Field","year":"2010","journal-title":"Alcohol. Clin. Exp. Res."},{"key":"ref_15","first-page":"135","article-title":"The risks associated with alcohol use and alcoholism","volume":"34","author":"Rehm","year":"2011","journal-title":"Alcohol Res. Health"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1080\/15389588.2017.1419342","article-title":"Is there a link between motor vehicle collisions and being a cigarette smoker in Canada? Analysis of survey data from Ontario from 2002 to 2014","volume":"19","author":"Vingilis","year":"2018","journal-title":"Traffic Inj. Prev."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1016\/j.pmedr.2018.12.013","article-title":"The relationship between motor vehicle collisions and cigarette smoking in Ontario: Analysis of CAMH survey data from 2002 to 2016","volume":"13","author":"Pederson","year":"2019","journal-title":"Prev. Med. Rep."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1006\/pmed.1994.1070","article-title":"Smoking and injuries: An overview","volume":"23","author":"Sacks","year":"1994","journal-title":"Prev. Med."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Latvala, T., Lintonen, T., and Konu, A. (2019). Public health effects of gambling\u2014Debate on a conceptual model. BMC Public Health, 19.","DOI":"10.1186\/s12889-019-7391-z"},{"key":"ref_20","unstructured":"Abbott, M., Bellringer, M., Garrett, N., and Mundy-McPherson, S. (2014). New Zealand 2012 National Gambling Study: Gambling Harm and Problem Gambling, Auckland University of Technology."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"2196","DOI":"10.1111\/add.13522","article-title":"Gambling and violence in a nationally representative sample of UK men","volume":"111","author":"Roberts","year":"2016","journal-title":"Addiction"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1556\/JBA.2.2013.009","article-title":"Serious physical fighting and gambling-related attitudes and behaviors in adolescents","volume":"2","author":"Slavin","year":"2013","journal-title":"J. Behav. Addict."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"508","DOI":"10.1556\/2006.8.2019.42","article-title":"Weapon-carrying is associated with more permissive gambling attitudes and perceptions and at-risk\/problem gambling in adolescents","volume":"8","author":"Zhai","year":"2019","journal-title":"J. Behav. Addict."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1177\/1524838014561269","article-title":"Problem gambling and intimate partner violence: A systematic review and meta-analysis","volume":"17","author":"Dowling","year":"2016","journal-title":"Trauma Violence Abuse"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1556\/2006.5.2016.066","article-title":"Gambling disorders, gambling type preferences, and psychiatric comorbidity among the Thai general population: Results of the 2013 National Mental Health Survey","volume":"5","author":"Assanangkornchai","year":"2016","journal-title":"J. Behav. Addict."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1016\/j.jadohealth.2016.03.016","article-title":"Research priorities for eight areas of adolescent health in low- and middle-income countries","volume":"59","author":"Nagata","year":"2016","journal-title":"J. Adolesc. Health"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"010501","DOI":"10.7189\/jogh.08.010501","article-title":"Research priorities for adolescent health in low- and middle-income countries: A mixed-methods synthesis of two separate exercises","volume":"8","author":"Nagata","year":"2018","journal-title":"J. Glob. Health"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Assanangkornchai, S., Saingam, D., Jitpiboon, W., and Geater, A.F. (2020). Comparison of drinking prevalence among Thai youth before and after implementation of the Alcoholic Beverage Control Act. Am. J. Drug Alcohol Abuse, 1\u20138.","DOI":"10.1080\/00952990.2019.1692213"},{"key":"ref_29","first-page":"429","article-title":"Smoking trends among Thailand\u2019syouths from 1996-2015: An age-period-cohort analysis of national health surveys","volume":"48","author":"Intarut","year":"2019","journal-title":"Iran J. Public Health"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1177\/1010539514548759","article-title":"Health risk behavior among Thai youth: National survey 2013","volume":"27","author":"Sirirassamee","year":"2014","journal-title":"Asia Pac. J. Public Health"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Angkurawaranon, C., Pateekhum, C., and Thaikla, K. (2020). Probability sampling in population-based behavioral health surveys: Lessons from Thailand. SAGE Research Methods Cases, SAGE.","DOI":"10.4135\/9781529735536"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Pinyopornpanish, K., Thanamee, S., Jiraporncharoen, W., Thaikla, K., McDonald, J., Aramrattana, A., and Angkurawaranon, C. (2017). Sexual health, risky sexual behavior and condom use among adolescents young adults and older adults in Chiang Mai, Thailand: Findings from a population based survey. BMC Res. Notes, 10.","DOI":"10.1186\/s13104-017-3055-1"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1186\/s13690-017-0210-z","article-title":"A population-based survey on physical inactivity and leisure time physical activity among adults in Chiang Mai, Thailand, 2014","volume":"75","author":"Thanamee","year":"2017","journal-title":"Arch. Public Health"},{"key":"ref_34","unstructured":"World Health Organization (2010). The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST): Manual for use in Primary Care, World Health Organization."},{"key":"ref_35","unstructured":"Aekplakorn, W., Nitiyanant, W., Sornpaisarn, B., and Khananuraksa, P. (2020, March 30). Bureau of Non Communicble Disease Ministry of Public Health. Thai National Health Examination Survey, NHES V. Available online: http:\/\/kb.hsri.or.th\/dspace\/handle\/11228\/4604?locale-attribute=th."},{"key":"ref_36","unstructured":"Babor, T.F., Higgins-Biddle, J.C., Saunders, J.B., and Monteiro, M.G. (2001). AUDIT The Alcohol Use Disorders Identification Test Guidelines for Use in Primary Care, World Health Organization. [2nd ed.]."},{"key":"ref_37","unstructured":"Center for Gambling Studies (2020, March 29). Stituations, Behaviours, and Impacts of Gambling in Thailand, 2013: A Study in Higher Education Institutions [in Thai]. Available online: http:\/\/www.gamblingstudy-th.org\/imgadmins\/research_file\/2556-Monrudee-surveystudent.pdf."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"763","DOI":"10.1016\/j.joca.2016.01.008","article-title":"Multiple P-values and Bonferroni correction","volume":"24","author":"Ranstam","year":"2016","journal-title":"Osteoarthr. Cartil."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"902","DOI":"10.1136\/jech.2005.038117","article-title":"Adult outcomes of binge drinking in adolescence: Findings from a UK national birth cohort","volume":"61","author":"Viner","year":"2007","journal-title":"J. Epidemiol. Community Health"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1016\/j.cpr.2009.06.003","article-title":"Gender differences in factors influencing alcohol use and drinking progression among adolescents","volume":"29","author":"Schulte","year":"2009","journal-title":"Clin. Psychol. Rev."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"e011827","DOI":"10.1136\/bmjopen-2016-011827","article-title":"Birth cohort trends in the global epidemiology of alcohol use and alcohol-related harms in men and women: Systematic review and metaregression","volume":"6","author":"Slade","year":"2016","journal-title":"BMJ Open"},{"key":"ref_42","unstructured":"World Health Organization (2018). Global Status Report on Alcohol and Health 2018, World Health Organization."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"e005663","DOI":"10.1136\/bmjopen-2014-005663","article-title":"Do smoking habits differ between women and men in contemporary Western populations? Evidence from half a million people in the UK Biobank study","volume":"4","author":"Peters","year":"2014","journal-title":"BMJ Open"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1016\/j.amepre.2014.06.013","article-title":"Gender differences in smoking among U.S. working adults","volume":"47","author":"Syamlal","year":"2014","journal-title":"Am. J. Prev. Med."},{"key":"ref_45","unstructured":"World Health Organization (2017). WHO Report on the Global Tobacco Epidemic, 2017: Monitoring Tobacco use and Prevention Policies, World Health Organization."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"e022129","DOI":"10.1136\/bmjopen-2018-022129","article-title":"Trends in gambling participation and gambling severity among Finnish men and women: Cross-sectional population surveys in 2007, 2010 and 2015","volume":"8","author":"Heiskanen","year":"2018","journal-title":"BMJ Open"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1007\/s10899-012-9305-1","article-title":"Examining gender differences for gambling engagement and gambling problems among emerging adults","volume":"29","author":"Wong","year":"2013","journal-title":"J. Gambl. Stud."},{"key":"ref_48","unstructured":"World Health Organization (2014). Injuries and Violence: The facts, World Health Organization."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1016\/j.ypmed.2014.08.007","article-title":"The status of men\u2019s health in Asia","volume":"67","author":"Ng","year":"2014","journal-title":"Prev. Med."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1016\/j.socscimed.2003.11.024","article-title":"Gender and physical violence","volume":"59","author":"Steen","year":"2004","journal-title":"Soc. Sci. Med."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"2368","DOI":"10.2105\/AJPH.2011.300275","article-title":"Vulnerability of female drivers involved in motor vehicle crashes: An analysis of US population at risk","volume":"101","author":"Bose","year":"2011","journal-title":"Am. J. Public Health"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1001\/archpedi.160.1.74","article-title":"Longitudinal trends in race\/ethnic disparities in leading health indicators from adolescence to young adulthood","volume":"160","author":"Harris","year":"2006","journal-title":"Arch. Pediatr. Adolesc. Med."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1016\/j.gaceta.2014.02.017","article-title":"Heavy drinking and alcohol-related injuries in college students","volume":"28","author":"Doallo","year":"2014","journal-title":"Gac. Sanit."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1080\/17437199.2014.941722","article-title":"Theories of behaviour and behaviour change across the social and behavioural sciences: A scoping review","volume":"9","author":"Davis","year":"2015","journal-title":"Health Psychol. Rev."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1007\/s10899-007-9077-1","article-title":"Problem gambling and intimate partner violence","volume":"24","author":"Korman","year":"2008","journal-title":"J. Gambl. Stud."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1080\/09602011.2010.519613","article-title":"Self-reported traumatic brain injury in male young offenders: A risk factor for re-offending, poor mental health and violence?","volume":"20","author":"Williams","year":"2010","journal-title":"Neuropsychol. Rehabil."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1829","DOI":"10.1016\/j.paid.2007.06.002","article-title":"Functional and dysfunctional impulsivity in pathological gambling","volume":"43","author":"Maccallum","year":"2007","journal-title":"Pers. Individ. Dif."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1186\/s12889-016-3120-z","article-title":"The correlates and course of multiple health risk behaviour in adolescence","volume":"16","author":"Hale","year":"2016","journal-title":"BMC Public Health"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1146\/annurev.publhealth.012809.103616","article-title":"A review of unintentional injuries in adolescents","volume":"31","author":"Sleet","year":"2010","journal-title":"Annu. Rev. Public Health"},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"Sanci, L., Grabsch, B., Chondros, P., Shiell, A., Pirkis, J., Sawyer, S., Hegarty, K., Patterson, E., Cahill, H., and Ozer, E. (2012). The prevention access and risk taking in young people (PARTY) project protocol: A cluster randomised controlled trial of health risk screening and motivational interviewing for young people presenting to general practice. BMC Public Health, 12.","DOI":"10.1186\/1471-2458-12-400"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1002\/dev.20442","article-title":"Adolescent risk taking, impulsivity, and brain development: Implications for prevention","volume":"52","author":"Romer","year":"2010","journal-title":"Dev. Psychobiol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1186\/s40621-020-0233-8","article-title":"Adolescents\u2019 engagement in multiple risk behaviours is associated with concussion","volume":"7","author":"Shore","year":"2020","journal-title":"Inj. Epidemiol."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/17\/10\/3696\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T09:31:58Z","timestamp":1760175118000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/17\/10\/3696"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,5,24]]},"references-count":62,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2020,5]]}},"alternative-id":["ijerph17103696"],"URL":"https:\/\/doi.org\/10.3390\/ijerph17103696","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,5,24]]}}}