Relationship between health literacy in substance use and alcohol consumption and tobacco use among adolescents, Northeast Thailand

Health literacy (HL) is an important role‑play in health risk behaviors such as alcohol drinking and smoking. Inadequate HL in substance use (HLSU) is a barrier to reduce the risk of alcohol and tobacco use. This study aims to investigate the association of HLSU with alcohol consumption and tobacco use among Thai adolescents. Hence, the strengthening of HL program intervention may applied to reduce substance abuse among Thai adolescents.

This was a cross‑sectional study conducted on 1087 university students studying in three universities located in northeastern area with multistage sampling methods by geographical areas. The data were collected by self‑administered questionnaire. Multiple logistic regression was applied to determine the effect of HLSU of alcohol consumption and tobacco use.

Most adolescents were drinkers (60.7%) and about 20.7% were smokers. Approximately 40% of them reported as inadequate HLSU. Adolescents with inadequate HLSU and a high level of positive alcohol expectancies and smoking outcome expectancies (SOE) were more likely to drink alcohol and smoke. Conversely, those who had a high level of negative alcohol drinking and SOE were less likely to consume alcohol and tobacco.

Adolescents’ alcohol consumption and tobacco use were influenced by HL, hence improving adolescents’ HLSU could help prevent or reduce the risk of drinking and smoking behaviors.