Background to the Research

• The Health Behaviour of School Children survey is a unique cross-national survey conducted in collaboration with the European Region of the World Health Organisation. The study began with three countries in 1982. NI became associated with the study in 1992 with the administration of the 1989/1990 questionnaire to over 3,000 young people. Twenty-six European countries now participate in the survey, as well as the USA and Canada.
• The survey aims to gain new insights into, and increase understanding of, health behaviours and lifestyles and their context in young people's lives. It also aims to influence health promotion policy and practice, and to facilitate the networking of research information and expertise.
  

Research Approach

• The questionnaire survey, conducted in the school setting, comprised three parts: core questions, included in every study; focus questions on particular topics - unique to that year's study; and national questions, which can be added to the survey in individual countries.
• The 1997/1998 survey gathered information on demographic characteristics and behaviour questions relating to areas such as smoking, drinking, psycho-social aspects of health and the school environment. The NI survey (and some others) also asked questions about sexual behaviour and knowledge and experience of drugs.
• The target population for the study is children within 6 months of three ages: 11 years 6 months, 13 years 6 months, and 15 years 6 months.
• The report opens with an overview of the findings from the international study, followed by individual chapters relating to results from NI.
  

Main Findings

Overview of findings from the international study (with emphasis, where stated, on those findings relevant to NI)

• Most students considered themselves happy and healthy, with slightly more boys than girls claiming to feel 'very' or 'quite healthy'.
• In almost half the countries, 10% or more of children live with a step-parent, reflecting the rise in divorce rates and single parent families.
• Young people generally found it easier to talk to their mothers than fathers. Boys in NI also reported difficulties in talking to their mothers.
• Individual perceptions of school were moderately associated with risk factors such as smoking, physical activity and perceived health. However, those who did not feel involved/supported in school were more likely to distance themselves from school and to start smoking.
• Using the 15 year old age group, increased family affluence was consistently associated with positive health behaviours; perceived health, happiness with life and self-confidence; and a greater incidence of daily symptoms of some description and feelings of helplessness were associated with lower family affluence. Greater wealth was associated with subjective happiness and feeling confident.
• Smoking and drinking among 15 year olds were not particularly linked to the family's socioeconomic status, although there was a moderately consistent pattern linking socioeconomic status with physical activity and fruit consumption, both of which confer health benefits.
• Regular exercise was more common among boys, and young people were found to exercise less as they get older. In all age groups, boys and girls in NI are among those who exercise most regularly.
• While NI students rank highly for daily consumption of cooked vegetables and low fat milk, they also consume the highest levels of crisps, sweets and chocolate, and among the highest for chips or fried potatoes, and soft drinks.
• Smoking had increased across all age groups and both genders, in all the participating countries. Drinking and smoking behaviour appear closely linked, with those abstaining from alcohol being more likely never to have smoked. Abstinence levels for girls generally exceed those for boys, although 15 year old boys and girls in NI had almost equal drinking levels. School and peer factors seemed closely related to drinking and smoking behaviours, particularly among older children.
• In all age groups, the incidence of drunkenness in NI, England, Scotland and Wales was consistently high. A rise in the prevalence of binge drinking was apparent in a number of countries, including NI.
• Boys and girls in NI, Scotland and the United States show no real differences in terms of their experience of sexual intercourse. More boys than girls reported the use of condoms, except in NI.
  

Young People and NI

• 41.6% of 6,589 young people admitted to having smoked at least once (average age - 11 for boys; 11.5 for girls). More boys than girls reported having their first cigarette by the age of 10. The majority of those who had smoked got their first cigarette from a friend or someone their own age. 18.5% of the sample currently smoked (more girls than boys). There were dramatic increases in smoking prevalence as young people moved through the school years. Daily smoking was shown to be a concern, particularly for girls.
• Boys were likely to experiment with cigarettes at a younger age, but from year 9 onwards, more girls than boys smoked. The number of boys smoking fell between years 11 and 12, while the corresponding number of girls increased.
• 74% of the survey group, and more boys than girls, had tasted alcohol; 83.3% of boys and 80% of girls by the age of 13. The majority got their first alcoholic drink from a friend, followed by a parent. For both the whole sample and for those who have tasted alcohol, a majority answered that they rarely drink any alcohol now, while a small minority drink alcohol every day.
• Of those who have tasted alcohol, 46.9% (34.3% of the total sample) were noted to drink at least monthly. 34.9% of the total sample could be described as non-drinkers. By year 12 there was no great difference in terms of weekly drinking between girls and boys. The most frequently mentioned drinks were alcopops, beer and lager.
• Among regular drinkers, 31.5% of boys and 23.3% of girls reported being drunk more than 10 times; 20.7% had never been drunk.
• Both sexes most commonly choose 'to celebrate' followed by 'like the taste' as reasons for drinking. More girls than boys cited the reasons 'to be more confident', 'to cheer them up' and 'to escape problems', while more boys than girls 'drank to get drunk'. Most of the reasons given increase with age in relation to regular drinkers, most notably the psycho-social reasons such as 'to be confident or sociable'.
• 1,535 (23%) young people reported having been offered drugs (non-medical), most commonly outdoors and by someone they knew. 33% of the complete sample stated that it would be easy for them to get illegal drugs if they wanted to.
• 787 (12.3%; 13.7% of boys and 10.7% of girls) reported trying drugs at least once. 467 (7.1%) admitted to currently using drugs. Overall, 2.9% could be designated as regular drug users. Of those who had tried drugs, 58.7% had tried them more than once and 24.3% were now regular drug users. The most regular drug users were boys (59.7%) in years 10 - 12 (90%).
• Half of the regular drug users admit to having offered drugs to others, while half also would like to stop their drug use. Drug use caused one third to be depressed and worried, and many reported that their drug use caused them to be in trouble of some sort.
• From those year 9-12 young people who had indicated they had, at some stage, had a boyfriend or girlfriend, 655 (14.9% of age group) reported having experienced sexual intercourse; boys claimed to have more experience and to have become sexually active at an earlier age. 79.2% reported using some form of contraception, with girls more likely to report this. The condom, then a combination of the pill and condom, was most commonly used.
• Two thirds saw obtaining contraception as easy; over one quarter of boys and almost 40% of girls thought it would be difficult. There were no notable differences in where the sexes would obtain contraception.
• More girls than boys liked school (83.8% compared to 69.8%), but the numbers liking school decreased with class year. Boys were less likely than girls and older pupils less likely than younger pupils, to agree that 'our school is a nice place to be'.
• One quarter of all pupils had experienced bullying, but for 60% of these it had occurred only once or twice. Boys were more likely to be bullied than girls, and younger children of both sexes were more likely to report being bullied. 19.8% of the survey group admitted having taken part in bullying others, but only 1.2% admitted to frequently bullying others. Those who had been bullied were more likely to bully others.
• 71.7% of pupils had not played truant in the current term. Boys were more likely than girls to miss school. The number of young people truanting increased through the school years for both sexes.
• 2,824 (42.7%) young people thought they had too much homework to do, but only 23.4% found the work too difficult. A total of 1,830 young people (27.7%) said they felt pressurised because of schoolwork, with the proportion saying this increasing as they get older. Up to year 12, more boys report feeling pressurised. There was a large increase in the number of boys and girls feeling under pressure in Year 12.
• Many of the behaviours considered can jeopardise a young person's health, however, a proportion of young people report a combination of risky behaviours, making them most likely to suffer ill health as a consequence.
• A clear relationship existed between some 'clustering behaviours', allowing a profile of this 'at risk' group to be drawn up. This group was made up of slightly more boys than girls, and the percentage of those 'at risk' increased with age. Other characteristics of the group were: feeling that teachers viewed their performance as below average; not liking and skipping school; feeling under pressure; and experience of bullying. The group was also more than twice as likely to report being very unhappy with their life and to feel that they were very unhealthy; and to come from a poorer socio-economic background.

Conclusions

• The health of our young people is concluded to be a legitimate worry, and risks taken by young people need to be minimised. Interventions and information are necessary for such children. The report ends with a further emphasis on that group of young people exposed to multiple risks, and the importance of giving them particular attention.