ArticleEuropean journal of public health2022
The role of health literacy in the association between academic performance and substance use.
Article in European journal of public health, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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Who cites it
17 citing papers in PubMed.
- Systematic Review of Health Literacy and Health Behavior in Adolescents Research.Epidemiologia (Basel, Switzerland) · 2026Review
- Exploring the factors associated with health literacy among adolescents in Hong Kong.Scientific reports · 2026Article
- Global Trends in Adolescent Health Inequalities and Their Social Determinants: A Bibliometric and Scoping Review.Healthcare (Basel, Switzerland) · 2026Review
- Health literacy and health behaviors among college students in underdeveloped regions of China: a cross-sectional study in Yunnan Province.Frontiers in public health · 2026Article
- Exploring adolescents' ability to appraise health information: validation of the self-report short-form Critical Health Literacy Questionnaire.Frontiers in public health · 2026Article
- The relationship between proactive health literacy and lifestyle behaviors among residents in a region of China.Frontiers in public health · 2026Article
- Mediating role of health literacy in self-care among female college students with menstrual symptoms: a cross-sectional study.Nagoya journal of medical science · 2025Article
- Effectiveness of an Interactive Digital Intervention Program on Knowledge, Health Literacy, and Learner Engagement in Senior High School Students: Intragroup and Intergroup Comparison of 2 Teaching Models.Journal of medical Internet research · 2025Article
- Mapping the Landscape: A Scoping Review of Evaluated Substance Use Harm Reduction Programs for Youth.Journal of drug education · 2025Article
- A Biopsychosocial and Environmental Perspective of Youth Health Literacy in Portugal.Children (Basel, Switzerland) · 2025Article
- Health literacy disparities in Thai university students: exploring differences between health science and non-health science disciplines.BMC public health · 2025Article
- Exploring the Association Between Adolescents' Health Literacy and Health Behavior by Using the Short Health Literacy (HLSHealthcare (Basel, Switzerland) · 2024Article
- A cross-sectional assessment of the influence of information sources about substance use in adolescents' tobacco prevalence.Heliyon · 2024Article
- Comparison of the Predictors of Smoking Cessation Plans between Adolescent Conventional Cigarette Smokers and E-Cigarette Smokers Using the Transtheoretical Model.Children (Basel, Switzerland) · 2024Article
- Factors associated with the use of cannabis for self-medication by adults: data from the French TEMPO cohort study.Journal of cannabis research · 2024Article
- The development and cross-national validation of the short health literacy for school-aged children (HLSAC-5) instrument.Scientific reports · 2023Article
- A Mediation Model for Biculturalism and Cigarette and Betel Nut Use: The Case of Adolescents in Guam.Asian American journal of psychology · 2023Article
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8 authors.
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Abstract
backgroundTo address social inequalities in adolescent substance use and consequent disparities in health, it is important to identify the mechanisms of the association between substance use and academic performance. We study the role of health literacy (HL) in the association between academic performance and weekly smoking, monthly alcohol use and cannabis ever-use among adolescents in Europe.
methodsSILNE-R school survey data, which was collected in 2016-17 with paper-and-pencil-method from Hanover (GE), Amersfoort (NL) and Tampere (FI), were used (N = 5088, age 13-19). Health Literacy for School-aged Children instrument was used to assess students' HL. Logistic regression analyzed the association of substance use with academic performance and HL, separately and in the same model. Linear and multinomial logistic regression analyzed the association between academic performance and HL.
resultsPoor academic performance compared with high was associated with smoking [odds ratio (OR) 3.94, 95% confidence interval (CI) 2.83-5.49], alcohol use (OR: 2.94, 95% CI: 2.34-3.68) and cannabis use (OR: 2.56, 95% CI: 1.89-3.48). Poor HL was also associated with each substance use (with ORs of 2.32, 1.85 and 1.29). HL was positively associated with academic performance (β = 1.04, 95% CI: 0.89-1.20). The associations between academic performance and substance use were only slightly attenuated after controlling for HL.
conclusionsAcademic performance and HL were both determinants of substance use, confirming their role in tackling the disparities in substance use. However, HL did not demonstrably mediate the association between academic performance and substance use. A wider set of factors needs to be tackled to address emerging social inequalities in adolescent substance use.
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