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BackgroundAdolescence is a vulnerable period for many lifestyle risk behaviors. In this study, we investigated the clustering of risk behaviors and role of the school health promotion programs among adolescents in Vietnam. MethodsWe analyzed data of 7,541 adolescents aged 13-17y from the 2019 nationally representative Global School-based Student Health Survey, conducted in 20 provinces and cities in Vietnam. We applied the latent class analysis to identify groups of clustering and used Bayesian 2-level logistic regressions to evaluate the effects of school health promotion programs on these clusters. We reassessed the school effect size by incorporating different informative priors to the Bayesian models. FindingsThe most frequent lifestyle risk behavior among Vietnamese adolescents was unhealthy diet ([~]67%), followed by sedentary behavior (37% in boys and 48% in girls) and low fruit/vegetable intake ([~]31%). More than half of students had a cluster of at least two risk factors and a quarter with three risk factors. Latent class analysis detected 18% boys and 15% girls being at high-risk of lifestyle behaviors. Consistent through different priors, high quality of health promotion programs associated with lower the odds of lifestyle risk behaviors (highest quality schools vs. lowest quality schools; boys: Odds ratio (OR) = 0{middle dot}69, 95% Highest Density Interval (HDI): 0{middle dot}49 - 0{middle dot}99; girls: OR = 0{middle dot}62, 95% HDI: 0{middle dot}42 - 0{middle dot}92). InterpretationOur findings demonstrated the clustering of specific lifestyle risk behaviors among Vietnamese adolescents, suggesting a special need for required courses in schools and join interventions that target sex-specific multiple risk behaviors. FundingThe 2019 Global School-based Student Health Survey was conducted with financial support from the World Health Organization. The authors received no funding for the data analysis, data interpretation, manuscript writing, authorship, and/or publication of this article. Research in contextO_ST_ABSEvidence before this studyC_ST_ABSAdolescence is a vulnerable period for many lifestyle risk behaviors which normally cluster and interact to exponentially elevate the risks of non-communicable diseases (NCDs). The school might play an essential role in preventing risk behaviors and motivating healthy lifestyle behaviors for in-school adolescents. We searched on PubMed and Google Scholar to identify peer-reviewed articles published in English between Jan 1, 2000 and November 25, 2020; using keywords ("health behaviors" OR "lifestyle risk behaviors "OR "health risk behaviors" OR "tobacco" OR smok* OR "alcohol" OR "physical activity" OR "physical inactivity" OR "fruit intake" OR "vegetable intake" OR "diet") AND (cluster* OR "co-occurrence") AND ("adolescent" OR "teenager" OR "youth" OR "student"). We complemented the searching database with a manual search on reference lists. We identified 39 studies that evaluated the clustering of risk behaviors among adolescents (Supplemental materials S1). Two-thirds of the studies were conducted in high-income countries. The evidence from low- and middle-income countries is currently limited in some countries; however, most of these studies used descriptive techniques to analyze the co-occurring behaviors, i.e., treating the effects of risk behaviors equally or computing the observed prevalence-to-expected prevalence ratio, which hardly evaluates the underlying association among these co-occurrences. Furthermore, no studies have focused on the role of school health promotion programs in preventing the high-risk cluster of these behaviors. Added value of this studyOur study is a pioneer in using analytical technique to investigate the clustering pattern of six major lifestyle risk behaviors of NCDs (smoking, drinking, physical inactivity, sedentary behavior, low fruit/vegetable intake, and unhealthy diet) among school-going adolescents in Vietnam. We found more than half of adolescents had a cluster of at least two factors and a quarter had three factors, with the common clusters being unhealthy diet, sedentary behaviors, low fruit/vegetable intake (in girls), and drinking (in boys). Using latent class analysis, we identified 18{middle dot}1% of boys and 14{middle dot}7% of girls were at high-risk pattern of lifestyle behaviors. Consistent across scenarios, Bayesian multilevel models showed that the quality of school health promotion programs was associated with minimizing the high-risk cluster of lifestyle behaviors. Implications of all available evidenceOur findings highlight the need for required courses in school with high-quality content for essential joint knowledge and skills to prevent multiple lifestyle risk behaviors. This becomes urgent as the current curriculum is not required in Vietnam, therefore, although the high prevalence of students completed a module for preventing an individual risk behavior; a limited number of them achieved three such modules. We also emphasize separated intervention for boys and girls since the patterns of lifestyle risk behaviors combination are different by sexes.

Youth suicide is a leading cause of death among adolescents, but evidence about the influences of parental involvement on adolescent suicidal behaviors is inconsistent and have not been well studied. We used nationally representative data from the Vietnam Global School-based Student Health Survey (GSHS) 2019 (n = 7796 students aged 13–18 years). Using the 2-level random intercept logistic regressions, we evaluated the relationship between parental involvement (high expectation, monitoring, and understanding) and suicidal ideation and identified related factors of suicidal ideation. The overall prevalence of suicidal ideation was 15.6%. While high level of parental monitoring and understanding were associated with lower odds of suicidal ideation among adolescents (OR: 0.63; 95% CI: 0.52–0.77 and OR: 0.60; 95% CI: 0.49–0.73, respectively), high parental expectation was linked to higher odds of suicidal ideation (OR: 1.42; 95% CI: 1.24–1.63). Other risk factors at the individual- and school-level for suicidal ideation included being girls, living in urban areas, having mental health problems, involving in risk behaviors, suffering from bullying and violence, and poor school quality. Targeted suicide prevention initiatives should take into account comprehensive aspects of parent-child bonding, student, and school factors to mitigate the burden of suicidal behaviors among adolescents.

Background: Adolescence is a vulnerable period for many lifestyle risk behaviors. In this study, we investigated the clustering of risk behaviors and role of the school health promotion programs among adolescents in Vietnam. Methods: We analyzed data of 7,541 adolescents aged 13–17y from the 2019 nationally representative Global School-based Student Health Survey, conducted in 20 provinces and cities in Vietnam. We applied the latent class analysis to identify groups of clustering and used Bayesian 2-level logistic regressions to evaluate the effects of school health promotion programs on these clusters. We reassessed the school effect size by incorporating different informative priors to the Bayesian models. Findings: The most frequent lifestyle risk behavior among Vietnamese adolescents was unhealthy diet (~67%), followed by sedentary behavior (37% in boys and 48% in girls) and low fruit/vegetable intake (~31%). More than half of students had a cluster of at least two risk factors and a quarter with three risk factors. Latent class analysis detected 18% boys and 15% girls being at high-risk of lifestyle behaviors. Consistent through different priors, high quality of health promotion programs associated with lower the odds of lifestyle risk behaviors (highest quality schools vs. lowest quality schools; boys: Odds ratio (OR) = 0·69, 95% Highest Density Interval (HDI): 0·49 – 0·99; girls: OR = 0·62, 95% HDI: 0·42 – 0·92). Interpretation: Our findings demonstrated the clustering of specific lifestyle risk behaviors among Vietnamese adolescents, suggesting a special need for required courses in schools and join interventions that target sex-specific multiple risk behaviors. Funding Information: The 2019 Global School-based Student Health Survey was conducted with financial support from the World Health Organization. The authors received no funding for the data analysis, data interpretation, manuscript writing, authorship, and/or publication of this article. Declaration of Interests: The authors declare that they have no conflict of interest. Ethics Approval Statement: Written informed consent was obtained from all participants’ parents/guardians before the study. All procedures performed in this study followed the ethical standards of the Institution Review Board of Hanoi University of Public Health (IRB decision No. 421/2019/YTCC-HD3, dated: 06/08/2019).

Introduction: Vietnam is among the countries with the highest smoking prevalence among male adults, as well as high prevalence of secondhand smoke exposure at indoor places. In many countries, including Vietnam, exposure to tobacco smoking is greatest in restaurants/bars and hotels. This study aims to analyze the compliance of hotels and restaurants to smoke-free environment regulations before and after an intervention. Methods: Direct observations were done at the receptions, conference rooms, designated smoking areas, restaurants, and lobbies of 140 hotels and the dining rooms, kitchens, and toilets of 160 restaurants before and after an intervention. The intervention was a training course conducted by police officers followed by 3 monthly supervision visits by police officers. Compliance with smoke-free enviornment regulations was observed and assessed to generate a compliance score for each location and overall. Tobit regression was used to examine the relationship between compliance scores and the intervention and other variables such as hotel and restaurant characteristics. Results: Before the intervention, the highest compliance rates were found for “no tobacco advertisement” and “no cigarette selling” regulations (95%-100%) in almost all sites in hotels and restaurants. The lowest compliance rates were found for “having nonsmoking signs.” The rate of compliance with all regulations was only 5% for hotels and 0.06% of restaurants. Improvement after intervention was clearly observed, in the rate of compliance with all regulations by more hotels (15.7%) and overall compliance scores of hotels and restaurants. Conclusions: The intervention with participation of the police officers proved to be effective in improving compliance with smoke-free regulations. It is recommended to continue this intervention in the same areas as well as to expand the intervention to other areas.

Objectives This paper explores changes in the level of secondhand smoke (SHS) exposure at indoor workplaces between 2010 and 2015 in Viet Nam and the association between the exposure and various demographic factors, using data from Viet Nam's Global Adult Tobacco Surveys (GATS) 2010 and 2015. Methods Data was pooled from the two GATS surveys and analysed using descriptive and Poisson regression analyses. Results There was a highly statistically significant reduction in the level of SHS exposure at indoor workplaces from 55.9% to 42.6% (p.

We report the prevalence of tobacco smoking among adult populations in Vietnam, 2015. The Vietnam GATS 2015 was a nationally representative survey. 9513 households were selected using two-stage random systematic sampling method. Handheld computers were used for capturing data. Data collection was carried-out by National Statistics Office of Vietnam in 2015. Weight was used in all estimates. The Vietnam GATS 2015 found that the prevalence of smoking in Vietnam was 22.5% overall, 45.3% among men, and 1.1% among women. The overall 2015–2010 reduction in prevalence of any tobacco product was 5.3%. However, the reduction was not statistically significant. The significant reduction in prevalence of tobacco smoking was found for any type of cigarette (−8.4%), and especially for hand-rolled cigarettes (−38.3%). The use of cigarettes significantly decreased in urban areas (−14.7%). The reduction in the prevalence of tobacco smoking in Vietnam during the last 5 years (2010–2015) has not been as high as expected, especially in rural areas. Further efforts are needed to continue to reduce the harms caused by tobacco smoking.

Second-hand tobacco smoke (SHS) exposure at home, especially among children, is a serious issue in Viet Nam. During the past decade, much effort has been taken for tobacco control in the country, including various prgorammes aiming to reduce SHS exposure among adults and children. This article analysed trends and factors associated with SHS exposure at home among school children aged 13-15 in Viet Nam, using the Global Youth Tobacco Surveys conducted in 2007 and 2014. Descriptive and inferential statistical methods with logistic regression were applied. Overall, there was a significant reduction in the level of exposure, from 58.5% (95%CI: 57.6-59.3) in 2007 to 47.1% (95%CI: 45.4-48.8) in 2014. Of the associated factors, having one or both parents smoking was significantly associated with the highest odds of SHS exposure at home (OR=5.0; 95%CI: 4.2-6.1). Conversely, having a mother with a college or higher education level was found to be a protective factor (OR=0.5; 95%CI: 0.3-0.8).

Viet Nam is a country with the highest rate of adult male smokers in the world. In 2010, the percentage of adult male smokers was 47.4%. Each year in Viet Nam, there are 40,000 lives lost from tobacco-related diseases. The Global Tobacco Youth Survey is an international standardized survey that has been conducted in more than 140 countries. To provide evidence for tobacco control, Viet Nam already conducted two rounds of GYTS in 2003 and 2007. The GYTS in 2014 is the survey's third iteration. This paper aims to document key methodological details and socio-demographic characteristics of the respondents included in the 2014 GYTS in Viet Nam. This survey followed international protocol and was conducted in 13 provinces representative of 6 geographical regions. A total of 3,430 school children, aged 13 to 15 years used a standardized answer sheet to answer 76 questions about seven tobacco-related topics, including prevalence of tobacco use, environmental tobacco smoke, access and availability, media and advertisement, cessation, knowledge and attitudes, tobaccorelated school curriculum. This GYTS provides valid and reliable data for monitoring tobacco use among youth in Vietnam and is recommended to be regularly repeated.

The aim of this paper is to report the rate of current and ever cigarette smoking and explore correlates of current cigarette smoking among adolescents aged 13-15 in Viet Nam. This analysis was derived from GYTS survey, which comprised of 3,430 adolescents aged 13-15, conducted in 2014 in 13 cities and provinces of Viet Nam. We calculated the weighted rates of current and ever cigarette smoking and reported patterns of smoking behavior. We also performed logistic regression to explore correlates of current cigarette smoking behavior. The weighted rate of ever cigarette smoking was 9.5% (95% confidence interval (CI): 8.5 %-10.5%), in which the weighted rate among males (15.4%; 95% CI: 13.6%-17.0%) was higher than that among females (4.2%; 95% CI: 3.3%-5.1%). The weighted rate of current cigarette smoking was relatively low at 2.5% (95%CI: 2.0%- 3.0%) with higher weighted rate among males (4.9%; 95% CI: 3.8%-5.9%) compared to the corresponding figure among females (0.2%; 95% CI: 0.0 %-0.5%). Current cigarette smoking was significantly higher among males than females, in students aged 15 versus 13 years old, and in students who had several or all close friends smoking and students with daily observation of smoking at school. For greater smoking reduction outcomes, we recommend that tobacco interventions for adolescents should consider targeting more male students at older ages, establish stricter adherence to school-based banning of cigarette smoking, engage both smoking and nonsmoking adolescents and empower adolescents to resist peer smoking influence as well as changing their norms or beliefs towards smoking benefits.

Efforts to reduce tobacco use among school children need to be based on understanding of access to cigarettes by these subjects because previous studies indicated that enforcement of laws for controlling tobacco sales seems to not affect teen/school children because they can obtain cigarettes from different sources. This paper aims to describe access to and availability of cigarettes among school students (aged 13-15 years old) according to the data from GYTS Vietnam 2014. In GYTS, a national school-based survey of students of grades 8-10, our findings showed that about 15% school children are current smokers who smoke at home, and that they could easily buy cigarettes from stores (63.2%), or someone else (27.8%), or street vendors (9%). Notably, over 85% of school children answered that they were not refused because of their age. This high percentage was nearly the same in the North (85.7%), the Centre (92.5%), and the South (89.7%) of Viet Nam. These findings show that it is quite easy for school children to obtain cigarettes and this is a crucial challenge for policy makers aiming to reduce tobacco use among youth in general and school-age students in particular.

Scientific evidence on all aspects of smoking amongst youth is very important for designing appropriate interventions to reduce smoking among this vulnerable population. This paper describes current access to antismoking information among school children aged 13 to 15 years in Vietnam in 2014 and examines its potential impact on preventing smoking initiation. The data used in this paper were obtained from the 2014 Global Youth Tobacco Survey (GYTS) in Vietnam. Students were asked questions about their level of awareness of anti-smoking information from various sources in the past 30 days and about lessons in school regarding the dangers of tobacco use during the last 12 months. Those who have never smoked were asked "whether or not they thought about avoiding cigarettes because of health warnings on cigarette packages" and answers were analyzed in combination with data on access to anti-smoking information from other sources. The prevalence of exposure to antismoking campaigns was high among school children in Viet Nam: 55.3% of current smokers reported thoughts of smoking cessation because of health warnings on cigarette packages; 60.5% of never smokers avoided initiating smoking because of the same health warnings. The potential impact of graphic health warnings to prevent school-aged children from smoking initiation would be stronger if there was concurrent access to anti-smoking programs on the dangers of tobacco use in schools. However, school education for tobacco prevention and control has not been as strong as expected. A more comprehensive school curriculum on tobacco prevention and control is recommended to reinforce antismoking messages among school children.

Studies have shown that smoking is a learnt behavior, often initiated during adolescence. This paper aims to describe tobacco-related knowledge, attitude and associations among school adolescents aged 13-15 with exposure to anti-smoking information. Using data from the Global Youth Tobacco Survey (GYTS) in Viet Nam, 2014, knowledge was measured through 4 questions about tobacco use, and attitude was assessed through 3 questions on personal, social and environmental aspects. Students giving most anti-tobacco responses to all questions were considered as having correct knowledge or appropriate attitude or both. Access to anti-smoking information was determined by exposure to any media messages on tobacco control during the past 30 days and teaching in school about the danger of tobacco use during the past 12 months. A substantial percentage of students thought that being near others who smoke might be harmful to them and smoking is harmful to health (89.4% and 89.6% respectively). However, only 46.4% reported that it is definitely difficult to quit smoking and 66.9% thought that smoking for only 1 or 2 years, once stopped, is harmful to health. Slightly more than half of the respondents reported appropriate attitude that young smokers have fewer friends than others and smoking makes them less attractive and less comfortable at social events. Noticing anti-smoking messages in the media together with having lessons in school about the dangers of tobacco substantially increased the likelihood of having correct knowledge, appropriate attitude and both. Despite relatively high awareness about smoking harms, effective educational communication is still highly needed to improve the level of comprehensive knowledge and an appropriate attitude regarding tobacco use.

Evidence shows that tobacco advertising and promotion activities may increase tobacco consumption and usage, especially in youth. Despite the regulation on prohibiting advertisement of any tobacco product, tobacco advertisement and promotion activities are still common in Vietnam. This article presents current exposure to tobacco advertising and promotion (TAP) among school children aged 13 to 15 years in Vietnam in 2014 and potential influencing factors. Data from the Global Youth Tobacco Survey 2014 in Vietnam covering 3,430 school aged children were used. Both descriptive and analytical statistics were carried out with Stata 13 statistical software. Binary logistic regression was applied to explain the exposure to TAP among youth and examine relationships with individual factors. A significance level of p

The paper describes the pattern of exposure to second-hand smoke (SHS) at home among the adult population of Vietnam and examines associated socio-demographic factors. A total of 11,142 households were selected for this survey using a two-phase sampling design analogous with three-stage stratified cluster sampling. The dependent variable was the status of exposure to SHS at home. Independent variables included gender, age, occupation, asset-based wealth quintile, ethnicity, marital status, residence. Logistic regression modelling was performed to examine the association with relevant factors of patterns of exposure to second-hand smoke among non-smokers. Of adults aged 15 years and above (representing approximately 47 million people) 73.1% reported they were exposed to SHS at home at least monthly. Considering non-smokers only, the prevalence of exposure to SHS at home was 67.6% (equivalent to approximately 33 million non-smokers). The significant correlates of the status of exposure to SHS at home among non-smokers were female gender, ethnic minority, low education, and lack of smoking restriction at home. The study showed that a high percentage of people are exposed to second-hand smoke at home. Disadvantaged people were more likely than the better-off to be exposed to SHS at home.

Background: Even though the number of research on tobacco in Vietnam has recently increased rapidly, there remains a lack of reporting on the pattern of quit smoking and its correlates. It is necessary to have scientific evidence on this issue to help the policy makers and the Public Health sector to have appropriate intervention program to enhance the smoke cessation smoke program and improve the health status of the smokers. This study aims to: (1) Describe the pattern of smoking cessation in Vietnam 2010. (2) Examine the association between smoking cessation with some associated factors in Vietnam 2010. Methods: Data used in this paper were obtained from the Global Adult Tobacco Survey (GATS) conducted in Vietnam in 2010. A total of 11,142 households were selected for this survey using a two-phase sampling design analogous to a three-stage stratified cluster sampling. Both descriptive and analytical statistical analyses were carried out. Multivariate logistic regression modeling was performed to examine the association between the patterns of quit daily; quit smoke; attempt to quit and intend to quit among smokers with relevant factors. Results: The prevalence of the different type of cessation among male and female were 23.3% and 28.6% for quit daily; 19.1% and 1.0% for quit; 55.6% and 44.4% for attempt to quit and 29.6% and 19.3% for intend to quit respectively. The prevalence of quit daily and quit increased with age whereas attempt to quit decreased with age. Prevalence of cessation was highest among the group who were asked about smoking tobacco by health care providers. Some determinants of quit daily and quit include age, area, and knowledge of illnesses caused by smoking. There was no association between attempt and intend to quit with any socio-characteristic except for area. People in rural area were 2.1 and 1.7 times more likely attempt to quit and intend to quit than those in urban area, respectively. Conclusion: The GATS Vietnam 2010 showed that the prevalence of cessation in Vietnam was low. Quit daily and quit had association with age, area, knowledge about the top three consequences of smoke. People in rural area were 2.1 and 1.7 times more likely attempt to quit and intend to quit than those in urban area, respectively.

Introduction The prevalence of waterpipe tobacco smoking is increasing globally and is associated with adverse outcomes requiring tobacco control interventions. We estimated the prevalence of waterpipe tobacco use among adult populations in Vietnam in 2010 and examined its association with sociodemographic factors. Methods We used data from the Global Adult Tobacco Survey (GATS) conducted in Vietnam in 2010. GATS surveyed a national representative sample of adults aged 15 years or older from 11,142 households by using a 2-phase sampling design analogous to a 3-stage stratified cluster sampling. Descriptive statistical analyses and multivariate logistic regression modeling were conducted. Results A total of 6.4% of Vietnamese aged 15 years or older (representing about 4.1 million adult waterpipe smokers) reported current waterpipe tobacco smoking. The prevalence of waterpipe tobacco smoking was significantly higher among men than women (13% vs 0.1%). Area of residence (rural or urban), age group, asset-based wealth quintile, and geographic region of residence were significantly associated with waterpipe tobacco smoking among men. The significant correlates of current waterpipe tobacco smoking among men were lower education levels, being middle-aged (45–54 years), lower asset-based wealth levels, living in rural areas, not living in the South East and the Mekong River Delta geographic regions, and the belief that smoking does not causes diseases. Conclusion Rural dwellers who are poor should be targeted in tobacco control programs. Further studies are needed that examine perceptions of the adverse health effects and the cultural factors of waterpipe tobacco smoking.

Background: Although substantial efforts have been made to curtail smoking in Vietnam, the 2010 Global Adult Tobacco Survey (GATS) revealed that the proportion of male adults currently smoking remains high at 47.4%. Objectives: To determine the level of, and characteristics associated with, knowledge of the health consequences of smoking among Vietnamese adults. Design: GATS 2010 was designed to survey a nationally representative sample of Vietnamese men and women aged 15 and older drawn from 11,142 households using a two-stage sampling design. Descriptive statistics were calculated and multivariate logistic regression was used to examine associations between postulated exposure factors (age, education, access to information, ethnic group etc.) and knowledge on health risks. Results: General knowledge on the health risks of active smoking (AS) and exposure to second hand smoke (SHS) was good (90% and 83%, respectively). However, knowledge on specific diseases related to tobacco smoking (stroke, heart attack, and lung cancer) appeared to be lower (51.5%). Non-smokers had a significantly higher likelihood of demonstrating better knowledge on health risks related to AS (OR 1.6) and SHS (OR 1.7) than smokers. Adults with secondary education, college education or above also had significantly higher levels knowledge of AS/SHS health risks than those with primary education (AS: ORs 1.6, 1.7, and 1.9, respectively, and SHS: ORs 2.4, 3.9, and 5.7 respectively). Increasing age was positively associated with knowledge of the health consequences of SHS, and access to information was significantly associated with knowledge of AS/ SHS health risks (ORs 2.3 and 1.9 respectively). Otherwise, non-Kinh ethnic groups had significantly less knowledge on health risks of AS/SHS than Kinh ethnic groups. Conclusions: It may be necessary to target tobacco prevention programs to specific subgroups including current smokers, adults with low education, non-Kinh ethnics in order to increase their knowledge on health risks of smoking. Comprehensive messages and/or images about specific diseases related to AS/SHS should be conveyed using of different channels and modes specific to local cultures to increase knowledge on smoking health consequences for general population. Keywords: knowledge; smoking; health consequences; global adult tobacco survey; Vietnam (Published: 31 January 2013) Citation: Glob Health Action 2013, 6 : 18707 - http://dx.doi.org/10.3402/gha.v6i0.18707 This paper is part of the thematic cluster Public health in Vietnam: here's the data, where's the action? - more papers from this cluster can be found here .

This paper aims to estimate the prevalence of cigarette smoking among students in Vietnam ages 13-15 and examines its relationship with compositional and contextual factors. The data used in this paper were obtained from the 2007 Global Youth Tobacco Survey conducted in nine provinces in Vietnam. A multilevel logistic regression model was applied to analyse the association between the current incidence of cigarette smoking and factors on both the individual and school level. The prevalence of cigarette smoking among students was 3.3% overall. The prevalence of smoking among male students (5.9%) was higher than that among females (1.2%). Parental smoking was a significant risk factor for smoking among the students. Having a friend who smoked was the strongest predictor of smoking status among the study subjects. We have demonstrated that school-level factors appeared to impact the prevalence of cigarette smoking among students ages 13-15. This paper highlights the importance of utilising an extensive range of actions to prevent students from using tobacco in Vietnam. These actions should include providing specific curricula for students that address both individual characteristics and the school environment. Further, prevention programmes should also target both parental- and peer-smoking issues.

Background: Alcohol abuse, together with tobacco use, is a major determinant of health and social well-being, and is one of the most important of 26 risk factors comparatively assessed in low and middle income countries, surpassed only by high blood pressure and tobacco. Objectives: The alcohol consumption patterns and the associations between consumption of alcohol and socio-demographic and cultural factors have been investigated in nine rural Health and Demographic Surveillance System (HDSS) located in five Asian countries. Methods: The information was collected from multiple study sites, with sample sizes of sufficient size to measure trends in age and sex groups over time. Adopting the WHO STEPwise approach to Surveillance (WHO STEPS), stratified random sampling (in each 10-year interval) from the HDSS sampling frame was undertaken. Information regarding alcohol consumption and demographic indicators were collected using the WHO STEPwise standard surveillance form. The data from the nine HDSS sites were merged and analysed using STATA software version 10. Results: Alcohol was rarely consumed in five of the HDSS (four in Bangladesh, and one in Indonesia). In the two HDSS in Vietnam (Chililab, Filabavi) and one in Thailand (Kanchanaburi), alcohol consumption was common in men. The mean number of drinks per day during the last seven days, and prevalence of at-risk drinker were found to be highest in Filabavi. The prevalence of female alcohol consumption was much smaller in comparison with men. In Chililab, people who did not go to school or did not complete primary education were more likely to drink in comparison to people who graduated from high school or university. Conclusions: Although uncommon in some countries because of religious and cultural practices, alcohol consumption patterns in some sites were cause for concern. In addition, qualitative studies may be necessary to understand the factors influencing alcohol consumption levels between the two sites in Vietnam and the site in Thailand in order to design appropriate interventions.Keywords: alcohol consumption; risk factor surveillance; INDEPTH; Asia; WHO STEPS(Published: 28 September 2009)Citation: Global Health Action Supplement 1, 2009. DOI: 10.3402/gha.v2i0.2017