National trends in alcohol and substance use among adolescents from 2005 to 2021: a Korean serial cross-sectional study of one million adolescents

Sangil Park; Hyunju Yon; Chae Yeon Ban; Hyoin Shin; Seounghyun Eum; Seung Won Lee; Youn Ho Shin; Jung U Shin; Ai Koyanagi; Louis Jacob; Lee Smith; Chanyang Min; Abdullah Özgür Yeniova; So Young Kim; Jinseok Lee; Vlasta Hadalin; Rosie Kwon; Min Ji Koo; Guillaume Fond; Laurent Boyer; Sunyoung Kim; Jong Woo Hahn; Namwoo Kim; Eléa Lefkir; Victoire Bondeville; Sang Youl Rhee; Jae Il Shin; Dong Keon Yon; Ho Geol Woo

doi:10.1007/s12519-023-00715-9

National trends in alcohol and substance use among adolescents from 2005 to 2021: a Korean serial cross-sectional study of one million adolescents

World J Pediatr. 2023 Nov;19(11):1071-1081. doi: 10.1007/s12519-023-00715-9. Epub 2023 Mar 29.

Authors

Sangil Park¹, Hyunju Yon², Chae Yeon Ban², Hyoin Shin², Seounghyun Eum², Seung Won Lee³, Youn Ho Shin⁴, Jung U Shin^{5

6}, Ai Koyanagi^{7

8}, Louis Jacob^{7

9}, Lee Smith¹⁰, Chanyang Min¹¹, Abdullah Özgür Yeniova¹², So Young Kim¹³, Jinseok Lee¹⁴, Vlasta Hadalin¹⁵, Rosie Kwon^{11

16}, Min Ji Koo^{11

17}, Guillaume Fond^{18

19}, Laurent Boyer^{18

19}, Sunyoung Kim²⁰, Jong Woo Hahn²¹, Namwoo Kim²², Eléa Lefkir²³, Victoire Bondeville², Sang Youl Rhee^{11

24}, Jae Il Shin²⁵, Dong Keon Yon^{26

27}, Ho Geol Woo²⁸

Affiliations

¹ Department of Neurology, Kyung Hee University Medical Center, 23 Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, South Korea.
² Department of Medicine, Kyung Hee University College of Medicine, Seoul, South Korea.
³ Department of Precision Medicine, Sungkyunkwan University School of Medicine, Suwon, South Korea.
⁴ Department of Pediatrics, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, South Korea.
⁵ Department of Dermatology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, South Korea.
⁶ Department of Pediatrics, Kyung Hee University College of Medicine, 23 Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, South Korea.
⁷ Research and Development Unit, Parc Sanitari Sant Joan de Deu, CIBERSAM, ISCIII, Barcelona, Spain.
⁸ Catalan Institution for Research and Advanced Studies (ICREA), Pg. Lluis Companys, Barcelona, Spain.
⁹ Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France.
¹⁰ Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK.
¹¹ Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea.
¹² Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, Tokat Gaziosmanpaşa University, Tokat, Turkey.
¹³ Department of Otorhinolaryngology-Head & Neck Surgery, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, South Korea.
¹⁴ Department of Biomedical Engineering, Kyung Hee University, Yongin, South Korea.
¹⁵ Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
¹⁶ Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA.
¹⁷ Department of Human Biology, University of Toronto, Toronto, ON, Canada.
¹⁸ AP-HM, Aix-Marseille University, CEReSS-Health Service Research and Quality of Life Center, Marseille, France.
¹⁹ FondaMental Foundation, Creteil, France.
²⁰ Department of Family Medicine, Kyung Hee University College of Medicine, Seoul, South Korea.
²¹ Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, South Korea.
²² Department of Neuropsychiatry, Seoul National University Hospital, Seoul, South Korea.
²³ Faculty of Medicine, University of Rennes 1, Rennes, France.
²⁴ Department of Endocrinology and Metabolism, Kyung Hee University College of Medicine, Seoul, South Korea.
²⁵ Department of Pediatrics, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea. SHINJI@yuhs.ac.
²⁶ Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea. yonkkang@gmail.com.
²⁷ Department of Pediatrics, Kyung Hee University College of Medicine, 23 Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, South Korea. yonkkang@gmail.com.
²⁸ Department of Neurology, Kyung Hee University Medical Center, 23 Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, South Korea. nr85plasma@naver.com.

Abstract

Background: Although previous studies have provided data on early pandemic periods of alcohol and substance use in adolescents, more adequate studies are needed to predict the trends of alcohol and substance use during recent periods, including the mid-pandemic period. This study investigated the changes in alcohol and substance use, except tobacco use, throughout the pre-, early-, and mid-pandemic periods in adolescents using a nationwide serial cross-sectional survey from South Korea.

Methods: Data on 1,109,776 Korean adolescents aged 13-18 years from 2005 to 2021 were obtained in a survey operated by the Korea Disease Control and Prevention Agency. We evaluated adolescents' alcohol and substance consumption prevalence and compared the slope of alcohol and substance prevalence before and during the COVID-19 pandemic to see the trend changes. We define the pre-COVID-19 period as consisting of four groups of consecutive years (2005-2008, 2009-2012, 2013-2015, and 2016-2019). The COVID-19 pandemic period is composed of 2020 (early-pandemic era) and 2021 (mid-pandemic era).

Results: More than a million adolescents successfully met the inclusion criteria. The weighted prevalence of current alcohol use was 26.8% [95% confidence interval (CI) 26.4-27.1] from 2005 to 2008 and 10.5% (95% CI 10.1-11.0) in 2020 and 2021. The weighted prevalence of substance use was 1.1% (95% CI 1.1-1.2) from 2005 to 2008 and 0.7% (95% CI 0.6-0.7) between 2020 and 2021. From 2005 to 2021, the overall trend of use of both alcohol and drugs was found to decrease, but the decline has slowed since COVID-19 epidemic (current alcohol use: β_diff 0.167; 95% CI 0.150-0.184; substance use: β^diff 0.152; 95% CI 0.110-0.194). The changes in the slope of current alcohol and substance use showed a consistent slowdown with regard to sex, grade, residence area, and smoking status from 2005 to 2021.

Conclusion: The overall prevalence of alcohol consumption and substance use among over one million Korean adolescents from the early and mid-stage (2020-2021) of the COVID-19 pandemic showed a slower decline than expected given the increase during the prepandemic period (2005-2019).

Keywords: Adolescent; Alcohol; Corona virus disease 2019; South Korea; Substance use.

MeSH terms

Adolescent
Alcohol Drinking / epidemiology
COVID-19* / epidemiology
Cross-Sectional Studies
Humans
Pandemics
Substance-Related Disorders* / epidemiology

Abstract

MeSH terms

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