Preventable lifestyle risk factors for non-communicable diseases in the Pakistan Adolescents Schools Study 1 (PASS-1).

Ali Khan Khuwaja, Aga Khan University
Saleem Khawaja
Komal Motwani
Adeel Akbar Khoja
Iqbal Syed Azam, Aga Khan University
Zafar Fatmi, Aga Khan University
Badar Sabir Ali, Aga Khan University
Muhammad Masood Kadir, Aga Khan University


Objectives: The rising burden of preventable risk factors for non-communicable diseases (NCDs) among adolescents is a major public health challenge worldwide. We identified the preventable risk factors for NCDs in adolescents. Methods: In a school-based study, pre-tested structured questionnaires were completed by 414 adolescents (14 to 17 years) at six schools in three cities in Pakistan. The chi-squared test and adjusted odds ratio (aOR) with 95% confidence interval (CI) were calculated in a multinomial logistic regression analysis. Results: Over 80% of the adolescents had unhealthy diets, and 54% were physically inactive. Most adolescents were exposed to passive smoking, and 14% were also current smokers. More than one-third of participants chewed betel nut, and one-quarter used oral tobacco. More girls were physically inactive (OR, 4.07, 95% CI, 2.69 to 6.17), whereas a greater proportion of boys were current smokers (OR, 2.17, 95% CI, 1.19 to 3.91), exposed to passive smoking (OR, 2.57, 95% CI, 1.72 to 3.83), and using betel nut (OR, 2.03, 95% CI, 1.34 to 3.06). Only 3.1% of the participants were without any preventable lifestyle risk factor for NCDs, and over 80% had ≥2 factors. Co-existence of risk factors was independently associated with fathers being blue-collar workers (aOR, 3.57, 95% CI, 1.07 to 11.92) and parents not treating their child fairly (aOR, 5.05, 95% CI, 1.29 to 19.78). Conclusions: Most of the adolescents studied had preventable risk factors for NCDs. These results warrant comprehensive and integrated interventions to prevent lifestyle risk factors, and parents are front-line stakeholders.