Young Adult Drug Use Research Articles

Risky behaviors in Ethiopian university students and its relationship with loneliness and coping self-efficacy

Research shows that risky behavior peaks in young adulthood, endangering young adult’s mental health and making it difficult for them to grow up to be responsible members of society. As a result, this study aimed to adapt the Risk Behavior Scale into Amharic and examine the relationships between risky behaviors, loneliness, and coping self-efficacy. A cross-sectional research design was used and convenience sampling was employed to gather data from a total of 242 Ethiopian university students. Confirmatory Factor Analysis (CFA) was carried out to test the factor structures of the Risky Behaviors Scale. The CFA results validated the scale’s four-factor structures (χ2 = 435, df = 183, (p < .001), CFI = 0.94, TLI = 0.91, RMSEA = 0.08, and SRMR =0.05). This would make it possible for mental health experts to research the psychological impacts of risky behaviors (alcohol use, suicidality, drug use, and khat use) in Ethiopian young adults. The findings of hierarchical regression analysis revealed that male gender and loneliness were predictors of risky behavior. This research holds significant implications for interventions that attempt to reduce loneliness in young adults to alter their vulnerabilities to risky behaviors.

Trait hedonic capacity correlates with sexual pleasure and motives for sexualized drug use in young adults

Although pleasure is a primary motivator for sexual activity, research into the mechanisms facilitating pleasurable sexual experiences is limited. The present research adopts a self-regulatory perspective on sexual pleasure, investigating individuals’ capacity to shield hedonic activities from distracting thoughts (trait hedonic capacity) as a correlate of sexual pleasure and sexualized drug use. Study 1 (N = 247) demonstrates that young adults with higher trait hedonic capacity experience more sexual pleasure and are less prone to cognitive distraction during partnered sexual activities. Pre-registered Study 2 replicates these findings while accounting for demand effects (N = 182, n = 86). Expanding on these findings, pre-registered Study 3 (N = 903) shows that young adults with lower trait hedonic capacity are more inclined to use alcohol as a means of coping with cognitive distraction during sexual activity. Exploratory moderation analyses suggest that this is particularly true for women and individuals with higher levels of stress. In summary, low trait hedonic capacity is associated with lower sexual pleasure and a tendency to use alcohol with the motivation to cope with distracting thoughts during partnered sexual activity.

A case study in developmental discontinuity: PROSPER Interventions and adolescent substance use trajectories shape young adult substance use and mental health problems.

The loss of John Schulenberg reverberates across the developmental and prevention sciences. In honor of his many contributions, this paper applies his ideas of developmental continuity and discontinuity to understand the process by which PROSPER delivered universal prevention programs (delivered in Grades 6 and 7) affect young adult outcomes. Guided by these developmental models, we deconstructed adolescent substance use initiation trajectories into two discrete phases-early and late adolescence, demarcated by substance use initiation levels at the end of 9th grade. We evaluated the effects of PROSPER interventions on these phases, and in turn, the effects of adolescent substance use initiation on young adult antisocial behavior, alcohol and drug use consequences, and depression symptoms. This sample included 1,984 young adults who participated in the PROSPER intervention trial in Grade 6 (two cohorts, 2002 and 2003), followed over 8 adolescent measurement occasions (Fall and Spring of Grade 6; Spring of Grades 7-12). Young adult outcomes were averaged across three waves (collected at ages 20, 23, and 25). PROSPER interventions were associated with reduced substance use initiation in early adolescence, but not escalation during late adolescence. In turn, substance use in both early and late adolescence was uniquely associated with young adult antisocial behavior, depression symptoms, and substance use consequences. PROSPER interventions were associated with young adult antisocial behavior and problematic substance use via reduced risk for early initiation status. Findings are discussed in terms of developmental continuity and discontinuity.

Quantitative Survey on Prevalence of Prescription Pain Medications and Stimulants Use in Young Adults

Prescription drug use including pain relievers and stimulants has been a growing problem in young adults and the issue has been a public health concern for years. This Quantitative Cross-sectional study aimed to collect preliminary data regarding prescription opioid use, prescription stimulant drug use and overdose treatment knowledge in young adults between 18 and 24 years old in a southern New Jersey university through administering an online survey. Of the 1663 students who completed the survey, 33% reported using prescription pain relievers and 15% reported using prescription stimulant drugs. Stimulant drug users were found to be more likely to use prescription pain relievers (49%) as compared to non-stimulant users (30%). Furthermore, students with overdose treatment knowledge of opioids were more likely to report misuse of prescription drugs (15%) than students with less knowledge (8%). This study reiterates the increasing usage of prescription drugs and stimulant use among college students. There is a need for effective education strategies to inform students about the prescription medication uses and misuse to reduce nonmedical use of prescription medications.

Determınatıon of OTC Use Among Young Adults

Aim: The aim of the study is to determine the over-the-counter drug use in young adults. Materials and Methods: The sample of the study consisted of 724 students studying at a public university in Central Anatolia between 01/04/2022-30/04/2022. Results: Of the young adults who participated in the study, 43% used painkillers without a doctor’s advice, 5.4% used drugs to watchfulness, 8.7% used hormone-derived drugs, 0.4% took drugs to prevent anxiety, 3.5% used special drugs prescription, 36.9% used protein-containing products for bodybuilding. 63.7% had knowledge that over-the-counter drugs could endanger life, 30.2% of drugs It was determined that they knew the damage they could cause to the tissues, and 57% of them used the drugs only for the duration and dose given by the doctor. Conclusion: The use of drugs without doctor’s approval is becoming increasingly addictive and governments need to find a solution to this situation urgently. Protecting the health of young people, who are our future, should be the most basic and primary task.

Investigating Whether Bereavement by Suicide and Other Unnatural Causes Has a Deterrent Effect on Alcohol or Drug Use in Young Adults.

Bereavement by suicide and other unnatural causes is associated with suicide but evidence regarding risk of substance misuse is inconsistent. This may be due to heterogeneity in patterns of alcohol or drug use after traumatic bereavement; some increasing use to cope with the loss and others reducing use. To highlight the problems of focussing on diagnostic thresholds when investigating substance use after traumatic loss, we aimed to test whether people bereaved by suicide or other unnatural causes are more likely to reduce or stop their substance use than people bereaved by sudden natural causes. Using multivariable logistic regression and data from an online survey of 1854 UK-based bereaved adults, we tested the association between bereavement by suicide and other unnatural causes and post-bereavement reduction/cessation in (i) alcohol and (ii) drug use. There were no group differences in the proportions who reduced/stopped alcohol use, but a significantly greater proportion of people bereaved by sudden unnatural causes reduced/stopped drug use post-bereavement than people bereaved by sudden natural causes (AOR = 2.61; 95% CI = 1.44–4.71; p = 0.001; 4.1% versus 1.7%). In sub-group analyses this applied separately to people bereaved by suicide and non-suicide unnatural causes. Research into post-bereavement substance use should accommodate apparent divergent sub-diagnostic patterns.

성인의 생애주기별 좌절경험과 위험요인

The purpose of this study was to provide basic data for the development of preventive measures and management programs suitable for each generational characteristics by promoting an understanding of adult frustration experiences by life cycle and identifying risk factors. As a secondary analysis study using the Korean Health Panel 2018 data (β-version 1.0), 12,666 subjects who responded to the experience of frustration were selected. The collected data were subjected to frequency analysis, descriptive statistics, and multiple logistic regression analysis. Frustration experiences may appear differently depending on the life cycle through various personal and social changes, so general characteristics, social and psychological factors, and risk factors affecting the frustration experience were identified. As a result of the study, as for the experience of frustration among adults by life cycle, 27.2% of young adults, 27,6% of middle-aged adults, and 26.0% of old adults had experiences of frustration. Risk factors affecting the experience of frustration by life cycle were found to be common in young adults, middle-aged adults, and old adults, the presence of a spouse, task stress, activity restrictions, and unmet medical care as risk factors. Compared with other life cycles, drug use and decision-making disorders in young adults were found to be factors that did not affect the experience of frustration. Risk factors affecting the experience of frustration in middle-aged adults were drug use, smoking status, and self-management, and gender and memory impairment were found to be factors that did not affect. Risk factors affecting the experience of frustration in old adults were economic activity, memory impairment, and self-management, and education level and decision-making impairment were not affected. Therefore, frustration experience is individual and can be felt from various areas, and it is necessary to find various ways to overcome frustration with a differentiated approach because it can be different for each life cycle, developmental task, generation, and situation. In addition, long-term and individualized programs and health policies for each life cycle should be prepared in consideration of risk factors that commonly affect adults' frustration experience and risk factors for each generation.

A transformative and social marketing ecosystem investigation into drug use among young adults

PurposeThe purpose of this study is to examine the underresearched transformative service research (TSR) and social marketing segment of young adults who use drugs and identify motivators that have been studied in previous literature, using a service ecosystem lens and provide direction for future research into this area. This research provides the evidence-based knowledge for transformative service and social marketing practitioners to design transformative services that target these motivators.Design/methodology/approachThis systematic review, guided by the preferred reporting items for systematic reviews and meta-analysis framework, examines and analyses 207 articles published between 2015 and 2020.FindingsThis study identified that young adults are motivated to take drugs to enhance one’s experience, to cope, for social reasons, because of individual characteristics and for other reasons. Research has largely focused on microsystem and mesosystem motivators with data collected mainly using a microsystem approach.Originality/valueThis paper contributes to the TSR and social marketing literature by providing a holistic investigation into all motivators relevant to young adult drug use. An ecosystem classification and theoretical framework of the motivators is curated to help guide future TSR and social marketing research and interventions.

Participatory Design of a Mobile App to Safeguard Mental Resilience in the Context of Drug Use in Young Adults: Multi-Method Study.

BackgroundExisting mental health apps are largely not aimed at generally healthy young people who may be experimenting with addictive substances and mind-altering experiences.ObjectiveThe aim of this study is to examine the interest and expectations of young people regarding a proposed smartphone app designed to help protect and promote mental health and resilience in the face of risks associated with substance use.MethodsThe study was based on agile system development and had 3 empirical substudies. Our feasibility study (study 1) included an anonymous questionnaire that examined the potential interest of young people in this type of app. It was answered by 339 Israelis aged 18-30 years. The second part of the feasibility study was a pilot study with 1.2% (4/339) of the people who answered the questionnaire and expressed interest in participating in a focus group. They tested and refined the elements planned for the focus groups. Study 2 was a participatory design study involving 7 focus groups of 5 to 7 participants each (young people aged 18-35 years, n=38). Persona development, open discussion, and a Technology Acceptance Model questionnaire were used to elicit user expectations and requirements for the app and to understand the perceived usefulness and usability of the proposed features. Study 3 comprised in-depth interviews with experts in the field of youth mental health and drug use to enlist their professional opinion regarding the value of such an app and recommendations about the features it should include.ResultsThe mock-up for the proposed app had five key features: personalized assessment of risk for a drug-associated mental crisis, support for self-monitoring, useful information (eg, warning signs and first-aid guidelines), resilience-building exercises, and a support center. Participants rated highly the usefulness of all 5 main features and 96% (24/25) of the specific features we proposed within those main categories. The participants also suggested additional features as well as a new user persona we had not considered: the parents or family members of the young person. The focus groups rated highly the perceived usability of the app. Most of the experts saw value in all the main features and suggested specific knowledge sources for the app’s content. Finally, participants of both the feasibility study and the participatory design study expressed moderate to high interest in using the app for self-help and high interest in using the app to help friends.ConclusionsThe findings provide preliminary encouraging support for the 5 main features suggested by the research team and reinforce recommendations for mobile health apps found in the literature. The findings emphasize the insight that this kind of app should be designed primarily for use by individuals seeking to help others.

Predicting Young Adult Tobacco, Drug and Alcohol Use Among Participants in the CAMP Trial.

The development of substance abuse in youth with asthma have seldom been examined with longitudinal research. The prospective and well-characterized CAMP cohort provides outcome data on youth with asthma over 13years. This manuscript seeks todetermine thecontributions of asthma features and child behavioral/emotional functioning to subsequent tobacco, alcohol, and drug use in early adulthood. Childhood smoking exposures as well as parent report and youth report of substance use were prospectively assessed concurrently with assessments of asthma symptoms, study medication, and lung development. Logistic regression models evaluated predictors of adolescent and young adult tobacco, alcohol, and drug use. Use of tobacco products was reported by 33% of youth with mild/moderate asthma. Tobacco use was significantly associated with self-reported externalizing behaviors. Early life passive smoke exposure, especially in utero exposure, makes a significant contribution to tobacco use (OR1.58). Greater risk for tobacco use is conveyed by self-reported externalizing behaviors, which are consistently robust predictors of any future use of tobacco products, alcohol and drugs. These findings provide evidence for health care providers to use routine behavioral screening in youth with asthma.

The mediating role of substance use motives in the relationship between personality dimensions and alcohol and drug use in adolescents and young adults with mild intellectual disabilities

Adolescents and young adults with mild intellectual disabilities or borderline intellectual functioning (MID-BIF) are a high-risk group for developing substance use disorders. The aim of this study was to gain a better understanding of the mechanisms that underlie substance use in this particular population. We tested the mediating role of substance use motives in the relationship between personality dimensions and substance use-related outcomes. Self-reported data on substance use risk personality dimensions (i.e., sensation seeking, impulsivity, anxiety sensitivity, and negative thinking), substance use motives (i.e., social, enhancement, coping, and conformity motives), and substance use were obtained from 163 individuals with MID-BIF (mean age 18.9 years). Results show that coping motives played a main role in the associations between personality dimensions and substance use in adolescents and young adults with MID-BIF, with significant relationships between impulsivity and negative thinking and severity of alcohol use or drug use via coping motives. Moreover, findings indicated a relatively high risk for several substance use motives and associated substance use (disorder) in individuals high on impulsivity. Results show significant relationships between impulsivity and severity of alcohol use or drug use via social, enhancement, and coping motives. No mediating associations were found for conformity motives, nor did we find any mediation associations in individuals with high levels of anxiety sensitivity. These insights provide the possibility of tailoring interventions to specific motives that underlie substance use in different types of users with MID-BIF based on personality dimensions.

Acid-Suppressive Drugs and Risk of Fracture in Children and Young Adults: A Meta-Analysis of Observational Studies.

Background: Recent studies have suggested that proton pump inhibitors (PPIs) and histamine type 2 receptor antagonists (H2RAs) may increase the risk of fracture. We performed a meta-analysis to evaluate the risk of fracture with PPIs and H2RAs use in children and young adults.Methods: PubMed, EMBASE database, Cochrane Library, and Web of Science for relevant articles published before May 2021 were searched. We included all the observational studies reporting on the risk of fracture with acid-suppressive drug (PPIs and H2RAs) use in children and young adults. We calculated pooled risk ratios (RRs) for fracture using random-effects models and conducted subgroup analyses.Results: A total of six studies were included in our analysis. Pooled analysis of PPIs use showed significant risk for fracture (RR = 1.23; 95% CI, 1.12–1.34; I 2 = 79.3), but not significant for PPIs combined with H2RAs use (RR = 1.22; 95% CI, 0.94–1.60; I 2 = 44.0%), as well as for H2RAs use alone (RR = 1.08; 95% CI, 0.94-1.24; I 2 = 84.1%). Grouping of studies by region showed a significantly increased fracture risk with PPIs use in North America (RR = 1.24; 95% CI, 1.16–1.32; I 2 =0.0%) than in Europe (RR = 1.23; 95% CI, 1.00–1.52; I 2 = 94.6%) and Asia (RR = 1.10; 95% CI, 0.96–1.25). However, there was no significant association between the H2RAs use and the fracture risk in North America (RR = 1.08; 95% CI, 1.00–1.09; I 2 = 0.0%). Moreover, PPIs use showed an increased risk of fracture in women (RR = 1.13; 95% CI, 1.07–1.19; I 2 = 0.0%), whereas there was no significant association between the PPIs use and the risk of fracture in men (RR = 0.93; 95% CI, 0.66–1.31; I 2 = 0.0%).Conclusion: PPIs use alone could increase the risk of fracture in children and young adults, but not for PPIs combined with H2RAs use or H2RAs use alone. Clinicians should exercise caution when prescribing PPIs for patients.

Glucose patterns following alcohol and illicit drug use in young adults with type 1 diabetes: A flash glucose monitoring study

IntroductionTo assess the effects of alcohol and illicit drug use in young adults (age 18–35) with type 1 diabetes (T1D) on flash glucose monitor sensor glucose (SG) readings.MethodsTwenty young adults with T1D were enrolled from a tertiary referral hospital outpatient department in Melbourne, Australia for a 6‐week prospective observational study using flash glucose monitoring (FGM). Glucometrics comparing substance using days (SUEDs) to those without substance use (non‐SUEDS) were analysed. The primary outcomes were the difference in mean SG values, its standard deviation and minutes/24‐h period out of range (SG <3.9 mmol/L or >10.0 mmol/L) between matched SUEDs vs non‐SUEDs. An interaction model with the primary effect of HbA1c on SG values was also performed.ResultsThere were no differences in the primary outcome measures between SUEDS and non‐SUEDs. However, there were differences in the regression coefficients for HbA1c and glucometrics between non‐SUEDs and SUEDs for mean SG, time out of range and time with SG > 10 mmol/L. This difference was also identified between non‐SUEDS and days of ≥40 g alcohol for mean SG.ConclusionsWhile there was no difference between glucometrics for SUEDs and non‐SUEDs on primary outcomes, HbA1C was found to be a less reliable predictor of glucose patterns in the 24‐h period following substance use than control days. Young adults with T1D need to monitor and respond to their glucose levels following substance use and engage in harm minimisation practices irrespective of baseline glucose control.

Assessment and treatment of substance use in adults with ADHD: a psychological approach.

Over half of young people and adults diagnosed with Attention Deficit Hyperactivity Disorder [ADHD] also have substance use disorder [SUD]. Their use of substances may arise from an attempt to self-medicate and/or to cope with their difficulties. This manuscript reviews key research in the literature and identifies that traditional SUD psychological interventions are an effective treatment for those presenting with a dual diagnosis of ADHD and SUD. However, typically, this is only available to those presenting to specialist SUD services for treatment of harmful use and/or dependency. This misses an opportunity to intervene much earlier, before drug use escalates to these levels. The manuscript aims to provide practical guidance for healthcare practitioners, by detailing a psychological framework for earlier assessment and intervention of problematic drug use in young people and adults with ADHD. Specific techniques are outlined drawing on psychoeducation, motivational interviewing and cognitive behavioural therapy in a phased approach to address factors that motivate initial use of substances and those that maintain use.

U.S. task force doesn't recommend for or against primary care prevention

In its most recent recommendation, the U.S. Preventive Services Task Force (USPSTF) last week said there is not enough evidence to recommend either for or against clinicians providing counseling to prevent drug use in young people. In the final recommendation statement, “Primary Care–Based Interventions to Prevent Illicit Drug Use in Children, Adolescents, and Young Adults: US Preventive Services Task Force Recommendation Statement,” published in the Journal of the American Medical Association (JAMA), the task force concluded that “the current evidence is insufficient to assess the balance of benefits and harms of primary care–based behavioral counseling interventions to prevent illicit drug use, including nonmedical use of prescription drugs, in children, adolescents, and young adults.”

USPSTF stops short of recommending pediatric drug prevention

In its most recent recommendation, the U.S. Preventive Services Task Force (USPSTF) last week said there is not enough evidence to recommend either for or against clinicians providing counseling to prevent drug use in young people. In the final recommendation statement, “Primary Care–Based Interventions to Prevent Illicit Drug Use in Children, Adolescents, and Young Adults: US Preventive Services Task Force Recommendation Statement,” published in the Journal of the American Medical Association (JAMA), the task force concluded that “the current evidence is insufficient to assess the balance of benefits and harms of primary care–based behavioral counseling interventions to prevent illicit drug use, including nonmedical use of prescription drugs, in children, adolescents, and young adults.”

Self-Reported Drug Use and Hearing Measures in Young Adults.

Purpose The purpose of this study was to examine marijuana or other substance use on pure-tone thresholds and distortion product otoacoustic emissions (DPOAEs) in young adults. Method Young adults (n = 243; 182 women, 61 men; M age = 20.9 years, SD = 2.7 years) participated in this study. Survey data included personal music system use, marijuana use, and misuse of prescription medications. Otoscopy, tympanometry, pure-tone audiometry, and DPOAEs were obtained. Pure tones from octave frequencies of 0.25 through 8 kHz were obtained, and DPOAEs were recorded between f2 frequencies of 1 and 6 kHz using two continuously presented stimulus tones swept in frequency. Results Those who reported marijuana or stimulant use had similar pure-tone averages (0.5, 1, 2, and 4 kHz) compared to those who reported never using marijuana or stimulants. Women who reported marijuana use in the past 30 days > two times had statistically significant higher mean DPOAEs compared to women who reported ≤ two times or no marijuana use in the past 30 days. Men, however, who reported marijuana use in the past 30 days > two times had lower, but not statistically significant, mean DPOAEs compared to men who reported ≤ two times or no marijuana use in the past 30 days. Women who reported ever using stimulants had statistically significant higher mean DPOAEs compared to women who reported never using stimulants; for men, mean DPOAEs were similar between those who reported ever using stimulants and those who never used stimulants. Conclusions The results of this study demonstrate different and contradictory associations between marijuana use, stimulant use, and hearing outcomes as a function of sex. Future research is needed to explore these associations utilizing larger sample sizes while accounting for additional harmful exposures to other noise exposures.

Drug use among Teenagers and Young Adults in Bhutan.

Background:Use, possession, and illegal transactions of controlled substances have increased in recent years in Bhutan. This study aimed to determine the national prevalence of ever drug use and identify its associated factors amongst teenagers and young adults.Methods:This study was conducted using data from the National Health Survey 2012 of Bhutan. The outcome variable of interest was ever drug use in teenagers and young adults. The questionnaire was developed following the WHO STEPwise approach to surveillance of non-communicable diseases (STEP). Univariate and multivariate logistic regression were performed to identify correlates of ever drug use.Results:The prevalence of ever drug use among teenagers and young adults was 3.2% (n = 672). The factors associated with ever drug use were: being men; being single; being in age group of 18-24 years; having a primary school, high school, monastic, university, or diploma education; being technicians or salespersons; feeling always lonely; having ever consumed alcohol, and having ever smoked.Conclusion:Compared to the other countries in the WHO South-east Asia region, the prevalence of ever drug use in Bhutan is low. Use of other substances, including smoking and alcohol use, was associated with ever drug use. For greater effect, drug use prevention strategies should include prevention of smoking and alcohol use.

Factors in the Transition from Legal to Illicit Drug Use in Young Adults from Northern Mexico.

Objective. This research sought to analyze the predictive effect of personal (personality traits), social (social support and social stigma) and community factors (characteristic of the neighborhood and exposure to consumption) on the transition of drug use in young adults. Methods. Case and control study. The cases were 70 individuals from 18 to 34 years of age who had already transitioned into illicit drug use and the controls were 210 legal drug usuers (tobacco or alcohol) in the same age range who had not had the transition. A data file was applied along with seven instruments that measured the transition and consumption variables. Results. Marihuana was the illicit drug of highest transition. It was shown that greater personality traits of neuroticism, extraversion, and openness to the experience meant higher probability of drug use transition; while greater personality traits of agreeableness and conscience meant lower probability for the transition. The characteristics of the neighborhood environment and exposure to the opportunity of consumption increase the probability of the drug use transition. Social support and social stigma influenced negatively upon the drug use transition. Conclusion. Personality traits, neighborhood characteristics, exposure to drug use, social support, and the social stigma of drug use are factors that intervene in the transition from legal to illicit drug use.

Prevalence and factors associated with safe sex behaviors among adolescent vocational students in Nakhon Ratchasima Province, Thailand

Purpose The purpose of this paper is to describe the prevalence and factors associated with safe sex behavior among vocational students in Nakhon Ratchasima Province, Thailand, and to determine the modifying factors listed as socio-demographic characteristic, the level of HIV and sexually transmitted infections’ knowledge, attitude toward reproductive health, and safe sex behavior among vocational students in Nakhon Ratchasima Province, Thailand. Design/methodology/approach A cross-sectional descriptive research was conducted from August to October 2018. The multistage stratified sampling, combined with purpose and random sampling, was used to select the participants. One vocational college with the highest number from urban, suburban and rural areas was purposely selected. The sample calculation by using Cochran’s formula, a random sampling by drawing from each college with male and female, was made to obtain the sample size of 355 students. Inclusion criteria included: vocational students, both male and female, aged between 15 and 19 years, resided in the study area, and volunteered to participate. Ethical consent including waiver of the parent’s consent for the participant aged under 18 years for this study was approved by the Institution Review Board for Human Research Ethics, Chulalongkorn University (Certification number JV 823/2561) A self-administered questionnaire was adapted by the principle researcher from the illustrative questionnaire for interview survey with young people (14), and The study of Prevalence of HIV, STD, Drug Use and Risk Behaviors in Adolescents and Young Adults, in Chaing Rai, Thailand (PRAYA) tool (15). All statistical analyses were performed by SPSS version 22. Findings The finding revealed that 332 participants were male (57.8 percent) and female (42.2 percent) with an average age of 16.8 years (±1.7). Approximately 60 percent of males and 50 percent of females had experience of sexual intercourse, with their first experience of sexual intercourse at the average age of 15. Most respondents 63.1 percent used a condom and 63.6 percent used contraception in their latest sexual intercourse. About 41.9 percent consumed alcohol and 15 percent reported substance abused. Sexual intercourse among adolescents vocational students were significantly associated with high knowledge of contraception (OR=0.30, 95%CI=0.10–0.82). Positive attitude toward reproductive health had a significant association with sexual intercourse (OR=0.17, 95%CI=0.05–0.58). Sexual intercourse among vocational students were also significant associated with low risk behavior (OR=0.45, 95%CI=0.22–0.91) and high risk behaviors (OR=0.24, 95% CI=0.10–0.59). Contraceptive used in the latest sexual intercourse had a significant association with cues to action (OR=0.43, 95% CI=0.22–0.86). Research limitations/implications This study used a self-reported questionnaire to collect information from participants about safe sex behaviors, which might contain bias data and socially desirable answers. The time for collecting data did not match vocational students’ schedule as they were about to have their final exams. An error in this questionnaire was the absence of condom use as one of the contraception methods. Practical implications The study showed that both male and female vocational students in Nakhon Ratchasima have a low level of knowledge of HIV, STIs and contraception. This study revealed that females have higher knowledge of all the factors more than males. Males usually received more harassment from peers for being sexually active than females do. Condoms and contraceptive used are inconsistent in all research conducted and have no common ground. Communication related to sex for those who have no partner was poor compared to students who have a partner. The four factors associated with safe sex behaviors should always be considered and surveyed among vocational students, as the study showed that all results vary for a future adolescence study. Social implications This research aims at government authorities. The policy makers should include reproductive health and rights in the curriculum. The Ministry of Public health and The Ministry of Education should provide training for the trainer program for teachers concerning safe sex behaviors. For future research, in-depth interview and qualitative study should be used to increase the reliability of the result of the inconsistency of using a condom and contraception. The researcher should do further studies into vocational college semester schedules before collecting data and should spend more time in the college, so the students become more acquainted to the researcher and give a more truthful answer. Moreover, condom use should be added as one of the contraception methods. Originality/value This is the first study among vocational students in Nakhon Ratchasima Province which emphasizes specifically on safe sex behaviors and factors related to it. Regarding the population of vocational students, this study covers almost 80 percent of the population. Sensitive questions for sexual activity status and sexually history were answered by a self-administered questionnaire in order to increase sincere answers on their experiences because participants were not shy to disclose their sexual experiences.