Exploring health-risk behaviors related to road safety and car drifting among adolescents in Saudi Arabia: the co-occurrence of multiple risk behaviors.

Objectives: Adolescence is a fundamental stage of life where they go through huge changes and development. As a result, they are more likely to engage in behaviors that may jeopardize their life and health. The main objectives of this paper is to investigate risky-behaviors related to road traffic safety and dangerious car drifting among adolescents in Saudi Arabia.

Methods: This was a school-based cross-sectional study conducted among male school adolescents in Riyadh, Saudi Arabia. A multi-stage probability sampling technique was performed to recruit the participants. A total of 1,501 male adolescents were included in this study, studying in private and public high schools.

Results: A total of 78.7% of the students were found to be driving cars, which indicated that a high proportion of adolescents drive without a license. A total of 96% and 97.7% of adolescents do not use seat belt when driving nor when riding a vehicle as a passenger, respectively. Using helmet was a very rare practice among adolescents since only 1.4% and 2.0% wore a helmet when using non-motorized and motorized vehicles, respectively. Attending car drifting events, joining people while performing car drifting and actual performing car drifting were prevalent as 46.7%, 42.9%, 36.1%, respectively. About 58% of the adolescents reported not been taught about how to avoid traffic accidents, and 80% reported the need for more health education regarding traffic safety. The logistic regression analysis indicates adolescents car drifting was independently associated with adolescents' age (OR = 1.2; 95%CI = 1.1-1.3; p < 0.01), studying in private schools (OR = 1.2; 95%CI = 1.2-2.0; p≤ 0.015), being Saudi (OR = 2.5; 95%CI = 1.9-2.8; p < 0.001), do not like schools (OR = 1.7; 95%CI = 1.4-2.4; p < 0.001) and poor academic performance (OR = 1.7; 95%CI = 1.3-2.3; p < 0.001). Also, the adjusted logistic regression confirmed that car drifting was independently associated with several health risk behaviors including joining people performing car drifting, attending car drifting events, not brushing teeth, smoking behavior, want to use drugs, carrying weapons, and taking part in bullying others.

Conclusion: Large proportions of adolescents engage in multiple risky road traffic behaviors. Therefore, it is strongly advisable for policymakers and other stakeholders to devise national strategies that consider road safety and risky driving behaviors among adolescents and school students. This study calls for a strategic intervention plan to change the culture of risky driving through a structured and comprehensive curriculum in school settings.