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Metrics details. This study aimed to describe the status of alcohol consumption and drug use among young adults as well as their determinants. We conducted a cross-sectional study of Palau girls sex adults aged 18 to 24 years living in Palau in The prevalence of self-reported alcohol and marijuana usage were compared within and between sexes, age groups, ethnicities, and education levels. The proportion of current drinking was higher in people aged 21—24 than in those aged 18—20 The proportions of current drinking and marijuana use were higher in Palauan than in other ethnicities current drinking: The proportion of frequent 3 times or more marijuana users was higher for the lower educated than for the higher educated Inthe World Health Organization WHO published a global strategy to reduce the harmful use of alcohol which is a ificant contributor to the global burden of disease and is listed as the third leading risk factor for premature deaths and disabilities in the world [ 1 ].

It is estimated that 3. With regard to patterns of alcohol consumption, Palau girls sex heavy episodic drinking was slightly more prevalent among young people between 15 and 19 years of age As for the most serious outcome that can result from illicit drug use, it is estimated thatdrug-related deaths occurred worldwide In addition, 27 million people aged 15—64 are problematic drug users [ 3 ].

The Republic of Palau, an island state in Oceania with a population of approximately 20, has been reported to have a high burden of non-communicable diseases NCDs attributable to lifestyles including alcohol consumption or drug use, as with another countries in Micronesia [ 4 ]. In general, a meta-analysis that included nine studies USA, UK, New Zealand, Finland, and Italy showed that lower socioeconomic status was associated with higher prevalence of alcohol and marijuana use among adolescents aged 10—15 years [ 5 ].

However, whether student habits become worse or better after graduation remains unclear. Therefore, in this study, our aim was to investigate the prevalence of alcohol and marijuana use and their social and demographic determinants among young adults living in Palau. This is a cross-sectional study involving the youth population from ages 18 to 24 years living in Palau. In Octoberwe established a survey station at Palau Community College PCClocated in the center of Koror, since PCC is the only college-level education institution in Palau, provides optimum geographic access, and is the sole organization with a majority of members in the target age group students.

In order to reach as many potential participants as possible, we also dispatched a mobile survey team to a few local communities and major employers in Koror.

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A total of people Palauan and 46 non-Palauan voluntarily participated in the survey. None of the analyzed surveys had missing answers with regards to alcohol consumption. Written, informed consent was obtained from all of the participants prior to the study. The questionnaire administered to participants consisted of lifestyle questions such as tobacco use, alcohol consumption, diet, physical inactivity, education level, household income, mental health, sleep habits, and illicit drug use.

The details of the protocol used in this study are described elsewhere [ 7 ]. Sex-specific, and age-adjusted proportions for each outcome according to ethnicities Palauan vs. Differences in the distributions of the frequency of alcohol consumption during the 12 months prior to surveying and marijuana use between sexes and two age groups were analyzed by Chi-squared testing.

Mantel-Haenszel tests were used for differences in the age-adjusted distributions of ethnicities and education levels. All statistical analyses were performed with SAS version 9. A total of individuals Palauan and 46 non-Palauan between 18 and 24 years of age with a mean age of In total, Sex-specific characteristics are presented in Table 1. Most of participants were aged 18—20 years, Palauans, and mostly with Palau girls sex education level. The proportion of current smoking was As shown in Table 2 The proportion of current alcohol drinking was higher in the age 21—24 category than the age 18—20 category The respective proportions among Palauans aged 18—20 years were The proportion of marijuana use did not differ by age groups.

As shown in Fig. In Table 4the proportion of current drinking was higher in Palauans than the non-Palauans The proportion of Palauans who had ever used marijuana was higher than in non-Palauans As shown in Table 5a low education level was associated with increased lifetime marijuana use in men. A similar but non-ificant trend was observed in women. Educational levels were not associated with alcohol consumption in either sex.

The proportion of men who used marijuana 3 or more times was higher in the low education group than in the high education group The corresponding proportion of women tended to be higher in the low education group than in the high education group, but the difference was not statistically ificant We found a high prevalence of alcohol and marijuana use among Palauan men and women aged 18—24 years.

Among young adults living in Palau, sex, age, ethnicity, and education level were ificant determinants of alcohol or marijuana use. As far as Palau girls sex know, this is the first study to identify demographic and social determinants sex, age, ethnicity, and education level of alcohol consumption and marijuana use among Palauans aged 18 to 24 years. We found that According to the statistics in Palau, one-half of adults were drinkers and the average of cans of standard drinks beer, wine, and spirits per adult were imported [ 8 ].

The proportions of alcohol drinking during the past 30 days among Americans aged Palau girls sex years were In England, the proportion who drank alcohol in the last week was The production, sale, and possession of any form of medicinal marijuana products are illegal in Palau; however, we found that Furthermore, in the present study, many Palauan youth started to use marijuana. The high usage of alcohol and marijuana in Palauan teens was probably due to their easy retail and social access because alcohol was widely sold and marijuana was often cultivated on private farms [ 12 ].

The common use of marijuana may also be due to Palauan cultural acceptance. In the present study, we found that the proportion of alcohol drinkers in the day period prior to the survey was The proportions of those Palauans who had used marijuana before were We found that the proportion of prior marijuana users was Therefore, marijuana usage among men may become common after students enter college due to peer pressure and easy access. In the present study, among men, low education was associated with lifetime marijuana use but not with alcohol consumption.

According to systematic reviews, childhood social disadvantages, including low education, were associated with risk of cannabis use but not alcohol use from adolescence to adulthood [ 1718 ]. However, the higher proportion of lifetime marijuana use in the low education group does not necessarily imply that low education per se led to marijuana use since it may be strongly confounded by low family income.

Leniency among low-income and low education parents may allow more teenagers or young adults to start marijuana usage [ 19 ]. Among women in the preset study, low education tended to be associated with lifetime marijuana use, but the association did not reach statistical ificance. A study of 45 men and 48 women aged 8—30 years showed that the magnitude of risk behaviors evaluated by gambling task were higher in men than in women for all age groups [ 20 ].

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The tendency of taking non-risky behaviors in women could make the association between education and lifetime marijuana use weaker. The strength of this study is in its clarification of demographic and social determinants sex, age, ethnicity, and education levels of alcohol consumption and marijuana use among young adult Palauans.

However, there are several limitations in the present study. Therefore, the impact of selection bias was likely to be negligible. Second, we did not obtain detailed information regarding the amounts and usage patterns of alcoholic beverages and marijuana. Sex, age, ethnicity, and education were ificant determinants of alcohol or marijuana use among young adults living in Palau, particularly Palauans.

This study was executed to serve as a baseline reference for the further development of public health Palau girls sex to control alcohol and drug use in Palau. World Health Organization. Global strategy to reduce the harmful use of alcohol. Accessed November Global Status Report on Alcohol and Health Accessed August United Nations Office on Drugs and Crime.

World Drug Report Longitudinal study shows increasing obesity and hyperglycemia in micronesia. Obesity Silver Spring. A meta-analysis of marijuana and alcohol use by socio-economic status in adolescents aged years. Can J Public Health.

Article Google Scholar. Centers for Disease Control and Prevention. Profile of non-communicable Disease risk factors among young people in Palau. J Epidemiol. Substance abuse prevention strategic plan, Republic of Palau.

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College Enrollment Status: Percentages, and Accessed April Office for National Statistics. Adult drinking habits in Great Britain: Accessed September Republic of Palau, Ministry of Health. National Health Profile Evans K. Prevention and control of alcohol and drug abuse: asment report, 24 June to 21 July Google Scholar. Drug Alcohol Rev. Peltzer K, Pengpid S. Early substance use initiation and suicide ideation and attempts among school-aged adolescents in four pacific island countries in Oceania. PubMed Google Scholar.

Is socioeconomic status in early life associated with drug use? A systematic review of the evidence. Socio-economic status in childhood and later alcohol use: a systematic review.

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Latent variable modeling of longitudinal and multilevel alcohol use data. J Stud Alcohol. A developmental study of risky decisions on the cake gambling task: age and gender analyses of probability Palau girls sex and reward evaluation. Dev Neuropsychol. Download references. Appreciation is also given to the President, the Dean, and other members of Palau Community College for their great help in preparation of the venue and promotion for the survey. The authors would like to additionally thank Dr. Bryan J. BoxKoror,Republic of Palau.

You can also search for this author in PubMed Google Scholar. MS deed the study, performed the statistical analyses, interpreted the data, and drafted and revised the manuscript. HI supervised the study. All authors read and approved the final manuscript. Written informed consent was obtained from all of the participants prior to the study.

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