Youths' Perception of Risky Lifestyles and Non-Communicable Diseases in South-West Nigeria

Received: 01-Mar-2022, Manuscript No. jdar-22-61052;;Accepted Date: Mar 29, 2022; Editor assigned: 03-Mar-2022, Pre QC No. jdar-22-61052 (PQ); Reviewed: 17-Mar-2022, QC No. jdar-22-61052; Revised: 22-Mar-2022, Manuscript No. jdar-22-61052 (R); Published: 29-Mar-2022, DOI: 10.4303/jdar/236166

Introduction

Lifestyles are generally acknowledged as affecting individual’s health by either decreasing or increasing their risk of dying young [1]. Thus, individuals’ health status is dependent on their already established way of life, which could either be healthy or unhealthy. A lifestyle of physical inactivity, tobacco smoking, harmful consumption of alcohol, and unhealthy eating are regarded as unhealthy, and a leading cause of preventable NCD mortality worldwide [2]. Youth is a crucial phase when adult behavioral patterns are built and the chances of getting engaged in risk taking lifestyle activities are at the peak. The WHO estimates that 70% of untimely deaths in adults globally are attributed to participation in risky lifestyle behaviors early in life [3,4]. This is because the negative impacts of these risky behaviors can last forever [5-7].

Non-communicable diseases (NCDs) are not directly transmissible from persons to persons as they are neither infectious nor contagious [8]. However, these diseases contribute considerably to global deaths, accounting for more deaths annually than the combination of all other causes of death [9]. The World Health Organization (WHO) documented that approximately 41 million deaths are attributed to NCDs yearly out of which fifteen million occur in over 85% of developing countries [10,11]. The four primary risk factors for NCDs (tobacco smoking, harmful alcohol consumption, physical inactivity, and unhealthy dietary patterns) as documented by WHO are usually engaged in as youths. The mentioned patterns prepares the ground for unhealthy lifestyle behaviors and the incidence of NCDs later in life [3,11-13]. These deaths are actually preventable if healthy lifestyles can be encouraged, specifically among youths. For example, when healthy behaviors like eating healthy and consistent physical exercise are inculcated from childhood, there is every possibility to maintain such behavior through to adulthood. The increasing incidence of NCDs can consequently drain family resources thereby causing them to live in poverty [14,15]. It is thus pertinent to work with youth, understand their perceptions of NCDs’ risk factors in order to address the challenges [11-13] so as to promote positive health behaviors early in life, foster a healthier adult population, and substantially lessen the burden of NCDs [3]. This article aims to report on the perception of youths on risky lifestyle associated with non-communicable diseases, and ultimately therefore on health outcomes.

Materials and Methodology

Study design and setting

A quantitative design, using questionnaires, but with a few open ended questions for qualitative enhancement, was adopted to amass data from respondents. The population for this the study included five million youths between the ages of 15–24 years in the South-West region of Nigeria [16].

Sample population and sample selection

Due to the large population, six tertiary institutions (one from each state) from the 64 accredited tertiary institutions within South-West Nigeria were conveniently selected to participate as the sampling frames. A sample size of 384 youths was drawn from the assessable population using Krejcie and Morgan’s table for determining sample size [17]. Stratified convenient sampling technique was done to select respondents from each tertiary institution based on the total population of each individual institution in order to ensure even representation per institution. A questionnaire, informed by the study objectives and developed after a thorough literature review, was used to gather data on the perception of youths on the association of risky life style on non-communicable diseases.

Data analysis

Numeric data that can be analyzed statistically were collected using 11 closed ended questionnaire with 2 open ended questions for qualitative enhancement.

Validity and reliability

To ensure validity and reliability of the instrument, ambiguous questions were avoided while the instrument was pre-tested to detect any inherent gaps and to determine how effectiveness the tool is. All the envisioned biases in the study design, data collection, sample selection, information and non-response were attended to after the pre-test, and eliminated.

Ethical considerations

The protection of both the rights of individual respondents and the tertiary institutions were not taken for granted. The ethical principles of informed consent/assent, autonomy, justice, fidelity, confidentiality, anonymity, non-maleficence and beneficence were ensured by providing a written information letter which explicitly stated the nature, purpose and benefits of the study. Parent or guardian gave permission for participants younger than 18 years to take part in the study. The Health Research Ethics Committee of the Department of Health Studies, University of South Africa provided Ethical approval to conduct the study add the certificate number here please. Permission to conduct this study was obtained from the dean of students’ affairs/ registrar of all six tertiary institutions.

Results

Table 1 depicts youths’ perception of the impact of alcohol consumption on health.

Table 2 indicates youths’ perception of the impact of tobacco smoking on health.

Table 3 describes youths’ perception of the impact of an unhealthy diet on health.

Table 4 shows youths’ daily involvement in physical inactivity.

Table 5 reveals youths’ perception on quitting unhealthy lifestyle.

Respondents gave the reasons for engaging in alcohol consumption and tobacco smoking. The following were reported by respondents in this study:

“All my friends drink, why won’t I drink too when they will not let me rest until I joined them?” (49 responses)

“I drink alcohol anytime I get bored because it helps me to feel better” (4 responses)

“We all get curious at one point or the other in our lives. Curiosity made me start smoking” (69 responses)

“Smoking increases social presence” (22 responses)

“My dad sees nothing wrong in drinking. He gave me the go ahead to start taking alcohol when I finished secondary school” (39 responses)

The respondents gave reasons for not wanting to quit the aforementioned motivations for engaging in unhealthy lifestyles to include:

Indecision (101 responses), Respondents indicated this by saying that:

“I need some time to think about this before I take a decision to quit”

“I’m not sure I want to quit my way of life or not.

“I can’t take a decision it is so hard for me” Enjoyment (84 responses), Respondents indicated this by stating that:

“You only live once. I want to enjoy my life to the fullest because I am still young”

“I am just 17 years old, why should I quit what I just started enjoying”

“I can’t just give up my own way of life, I’m not interested” Moderation (28 responses), Respondents indicated this by saying that:

“You just have to do things in moderation. Whether healthy or unhealthy. That is my candid opinion and that is how I live my life”

“A little here, a little there will definitely not kill”

“Moderation is the way to go”

Fear of losing friends (15 responses), Respondents mentioned that:

“If I quit now, my friends will stop being loyal to me”

“I don’t want my friends to dump me”

Discussion

Youths’ perception of the impact of alcohol consumption on health

Alcohol becomes transformed into a very dangerous chemical called acetaldehyde when consumed by humans poisoning the DNA, destroying and preventing it from replacing the dead cells, and by doing so, causing NCDs [18]. The substance is also well known to be accountable for over 60 categories of diseases and injuries [19]. Despite the understanding of the health hazards of alcohol consumption, a large percentage of respondents still consumed alcohol (Table 1). This may indicate a deliberate choice by youths to ignore their health [20]. Study findings from different contexts confirm this tendency by indicating that 25.4% of their respondents also ignore the negative impact of alcohol consumption on their health [21]. Respondents in this study confirmed they had no inkling that alcohol consumption can negatively impact their health in spite of the WHO’s warning on the increasing incidence of lifestyle related NCDs among youths. It is worrisome that many youths still remain unaware of the impact of unhealthy lifestyle on their health, making them less likely to practice health promotion activities [5,22]. This ignorance cannot be overlooked because the high rise in youth population makes their health status important for future population health and socioeconomic development [23]. Thus, the need to create awareness among young people on the importance of living healthy [24].

Table 1: Youths’ perception of lifestyle and NCDs (N=384).

Youths’ perception of the impact of tobacco smoking on health

Tobacco smoking poses a greater risk of developing NCDs to smokers and accounts for early death of about 7.2 million people annually [11,25,26]. This is because tobacco smoking is an unhealthy lifestyle and a top source of ill health [25,26]; as the frequent inhalation of substances which contain nicotine or tar make smokers suffer more health problems and die early than non-smokers [27]. Majority of the respondents in this study perceived smoking as very risky to their health while a smaller percentage of them did not perceive tobacco smoking to negatively impact their health (Table 2). These findings are similar to the findings reported by Bhimarasetty et al, where youths knew that smoking could lead poor health [28]. Despite respondents’ perception of the health hazards of smoking, more than half of the respondents still smoked. These findings are indicative of an alarming rate of tobacco smoking among youths in South-West Nigeria and that public health efforts need to be focused on preventing youths from being initiated into this harmful behaviour [29].

Table 2: Alcohol consumption and Smoking (N=384).

Youths’ perception of the impact of an unhealthy diet on health

A person’s diet is the greatest lifestyle factor that is directly related to health outcomes [30,31]. Like other researchers, the majority of respondents confirmed that they were aware of the fact that unhealthy diets are harmful to their health, whilst a few still perceived that an unhealthy diet will not pose any risk to their health (Table 3). Abraham, Noriega and Shin, also found that youths’ (89.3%) new poor eating choices are harmful to their health and could decrease the quality of life [31,32]. These study findings revealed that young people did not often eat fruits and consume vegetables regularly. This may indicate that youths’ level of awareness about the negative impact of poor diet on their health is inadequate or they do not take it as seriously challenging their health [33,34]. The fact that there is a wide spread of the fast food culture among the younger generation is not assisting a healthy eating pattern [35].

Table 3: Dietary patterns (N=384).

Youths’ perception of the impact of physical inactivity on health (N=384)

Around 3.2 million people die annually due to physical inactivity [9,36-38]. People who are physically inactive are more predisposed to developing NCDs and dying prematurely than people who are physically active [39]. To establish the perception of youths on how physical inactivity impacts health, it was a concern that the study findings revealed that some of the respondents did not realize that physical inactivity is hazardous, while some were not aware of the health risks associated with physical inactivity (Table 4). Young people seem to be uninformed of looming health dangers and the disadvantages of physical inactivity to their health [33,34]. Alarming is the fact that the findings revealed that almost all of the respondents spent between 5 to 14 hours daily being physically inactive as also found in a United States’ study [40] with respondents spending an average of 9.1 hours sitting daily. This could be because of youths’ daily routine of sitting for long lectures, reading and relaxation. An increasing number of youths sit for prolonged hours every day and fail to engage in moderate intensity aerobic physical exercises and vigorous physical activity [9,36,37] and extending this unhealthy lifestyle into adulthood. This lifestyle indicated extreme sedentary behaviour among youths which increases their risk of impaired health, developing NCDs by 20% to 30% and dying early [9,36,38,41]; hence the need to reverse youths’ sedentary lifestyle [42].

Table 4: Total minutes spent sitting down or resting.

Youths’ perception on the relationship between lifestyle and NCDs

A healthy lifestyle has been confirmed to reduce one’s risks of getting ill or dying untimely and helps people enjoy more quality health throughout their lifetime [43,44]. The perception of youths on the relationship between lifestyle and NCDs was summarized in this study. Surprisingly, despite the fact that majority of respondents were aware that an individual’s lifestyle can lead to NCDs later in life, an alarming percentage of them perceived that their lifestyle cannot dictate whether they would have NCDs in the future or not. This finding could contribute to the reluctance of youth to quit unhealthy lifestyle practices, thus the importance to examine youths’ perception on quitting unhealthy lifestyle in order to suggest effective ways of militating against inability to quit unhealthy lifestyle practices.

Youths’ perception on quitting unhealthy lifestyle (N=384)

Despite the reduced risk of untimely death from lifestyle related illnesses as well as an extended life expectancy with a healthy way of life [45], the reluctance to quit unhealthy behavior was emphasized in the study findings only a few respondents were keen on quitting smoking, believed they could stop eating unhealthy diets, believed they could stop consuming alcohol, and thought they could involve more in physical exercise (Table 5). Contributory features to healthy living include smoking cessation, physical activity, a healthy diet and moderate alcohol consumption amongst others [46,47] which was not appreciated by the participating youth in this study. Youth’s understanding of the lifestyle risk factors that are related to NCDs seems not to be sufficient as was confirmed by the study findings. Unfortunately, ideas, suggestions and recommendations proposed by friends, peers, family members of youths; the inability to say “No”, boredom, the desire to satisfy curiosity, pleasure, the need to satisfy the urge for enjoyment, fun, experimentation, social enhancement, conformity and relaxation push many youths into engaging in unhealthy behaviors [48-51]. Usually, when risky and unhealthy behaviors persist, they become very difficult to correct [5] as admitted by some respondents. This explains the difficulty individuals encounter while trying to give up behaviors that have persisted for a long time.

Table 5: Youths’ perception on quitting unhealthy lifestyle (N=384).

The respondents gave reasons for not wanting to quit the aforementioned motivations for engaging in unhealthy lifestyles to include

1. Indecision, which represents a condition whereby an individual finds it hard to make a choice [51], thus not knowing whether to quit or not

2. Enjoyment which is a feeling of pleasure [51]. Some respondents stated they were not ready to quit unhealthy lifestyle because they felt they were still too young to quit and were enjoying their young life; this finding is inconsistent with literature evidence that the best time to change an unhealthy lifestyle behaviour is during youth

3. Moderation for some respondents is harmless and doing everything in moderation is not injurious to their health. This line of thought among respondents could be attributed to the pleasure derived from living an unhealthy lifestyle or the incapability of saying “no” to unhealthy proposals [49].

4. One other factor mitigating against quitting an unsafe lifestyle is the fear of losing friends [49] as mentioned by some respondents. Hence the need to urgently develop health intervention programmes for youths.

Conclusion

Although respondents were of the opinion that alcohol consumption and smoking are unsafe and can lead to health problems, a large number of them revealed they have no inkling that alcohol consumption and smoking can negatively impact their health. Despite the fact that respondents were aware of the health risks associated with physical inactivity and unhealthy diets, an alarming proportion of respondents spent between 5 to 14 hours being physically inactive daily and they also did not often eat fruits and vegetables. An alarming few respondents were keen on quitting these unhealthy lifestyles.

These findings indicate that the perception of youths on the impact of risky life style on health outcomes are contrary to the actual lifestyle activities of youths despite their awareness of the benefits and importance of living healthy lifestyle as well as the risks of unhealthy lifestyle. Their eating patterns negates the daily recommended consumption of foods in accurate portions; they fail to meet the required daily physical activity level, they smoke and consume alcohol even though majority of them are aware of the consequences of unhealthy lifestyle. The mentioned findings are a concern as it is an indicator of increased incidence of non-communicable diseases in the future.

A healthy lifestyle has been found to promote better quality of life, preserve health and reduce the risk of being ill or dying prematurely. Conscious efforts to adhere to a healthy lifestyle (healthy diet, physical activity, smoking cessation, and moderate alcohol consumption) irrespective of age, reduces the risks of untimely mortality from non-communicable diseases and prolongs life expectancy. Thus the need for an urgent response to youths’ lifestyles by developing and enforcing an action plan that can motivate and change behavior as to improve youths lifestyle in order to reverse the negative expected health outcomes posed by NCDs in the future.

Funding

The lead author enjoyed a Ph.D. bursary from the University of South Africa, Pretoria and from Afe Babalola University Ado Ekiti. The funders had no influence on the study’s design, method of data collection and data analysis.

Acknowledgment

None

Conflicts of Interest

No conflict of interest was declared.

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