The Association Between Weapon Carrying and Health Risk Behaviors Among Adolescent Students in Bangkok,Thailand

Abstract

Carrying weapons is a significant social and public health problem worldwide, especially among adolescents. The present study examined the association between weapon carrying and related risk behaviors among Thai adolescents. A cross-sectional study of 2,588 high school and vocational school students aged 11 to 19 years from 26 schools in Bangkok, Thailand, was conducted in 2014. This study found that 7.8% of youth reported having carried a weapon in the past 12 months. The high prevalence of weapon carrying was reported by male students, and males were more likely to have reported carrying a weapon than females. The association between weapon carrying and the health risk behaviors like drinking, smoking, any drug use, and physical fighting were significant with higher odds of weapon carrying in all models. Among males, weapon carrying was related to drinking and smoking, any drug use, physical fighting, and school type. Among females, suicidal thoughts were significantly related along with drinking and smoking, any drug use, and physical fighting. Having a mother who used substances was significant only among females. These data could be used for further interventions about weapon carrying to reduce violence.

Keywords

weapon carrying health risk behaviors adolescent Thailand

Weapon carrying by adolescents is an important risk behavior for youth violence (Krug et al., 2002). Carrying weapons is one of the most important social and public health problems worldwide (Krug et al., 2002) and is defined as a major factor in reducing students’ safety, as a risk factor for homicide and suicide is the immediate access to a potentially lethal weapon (American Medical Association [AMA], 1990).

The Problem Behavior Theory (Jessor, 1987), a theoretical framework in which risk behaviors are considered in a psychosocial framework, describes health risk behaviors such as drinking problem, marijuana use, delinquency, and sexual intercourse, as syndromal among adolescents. This theory has supported the idea that both the individual and the social context predict behaviors (Jessor & Jessor, 1977).

Previous studies on weapon carrying indicated that gender was the most significant factor for carrying weapons among youth and that males were more likely to carry than females (Cao, Zhang, & He, 2008; Dukes, Stein, & Zane, 2010; Durant, Getts, Cadenhead, & Woods, 1995; Ferguson & Cricket Meehan, 2010; Gilreath, Astor, Cederbaum, Atuel, & Benbenishty, 2014; Kodjo, Auinger, & Ryan, 2003; Kulig, Valentine, Griffith, & Ruthazer, 1998; Orpinas, Basenengquist, Grunbaum, & Parcel, 1995; Stayton, McVeigh, Olson, Perkins, & Kerker, 2011; Vaughn et al., 2012; Walsh et al., 2013; Wright & Fitzpatrick, 2006). Studies also found that 14 to 16 year olds, when compared with younger and older teens, were significantly more likely to carry a weapon (Cao et al., 2008; Kodjo et al., 2003). Kodjo et al. (2003) found that parental education was associated with youth who carried weapons to school. Also, Cao, Zhang, and He (2008) found that adolescents who carried guns and other weapons to school had a peer who also carried a gun.

Studies have found some youth health risk factors associated with weapon carrying. These health risk factors include: smoking cigarettes and tobacco (DuRant, Krowchuk, Kreiter, Sinal, & Woods, 1999; Estell, Farmer, Cairns, & Clemmer, 2003; Orpinas et al., 1995; Stayton et al., 2011), alcohol (DuRant et al., 1999; Estell et al., 2003; Orpinas et al., 1995), and drug use (Cao et al., 2008; DuRant et al., 1999; Ferguson & Cricket Meehan, 2010; Kulig et al., 1998; Orpinas et al., 1995). Moreover, some studies found that students who thought about suicide were more likely to carry weapons than those who did not (Kulig et al., 1998; Orpinas et al., 1995; Stayton et al., 2011), and that youth with more sex partners, or who are sexually active, were more likely to carry than those who were not (Kulig et al., 1998; Orpinas et al., 1995; Stayton et al., 2011). In addition, another factor associated with weapon carrying includes being in physical fights (Cao et al., 2008; Durant et al., 1995; Lowry, Powell, Kann, Collins, & Kolbe, 1998; Stayton et al., 2011; Swahn, Bossarte, Palmier, Yao, & Van Dulmen, 2013).

In Thailand, studies have been conducted on high risk behaviors. Ruangkanchanasetr et al. (2005) found that 8.5% of adolescents had carried a weapon such as a gun, knife, or club to both school and other places. Separate health risk behaviors in adolescents that were monitored were physical fighting (31.5%), attempting suicide (12%), and making a specific plan for suicide (15.9%). Cigarette smoking and alcohol use were common. Only 10% of surveyed adolescents had reported a history of sexual intercourse. Furthermore, other Thai studies have been conducted on HIV-infection (Rongkavilit et al., 2007), bullying (Pengpid & Peltzer, 2013), cigarette smoking (McKnight-Eily, Arrazola, Merritt, Malarcher, & Sirichotiratana, 2010; Rudatsikira, Muula, Siziya, & Mataya, 2008), illicit drug use (Pengpid & Peltzer, 2013), and physical activity (Hidayati, Hatthakit, & Isaramalai, 2012). However, there are no studies that link weapon carrying and health risk behaviors among adolescents in Thailand. Therefore, the aim of this study was to examine the association between weapon carrying and these important risk behaviors among Thai adolescents.

To tie back to the Problem Behavior Theory, we included multiple problem behaviors as predictions of weapon carrying. We hypothesized that males would be more likely to use a weapon than females and that the type of school would be associated with weapon carrying, where attendance at a less academic school and peers who reported more risk behaviors would result in more weapon carrying. Finally, we hypothesized that health risk factors would be associated with weapon carrying.

Method

Sampling and Sample Size

Data come from the Thai Adolescent Student Study (TASS), a cross-sectional study of high school adolescents (Grades 7-12) and students in vocational school (Years 1-3). Students were between 11 and 19 years of age from 50 Bangkok districts. Two-stage stratified sampling techniques were used to select participants. Bangkok was divided into three strata for selection: inner, center, and outside city. Schools were classified as public, private, or vocational. The sample size of 2,425 was defined by Probability Proportional to Size (PPS). However, a 10% increase was added for attrition. Among 30 schools, 4 schools refused; among the consenting schools, 21 students declined to participate. They represented 7 schools. Thirty-two questionnaires from the study were excluded for lack of completion, yielding a final sample size of 2,588 students from 26 schools.

Measures

A self-administrated questionnaire on health behaviors of adolescents was designed and pretested at a private high school not included in the sampling pool. It then was approved by the Ethics Review Committee for Research Involving Human Research Subjects, at Chulalongkorn University, Bangkok, Thailand, which uses the principles of the International Conference on Harmonization–Good Clinical Practice (ICH–GCP). The participants received the information sheet and completed the consent form on the day of the survey. To determine weapon carrying (dependent variable), two questions were asked: “Have you ever carried a weapon such as a gun, a knife, a sword, a knuckle-duster, or a short stick to school property during the last 1 year?” and “Have you ever carried a weapon such as a gun, a knife, a sword, a knuckle-duster, or a short stick to another place during the last 1 year?” Youth who reported carrying a weapon to school or another place were compared with those who reported not carrying a weapon, and the latter served as the referent category for these analyses.

Four groups of independent variables were tested for their association with weapon carrying. First, demographic characteristic variables included gender and age. Gender was a binary variable, with females as the referent group. Age was measured by the participants’ actual age at the time of the survey and later divided into three categories: 17-19, 14-16, 11-13 with the youngest youth as the referent group. Second, social-economic status variables included school type, grade point average (GPA), family living structure, and parents’ education. The school type was a three-category nominal variable with the vocational and private school being compared with public school. Academic success was measured by the participants’ GPA in school year 2013 and was divided into three categories, with GPA 3.01 to 4.00 as the referent group. The family living structure was a binary variable with all living arrangements being compared with living with both mother and father (referent group). Parents’ education was analyzed separately for father and mother, with upper secondary education and above as the referent group. Third, behavioral variables included parental health risk behaviors and peer health risk behaviors. Parental substance use behaviors included drinking, smoking, and drug use behaviors for father and mother separately. Peer substance use was stratified into four categories, with having no close friends who used substance as the referent group.

Finally, health risk behaviors included the youth’s substance use (alcohol, tobacco, any drug use), the number of sexual partners, physical fighting, and suicidal thoughts. Past 3 month use of alcohol, tobacco, and any drug was merged into four categories, with no use as the referent group. The number of lifetime sexual partners was a three-category variable, with never having had sex as the referent group. Physical fighting in the past 12 months was a three-category variable, with no fighting as the referent group. Finally, suicide attempt and planned suicide were merged for a binary variable, with never having had a suicidal thought or planned attempt as the referent group.

Data Analysis

The dependent variable employed was weapon carrying. Independent variables were categorized into four groups: demographic characteristics—gender and age; socio-economic status—school type, GPA, family living structure, and parental education; behavioral variables such as parental drug use behaviors and peer drug use behaviors; and youth’s health risk behaviors such as the number of sexual partners, suicide attempt or planned suicide, physical fighting, and use of alcohol, tobacco, or any drug. All analyses were done using SAS (Version 9.4, SAS Inc., Cary, NC). The analyses were divided into three parts. First, we described the characteristics of the sample, including weapon carrying to school only, weapon carrying to another place, weapon carrying to both school and other place, and no weapon carrying. Second, we described the characteristics of Thai adolescents by weapon carrying status. We used the Bonferroni Correction (Weisstein, 2014) to set a significance level cutoff for p values less than .004. Third, we conducted univariate and multivariate logistic regression analyses to evaluate associations between weapon carrying and all other independent variables.

Results

Characteristics of the Study Sample

The study included 2,588 participants as shown in Table 1. Approximately half (51%) of the participants were male, with a mean age of 15.2 years. Most youth were in public or private high school (82.4%) and had less than a 3.00 academic GPA (56.2%). Most were living with both of their parents (66.4%). Among youth who knew their parents’ educational status, 62.8% of fathers and 59.1% of mothers had attained at least a secondary education. Mora than half of the participants reported substance use by their father (56.7%), compared with 22.9% of their mothers and 46.4% for their close friends. Student participants themselves reported drinking or smoking (without drug use) at higher rates than their close friends (24.2% vs. 15.5%, respectively). However, they reported drinking and smoking (without drug use) at lower rates than their close friends (9.4% vs. 22.5%, respectively), as well as reported lower rates of drug use (with or without drinking or smoking; 2.5% vs. 8.4%, respectively). In terms of health risk behaviors, 13% of youth reported having a sexual partner, 17.7% fought, and 5.1% attempted or reported a plan to commit suicide. Among the students, 7.8% reported carrying a weapon in the past 12 months. Most students (68.5%) who carried a weapon reported carrying it to school.

Table 1.

Characteristics of the Sample of the TASS (N = 2,588).

Variables	n	%
Total	2,588	100.0
Demographic variables
Gender
Male	1,329	51.4
Female	1,259	48.7
Age (M = 15.2, SD = 1.7, Minimum = 11, Maximum = 19)
11-13 years old	541	20.9
14-16 years old	1,359	52.5
17-19 years old	688	26.6
Social-economic status variables
School type
Public school	1,358	52.5
Private school	773	29.9
Vocational school	457	17.7
GPA
Below 2.01	159	6.1
2.01-3.00	1,300	50.2
3.01-4.00	1,129	43.6
Family living structure
With both mother and father	1,718	66.4
Others living arrangements	870	33.6
Father’s education
Don’t know or no father	799	30.9
Upper secondary level to graduate level	1,123	62.8
Lower than upper secondary level	666	37.2
Mother’s education
Don’t know or no mother	696	26.9
Upper secondary level to graduate level	1,119	59.1
Lower than upper secondary level	773	40.9
Behavioral variables
Father’s substance use behaviors (drinking, smoking, and any drug use)
Don’t know or no father	556	21.5
None	566	21.9
Only drinking or smoking (without drug use)	765	29.6
Drinking and smoking (without drug use)	649	25.1
Any drug use (with or without drinking or smoking)	52	2.0
Mother’s substance use behaviors (drinking, smoking, and any drug use)
Don’t know or no mother	396	15.3
None	1,600	61.8
Only drinking or smoking (without drug use)	495	19.1
Drinking and smoking (without drug use)	79	3.1
Any drug use (with or without drinking or smoking)	18	0.7
Close friends’ substance use behaviors (drinking, smoking, and any drug use)
One	1,390	53.7
Only drinking or smoking (without drug use)	400	15.5
Drinking and smoking (without drug use)	581	22.5
Any drug use (with or without drinking or smoking)	217	8.4
Health risk behaviors variables
Youth’s substance use behaviors (drinking, smoking, and any drug use; in past 3 months)
None	1,652	63.8
Only drinking or smoking (without drug use)	627	24.2
Drinking and smoking (without drug use)	244	9.4
Any drug use (with or without drinking or smoking)	65	2.5
Number of sexual partners (lifetime)
0	2,252	87.0
1	183	7.1
2+	153	5.9
Physical fighting (in past 12 months)
No fights	2,130	82.3
Fought 1-2 times	226	8.7
Fought 3 times or more	232	9.0
Suicide attempt or planned suicide (lifetime)
None	2,457	94.9
Any	131	5.1
Carried weapon in past 12 months to
School only	42	1.6
Another place only	64	2.5
School and another place	97	3.7
Did not carry weapons	2,385	92.2

Note. TASS = Thai Adolescent Student Study; GPA = grade point average.

Association Between Health Risk Behaviors and Weapon Carrying

Next, we look at differences between youth who carried versus did not carry a weapon, using the Bonferroni adjustment (p < .004), as shown in Table 2: males versus females (p < .001) and older youth versus younger (p < .001). Youth were more likely to carry a weapon and, when stratified by age, 14 to 16 year olds (55.7%) were most likely to carry a weapon compared with 11 to 13 year olds (10.3%) or 17 to 19 year olds (34.0%). Vocational students, middle grade youth, and students who reported substance use by their fathers were more likely to carry a weapon than their counterparts: youth who reported substance use by their close friends (p < .001), youth who themselves reported substance use or reported having a sexual partner were more likely to carry a weapon than those who did not. Finally, youth who reported fighting and who had suicidal thoughts were more likely to carry a weapon than others. Notably, four variables were not statistically significant in the Bonferroni Correction (p < .004): youth who lived with both a mother and a father, youth whose fathers had upper secondary education and above, youth whose mothers had upper secondary education and above, and youth who reported their mother never used substances.

Table 2.

Characteristic of Thai Adolescents by Weapon Carrying Status of the TASS.

Variables	Carried Weapons		p Value^a
	No	Yes
	% (n = 2,385)	% (n = 203)
Demographic variables
Gender
Male	48.8	81.3	<.001**
Female	51.2	18.7
Age group
11-13 years old	21.8	10.3
14-16 years old	52.2	55.7	<.001**
17-19 years old	26.0	34.0
Social-economic status variables
School type
Public school	54.4	30.1
Private school	29.8	30.5	<.001**
Vocational school	15.8	39.4
GPA
Below 2.01	5.8	9.9
2.01-3.00	48.8	67.0	<.001**
3.01-4.00	45.4	23.2
Family living structure
With both mother and father	67.0	58.6	.015
Others living arrangements	33.0	41.4
Father’s education (among those with a father; n = 1,892)
Upper secondary level to graduate level	63.6	53.3	.017
Lower than upper secondary level	36.4	46.7
Mother’s education (among those with a mother; n = 1,789)
Upper secondary level to graduate level	59.9	50.0	.023
Lower than upper secondary level	40.1	50.0
Behavioral variables
Father’s substance use behaviors (among those with a father; n = 2,032)
None	28.9	15.5
Only drinking or smoking (without drug use)	37.8	36.1	<.001**
Drinking and smoking (without drug use)	31.1	41.9
Any drug use (with or without drinking or smoking)	2.2	6.5
Mother’s substance use behaviors (among those with a mother; n = 2,192)
None	73.7	64.1
Only drinking or smoking (without drug use)	22.2	27.4	.020
Drinking and smoking (without drug use)	3.3	7.2
Any drug use (with or without drinking or smoking)	0.8	1.3
Close friends’ substance use behaviors
None	56.1	25.1
Only drinking or smoking (without drug use)	15.9	10.8	<.001**
Drinking and smoking (without drug use)	20.7	43.4
Any drug use (with or without drinking or smoking)	7.3	20.7
Health risk behaviors variables
Youth’s substance use behaviors (drinking, smoking, and any drug use; in past 3 months)
None	67.3	22.7
Only drinking or smoking (without drug use)	23.9	28.1	<.001**
Drinking and smoking (without drug use)	7.3	34.5
Any drug use (with or without drinking or smoking)	1.5	14.8
Number of sexual partners (lifetime)
0	88.9	64.5
1	6.4	15.3	<.001**
2+	4.7	20.2
Physical fighting (in past 12 months)
No fights	86.5	32.5
Fought 1-2 times	7.8	19.7	<.001**
Fought 3 times or more	5.7	47.8
Suicide attempt or planned suicide (lifetime)
None	95.9	83.3	<.001**
Any	4.1	16.8

Note. TASS = Thai Adolescent Student Study; GPA = grade point average.

Chi-square test.

Significant is less than Bonferroni Correction (p < .004).

Table 3 presents univariate and multivariate relationships between weapon carrying and health risk behaviors. For the univariate, overall weapon carrying was associated with youth’s substance use behaviors, number of sexual partners, physical fighting, and suicide attempt or planned suicide, in addition to demographic variables, social-economic status variables, and behavioral variables. Among males, weapon carrying was associated with all variables. However, weapon carrying among females was not associated with age, family living structure, and father’s substance use behaviors.

Table 3.

Logistic Regression Analysis of Association Between Health Risk Behaviors and Weapon Carrying in the TASS.

	Total		Males		Females
	(n = 2,588)		(n = 1,329)		(n = 1,259)
	Unadjusted	Adjusted	Unadjusted	Adjusted	Unadjusted	Adjusted
	OR	OR	OR	OR	OR	OR
Associate Variables	(95% CI)	(95% CI)	(95% CI)	(95% CI)	(95% CI)	(95% CI)
Male	4.56***	3.98***	—	—	—	—
(Ref: Female)	[3.17, 6.54]	[2.06, 7.68)]
Age group	1.53***	1.19	1.54***	1.06	1.26	1.36
(Ref: 11-13 years old)	[1.23, 1.89]	[0.76, 1.88]	[1.21, 1.97]	[0.62, 1.80]	[0.78, 2.03]	[0.42, 4.45]
School type	2.13***	1.58**	1.85***	1.59*	1.74*	1.68
(Ref: Public school)	[1.78, 2.55]	[1.12, 2.24]	[1.51, 2.26]	[1.07, 2.35]	[1.13, 2.67]	[0.71, 3.99]
GPA	2.03***	1.23	1.59***	1.30	2.33**	0.59
(Ref: 3.01-4.00)	[1.61, 2.57]	[0.78, 1.93]	[1.22, 2.07]	[0.78, 2.18]	[1.35, 4.03]	[0.17, 2.09]
Family living structure	1.44*	1.28	1.54*	1.40	1.38	0.97
(Ref: Live with both mother and father)	[1.07, 1.92]	[0.67, 2.44]	[1.10, 2.15]	[0.69, 2.86]	[0.72, 2.65]	[0.17, 5.43]
Father’s education	1.53*	1.51	1.69*	1.68	2.10*	4.64
(Ref: Upper secondary level)	[1.08, 2.17]	[0.77, 2.98]	[1.12, 2.57]	[0.77, 3.71]	[1.02, 4.30]	[0.82, 26.19]
Mother’s education	1.49*	1.35	1.61*	0.89	2.79*	2.30
(Ref: Upper secondary level)	[1.05, 2.11]	[0.70, 2.62]	[1.07, 2.42]	[0.41, 1.95]	[1.26, 6.15]	[0.48, 11.05]
Father’s substance use	1.61***	0.84	1.66***	0.96	1.54	0.49
Behaviors (ref: None)	[1.32, 1.97]	[0.60, 1.19]	[1.32, 2.08]	[0.65, 1.41]	[0.98, 2.43]	[0.20, 1.22]
Mother’s substance use	1.44***	1.34	1.41*	1.05	2.00**	3.92*
Behaviors (ref: None)	[1.13, 1.83]	[0.85, 2.11]	[1.06, 1.87]	[0.62, 1.78]	[1.22, 3.29]	[1.31, 11.75]
Close friends’ substance use	1.96***	1.18	1.71***	1.34	1.91***	0.85
Behaviors (ref: None)	[1.72, 2.24]	[0.91, 1.53]	[1.46, 1.99]	[0.99, 1.80]	[1.43, 2.57]	[0.42, 1.72]
Only drinking or smoking	3.50***	1.91	3.33***	1.96	2.96**	1.49
(Without drug use) (ref: None)	[2.35, 5.23]	[0.96, 3.78]	[2.09, 5.29]	[0.92, 4.19]	[1.29, 6.78]	[0.25, 8.97]
Drinking and smoking	14.24***	5.89***	10.75***	4.02***	12.02***	34.41***
(Without drug use) (ref: None)	[9.51, 21.32]	[2.79, 12.44]	[6.79, 17.02]	[1.75, 9.22]	[4.70, 30.77]	[5.26, 225.28]
Any drug use (with or without drinking or smoking)	30.00***	13.04***	23.35***	9.87***	36.82***	40.16*
(Ref: None)	[16.98, 52.97]	[4.43, 38.39]	[11.78, 46.28]	[2.97, 32.79]	[12.62, 107.49]	[2.25, 715.99]
Number of sexual partners	2.52***	0.75	2.49***	0.95	2.07**	0.31
(Ref: 0)	[2.09, 3.05]	[0.48, 1.19]	[2.01, 3.09]	[0.58, 1.55]	[1.30, 3.30]	[0.09, 1.10]
Physical fighting	4.77***	3.57***	4.10***	3.20***	6.02***	7.49***
(Ref: No fights)	[4.00, 5.68]	[2.61, 4.89]	[3.34, 5.03]	[2.25, 4.55]	[4.13, 8.78]	[3.04, 18.46]
Suicide attempt or planned suicide	4.75***	3.03**	3.60***	1.43	15.39***	12.09***
(Ref: None)	[3.12, 7.23]	[1.31, 7.02]	[1.97, 6.57]	[0.43, 4.74]	[7.73, 30.67]	[2.83, 51.59]

Note. TASS = Thai Adolescent Student Study; OR = odds ratio; CI = confidence interval; GPA = grade point average.

p < .05. **p < .01. ***p < .001.

Furthermore, Table 3 shows the adjusted OR with 95% CI for associations between health risk behaviors and weapon carrying (adjusted for the confounding factors of gender, age, school type, GPA, family living structure, father’s education, mother’s education, father’s substance use behaviors, mother’s substance use behaviors, and close friends’ substance use behaviors). Students who had reported drinking and smoking (without drug use; aOR = 5.89, CI = [2.79, 12.44]), used any drug (with or without drinking or smoking; aOR = 13.04, CI = [4.43, 38.39]), fought 1 to 2 times or more (aOR = 3.57, CI = [2.61, 4.89]), and attempted or planned to commit suicide (aOR = 3.03, CI = [1.31, 7.02]) were significantly more likely to report carrying a weapon. In addition, male students (aOR = 3.98, CI = [2.06, 7.68]) and students who were in vocational school or private school (aOR = 1.58, CI = [1.12, 2.24]) were significantly more likely to report carrying a weapon than their counterparts.

When controlling for gender, there were four variables associated with weapon carrying among males and five among females. Similarities between genders were found in health risk behaviors associated with weapon carrying. Students who had reported drinking and smoking (without drug use; aOR = 4.02, CI = [1.75, 9.22] for males; aOR = 34.41, CI = [5.26, 225.28] for females), used any drug (with or without drinking or smoking; aOR = 9.87, CI = [2.97, 32.79] for males; aOR = 40.16, CI = [2.25, 715.99] for females), and fought (aOR = 3.20, CI = [2.25, 4.55] for males; aOR = 7.49, CI = [3.04, 18.46] for females) had the highest odds of carrying a weapon among both male and female students. Obvious differences were found in the risk behavior associated with weapon carrying by gender. Among females (but not among males), suicide attempt or planned suicide (aOR = 12.09, CI = [2.83, 51.59]) was associated with weapon carrying. Moreover, female students who reported having a mother with substance use behavior (aOR = 3.92, CI = [1.31, 11.75]) were more likely to report carrying a weapon. Among males (but not among females), vocational or private school students (aOR = 1.59, CI = [1.07, 2.35]) were significantly more likely to report carrying a weapon than their counterparts.

Discussion

In this first study of weapon carrying and health risk behaviors among Thai youth, the most important finding was that 7.8% of youth reported having carried a weapon within the past 12 months. Of concern is that 68.5% of students who carried a weapon reported carrying the weapon to school. Our finding identified that 7.8% of adolescent students had carried a weapon in 2014 compared with a rate of 8.5% in Thailand in 2001 (Ruangkanchanasetr et al., 2005). In Thailand, weapon carrying among youth is illegal; thus students who carry may to some extent be more disobedient. The finding that males carry weapons both at higher proportions and in higher adjusted odd ratio than females aligned with earlier studies among adolescents (Cao et al., 2008; Dukes et al., 2010; Durant et al., 1995; Ferguson & Cricket Meehan, 2010; Gilreath et al., 2014; Kodjo et al., 2003; Kulig et al., 1998; Orpinas et al., 1995; Ruangkanchanasetr et al., 2005; Stayton et al., 2011; Vaughn et al., 2012; Walsh et al., 2013; Wright & Fitzpatrick, 2006).

The most important association between weapon carrying and health risk behaviors was that drinking and smoking, any drug use, and physical fighting were significantly related with the highest odds of weapon carrying among mixed gender. The findings also aligned with previous studies that have indicated the same youth health risk factors. Alcohol, tobacco, and drug use were strongly associated with weapon carrying (Durant et al., 1995; Estell et al., 2003; Orpinas et al., 1995; Stayton et al., 2011) and were significant in all models in this study. In Thailand, any drug use is illegal, and smoking and drinking among teenagers, especially females, is still disapproved by adults and society in general. These finding indicated that males were at greater risk of weapon carrying, perhaps due to social norms and gender roles. However, drinking and smoking, drug use, and fighting were associated with higher odds of weapon carrying among females than males. These finding showed that students who engaged in drinking and smoking or any drug use had greatest OR for weapon carrying. Physical fighting was also an important factor associated with weapon carrying in all models. Unsurprisingly, many studies have shown that more frequent weapon carrying was associated with more frequent physical fighting (Cao et al., 2008; Durant et al., 1995; Lowry et al., 1998; Stayton et al., 2011; Swahn et al., 2013).

Outstandingly, the mother’s substance use behaviors were associated with weapon carrying only among females (neither the mixed gender nor male model showed significant association). This finding indicated that the mother’s behaviors affect female students and thus could point toward more concern with intervention among females’ behaviors. Moreover, the students who were in the less academic type of school, including vocational schools, were more likely to carry a weapon than those students in public schools. Interestingly, this association was significant among males and mixed gender and thus points toward more concern with school type for male students.

The finding that suicide attempts or planned suicide among females was associated with significantly higher odds of weapon carrying aligned with other studies that have found an association between suicidal thoughts and weapon carrying (Kulig et al., 1998; Orpinas et al., 1995; Stayton et al., 2011).

Different from some previous studies suggesting age was significantly associated with weapon carrying (Cao et al., 2008; Kodjo et al., 2003), our study found that the age range with the highest prevalence of weapon carrying was from 14 to 16 years of age, rather than ages 17 to 19 or 11 to 13 years of age. However, this finding was consistent with U.S. studies, which found that the age range with the highest prevalence of weapon carrying was 13 to 16 years (DuRant et al., 1999). Our study was different from others, in that GPA (Krug et al., 2002; Orpinas et al., 1995), parental education (Kodjo et al., 2003), and close friend’s substance use behaviors (Cao et al., 2008) were not significant predictions of violence and weapon carrying. Moreover, in contrast to previous studies suggesting a larger number of sex partners was significantly associated with weapon carrying (Kulig et al., 1998; Orpinas et al., 1995; Stayton et al., 2011), this study did not show a significant association. Some possible explanations for the inconsistency might be differences in measurement and the difference in the socio-demographic status of the samples.

Strengths and Limitations

This study had a number of strengths, including that it was the first report of the association between weapon carrying and multiple health risk behaviors among Thai adolescent students. We found significant differences among a group of male and female students. These data could be used for further interventions about weapon carrying protection and health risk related to the violence.

We focused on adolescent students in school in Bangkok, Thailand, and thus our data may not be generalizable to adolescents outside of school or adolescents in other provinces in Thailand. Also, our data were derived from self-reports, which can be subject to memory bias. However, that is not expected of participants in this group. Participants may have also underreported weapon carrying because of the illegality of carrying a gun; however, the questionnaire included more than a gun.

Conclusion

In conclusion, this study explored the associations between weapon carrying and health risk behaviors. Results highlight the strong consistent relationship between risk behavior (drinking and smoking, any drug use, physical fighting, and suicidal thoughts) and weapon carrying and a high proportion of weapon carrying to school among young teens. Interventions are urgently needed to reduce weapon use and violence among Thai youth.

Footnotes

Acknowledgements

The authors thank the high and vocational schools, the school administration, the teachers, the students who participated, and those who were involved in the study.

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This research was funded by the Thailand Research Fund through the Royal Golden Jubilee PhD Program (Grant PHD/0184/2553) to On-anong Saiphoklang, and Professor Kua Wongboonsin, PhD, is acknowledged.

Author Biographies

On-anong Saiphoklang, MPA, is a PhD candidate in demography in College of Population Studies at Chulalongkorn University. Her research interests focus on health risk behaviors among adolescents, including violence, sexual behavior, alcohol, tobacco, and drug use. She used to be a visiting research scholar at Department of Epidemiology at the College of Public Health and Health Professions and the College of Medicine at University of Florida.

Kua Wongboonsin, PhD, is a professor of demography in College of Population Studies and deputy director for Administrative Affairs at the Sasin Graduate Institute of Business Administration at Chulalongkorn University. His research interests focus on demographic analysis, population and development, and population health. He has authored many books and had taken lead in a series of population projections in Thailand. He also provides consultancy services to various governmental ministries, the private sector, and international organizations.

Patcharawalai Wongboonsin, PhD, is a professor of demography in College of Population Studies at Chulalongkorn University. Her research interests focus on population and development, migration, human development, human security, family, and gender sensitivity. She is a member of the Executive Board of the Institute of Asian Studies at Chulalongkorn University, Asian Review editor-in-chief, Asia Trend editor-in-chief, East Asian Economic Cooperation Council member, deputy director of the European Studies Center in Thailand, and representative of Thailand to Network of East Asian Think Tank. She also served as advisor to Thai Delegates, ASEAN Inter-Parliamentary Organization.

Usaneya Perngparn, PhD, is head, Drug Dependence Research Center, WHO collaborating Centre for Research and Training in Drug Dependence (WHOCC) at College of Public Health Sciences, and assistant dean of College of Public Health Sciences at Chulalongkorn University. Her research interests include development and evaluation of substance abuse and alcohol intervention, epidemiological study of pattern of substance abuse and HIV/AIDS risk behavior among specific population such as students, truck drivers, commercial sex workers, and seafarers.

Linda B. Cottler, PhD, MPH, is associate dean for Research and Planning at the College of Public Health and Health Professions and dean’s professor and founding chair of the Department of Epidemiology at the College of Public Health and Health Professions and the College of Medicine at the University of Florida. Her research interests include the development of culturally reliable and valid measures for identifying substance use, abuse and dependence, along with psychiatric disorders and their risk factors; innovative methods for conducting national surveys of high risk behaviors; and community-based, peer delivered interventions to change HIV risk behaviors and substance abuse. The work she has done is directly related to reducing disparities for health research and health services. She has expanded her community focus to the CTSA community Engagement Program—HealthStreet model had leveraged funding from the NIH for the multisite Sentinel Network, a GO grant and other. Her work has had international focus as well.

References

American Medical Association. (1990). Healthy Youth 2000: National health promotion and disease prevention objectives for adolescents. Chicago, IL: Department of Adolescent Health, American Medical Association.

Cao

Zhang

(2008). Carrying weapons to school for protection: An analysis of the 2001 school crime supplement data. Journal of Criminal Justice, 36, 154-164.

Dukes

R. L.

Stein

J. A.

Zane

J. I.

(2010). Gender differences in the relative impact of physical and relational bullying on adolescent injury and weapon carrying. Journal of School Psychology, 48, 511-532. doi:10.1016/j.jsp.2010.08.001

Durant

R. H.

Getts

A. G.

Cadenhead

Woods

E. R.

(1995). The association between weapon-carrying and the use of violence among adolescents living in or around public-housing. Journal of Adolescence, 18, 579-592. doi:10.1006/jado.1995.1040

DuRant

R. H.

Krowchuk

D. P.

Kreiter

Sinal

S. H.

Woods

C. R.

(1999). Weapon carrying on school property among middle school students. Archives of Pediatrics & Adolescent Medicine, 153, 21-26.

Estell

D. B.

Farmer

T. W.

Cairns

B. D.

Clemmer

J. T.

(2003). Self-report weapon possession in school and patterns of early adolescent adjustment in rural African American youth. Journal of Clinical Child & Adolescent Psychology, 32, 442-452. doi:10.1207/S15374424jccp3203_12

Ferguson

C. J.

Cricket Meehan

(2010). Saturday night’s alright for fighting: Antisocial traits, fighting, and weapons carrying in a large sample of youth. Psychiatric Quarterly, 81, 293-302. doi:10.1007/s11126-010-9138-y

Gilreath

T. D.

Astor

R. A.

Cederbaum

J. A.

Atuel

Benbenishty

(2014). Prevalence and correlates of victimization and weapon carrying among military-and nonmilitary-connected youth in Southern California. Preventive Medicine, 60, 21-26. doi:10.1016/j.ypmed.2013.12.002

Hidayati

Hatthakit

Isaramalai

S.-A.

(2012). Correlates of physical activity in Asian adolescents: A literature review. Nurse Media Journal of Nursing, 2, 451-466.

10.

Jessor

(1987). Problem-behavior theory, psychosocial development, and adolescent problem drinking. British Journal of Addiction, 82, 331-342.

11.

Jessor

S. L.

(1977). Problem behavior and psychosocial development: A longitudinal study of youth. New York, NY: Academic Press.

12.

Kodjo

C. M.

Auinger

Ryan

S. A.

(2003). Demographic, intrinsic, and extrinsic factors associated with weapon carrying at school. Archives of Pediatrics & Adolescent Medicine, 157, 96-103.

13.

Krug

E. G.

Dahlberg

L. L.

Mercy

J. A.

Zwi

A. B.

Lozano

(Eds.). (2002). World report on violence and health. Geneva, Switzerland: World Health Organization.

14.

Kulig

Valentine

Griffith

Ruthazer

(1998). Predictive model of weapon carrying among urban high school students: Results and validation. Journal of Adolescent Health, 22, 312-319. doi:10.1016/S1054-139x(97)00256-5

15.

Lowry

Powell

K. E.

Kann

Collins

J. L.

Kolbe

L. J.

(1998). Weapon-carrying, physical fighting, and fight-related injury among U.S. adolescents. American Journal of Preventive Medicine, 14, 122-129.

16.

McKnight-Eily

Arrazola

Merritt

Malarcher

Sirichotiratana

(2010). Prevalence and psychosocial correlates of current smoking among adolescent students in Thailand, 2005. Health Education & Behavior, 37, 863-878. doi:10.1177/1090198110366100

17.

Orpinas

P. K.

Basenengquist

Grunbaum

J. A.

Parcel

G. S.

(1995). The co-morbidity of violence-related behaviors with health-risk behaviors in a population of high-school-students. Journal of Adolescent Health, 16, 216-225. doi:10.1016/1054-139x(94)00067-O

18.

Pengpid

Peltzer

(2013). Bullying and its associated factors among school-aged adolescents in Thailand. Scientific World Journal, 2013, Article 254083. doi:10.1155/2013/254083

19.

Rongkavilit

Naar-King

Chuenyam

Wang

Wright

Phanuphak

(2007). Health risk behaviors among HIV-infected youth in Bangkok, Thailand. Journal of Adolescent Health, 40(4), 358.e1-358.e8. doi:10.1016/j.jadohealth.2006.11.004

20.

Ruangkanchanasetr

Plitponkarnpim

Hetrakul

Kongsakon

(2005). Youth risk behavior survey: Bangkok, Thailand. Journal of Adolescent Health, 36, 227-235. doi:10.1016/j.jadohealth.2004.01.013

21.

Rudatsikira

Muula

A. S.

Siziya

Mataya

R. H.

(2008). Correlates of cigarette smoking among school-going adolescents in Thailand: Findings from the Thai global youth tobacco survey 2005. International Archives of Medicine, 1(1), 8. doi:10.1186/1755-7682-1-8

22.

Stayton

McVeigh

K. H.

Olson

E. C.

Perkins

Kerker

B. D.

(2011). Victimization and health risk factors among weapon-carrying youth. American Journal of Health Behavior, 35, 654-663.

23.

Swahn

M. H.

Bossarte

R. M.

Palmier

J. B.

Yao

Van Dulmen

M. H. M.

(2013). Psychosocial characteristics associated with frequent physical fighting: Findings from the 2009 National Youth Risk Behavior Survey. Injury Prevention, 19, 143-146. doi:10.1136/injuryprev-2012-040381

24.

Vaughn

M. G.

Perron

B. E.

Abdon

Olate

Groom

L. T.

(2012). Correlates of handgun carrying among adolescents in the United States. Journal of Interpersonal Violence, 27, 2003-2021. doi:10.1177/0886260511432150

25.

Walsh

S. D.

Molcho

Craig

Harel-Fisch

Huynh

Kukaswadia

. . .Pickett

(2013). Physical and emotional health problems experienced by youth engaged in physical fighting and weapon carrying. PLoS ONE, 8(2), e56403. doi:10.1371/journal.pone.0056403

26.

Weisstein

E. W.

(2014). Bonferroni correction. Retrieved from http://mathworld.wolfram.com/BonferroniCorrection.html

27.

Wright

D. R.

Fitzpatrick

K. M.

(2006). Social capital and adolescent violent behavior: Correlates of fighting and weapon use among secondary school students. Social Forces, 84, 1435-1453. doi:10.1353/sof.2006.0077