Purpose: To examine the extent to which the use of the three most commonly consumed drugs in Taiwan (i.e., alcohol, tobacco, and betel nut) is related with health-related quality of life among adolescents. We probe whether the relationship linking alcohol use with health-related quality varies by health-orientated domains (e.g., physical, social, or emotional) and if it differs with other drug involvement. Method: The data for this study come from a representative sample of 2235 adolescents (aged 12-18 years) collected as part of the 2001 National Health Interview Survey (NHIS), conducted in Taiwan. Recent alcohol, tobacco, and betel nut experiences were assessed by face-to-face interview. The 36-item short form Health Survey (SF-36) was used to assess respondents' generic health status. Results: Youth with recent alcohol use tend to experience a poorer level of health-related quality of life. The estimated associations were not constant over the eight domains of general health examined, and multivariate modeling with generalized linear models and generalized estimating equations found that the strongest inverse relationship appears in the domain of role limitation due to emotional problems (β = -10.5, 95% confidence interval [CI]: -16.9--4.12, p < .001). Greater deleterious effects were not found among youth also using tobacco and/or betel nut. Conclusions: Alcohol use was shown to be associated with impaired levels of health-related quality of life in adolescents. Although the temporality between alcohol involvement and lower levels of mental health is not explicit, the findings suggest that youth who are actively drinking might be a possible target group to intervene and avert mental health-related problems. ? 2006 Society for Adolescent Medicine.
