Leisure time physical activity and sedentary behavior and substance use among in-school adolescents in eight African countries

Background. Physical inactivity leads to higher morbidity and mortality from chronic non-communicable diseases. In high income countries, studies have measured school population level physical activity and substance use, but comparable data are lacking from most African countries. Purpose.To study the relationship between self-reported leisure time physical activity frequency and sedentary behavior and alcohol, tobacco, and other drug use behaviors among school children. Method. A cross-sectional survey was conducted with the total sample of 24,593 school children aged 13 to 15 years from nationally representative samples from eight African countries. Univariate and multivariate analyses were conducted to assess the relationship between physical activity frequency, six measures of alcohol, tobacco, and other drug use, socioeconomic status, and mental health variables. Results. In all, only 14.2% of the school children were frequently physically active (5 days and more in a week, at least 60 min/day) during leisure time; this was significantly higher among boys than girls. Ugandan and Kenyan school children were most physically active (17.7% and 16.0%, respectively), and Zambian and Senegalese the least (9.0% and 10.9%, respectively). Frequency of alcohol consumption and higher socioeconomic status were significantly associated with leisure time physical activity, while tobacco, illicit drug use, and mental health variables were not. Leisure time sedentary behavior of five and more hours spent sitting on a usual day were highly associated with all substance use variables. Conclusion. These findings suggest that leisure time physical activity frequency is associated with frequency of alcohol use and not with tobacco and illicit drug use, and leisure time sedentary behavior is highly associated with alcohol, tobacco, and drug use among adolescents.