"I am spiritual, but not religious": Does one without the other protect against adolescent health-risk behaviour?

Klara Malinakova*, Jaroslava Kopcakova, Andrea Madarasova Geckova, Jitse P. van Dijk, Jana Furstova, Michal Kalman, Peter Tavel, Sijmen A. Reijneveld

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Objectives: Spirituality and religious attendance (RA) have been suggested to protect against adolescent health-risk behaviour (HRB). The aim of this study was to explore the interrelatedness of these two concepts in a secular environment.

Methods: A nationally representative sample (n=4566, 14.41.1years, 48.8% boys) of adolescents participated in the 2014 Health Behaviour in School-aged Children cross-sectional study. RA, spirituality (modified version of the Spiritual Well-Being Scale), tobacco, alcohol, cannabis and drug use and the prevalence of sexual intercourse were measured.

Results: RA and spirituality were associated with a lower chance of weekly smoking, with odds ratios (OR) 0.57 [95% confidence interval (CI) 0.36-0.88] for RA and 0.88 (0.80-0.97) for spirituality. Higher spirituality was also associated with a lower risk of weekly drinking [OR (95% CI) 0.91 (0.83-0.995)]. The multiplicative interaction of RA and spirituality was associated with less risky behaviour for four of five explored HRB. RA was not a significant mediator for the association of spirituality with HRB.

Conclusions: Our findings suggest that high spirituality only protects adolescents from HRB if combined with RA.

Original languageEnglish
Pages (from-to)115-124
Number of pages10
JournalInternational Journal of Public Health
Issue number1
Publication statusPublished - Jan-2019


  • Health-risk behaviour
  • Adolescence
  • Religious attendance
  • Spirituality
  • HBSC study

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