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29.05.2018 | Original Article | Ausgabe 1/2019 Open Access

International Journal of Public Health 1/2019

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

International Journal of Public Health > Ausgabe 1/2019
Klara Malinakova, Jaroslava Kopcakova, Andrea Madarasova Geckova, Jitse P. van Dijk, Jana Furstova, Michal Kalman, Peter Tavel, Sijmen A. Reijneveld
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1007/​s00038-018-1116-4) contains supplementary material, which is available to authorized users.



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.


A nationally representative sample (n = 4566, 14.4 ± 1.1 years, 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.


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.


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

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