| Alcohol is a leading risk factor for public health;however,the alcohol use remains excessively high among adolescents and adults.In addition to the alcohol consequences,every day more than 1,000 young people under the age of 25 years are killed and are the primary victims of road traffic crashes(RTCs)globally.Drink-driving,one of the alcohol use behaviors,is a primary factor of the RTCs that causes fatalities and severe injuries daily.Cambodia is a country where alcohol use and the RTCs among adults are very critical;however,little research on alcohol use and drink-driving has been done.The main objectives of this dissertation are to lower alcohol consumption as well as to control drink-driving behaviors among Cambodian adults.The results of this dissertation could contribute to the design of the practical mechanisms and policies aiming at dealing with the said problems.Methodologically,this dissertation combined four studies,and thus different methodologies have been applied.The descriptive statistics,bivariate correlations,multiple regressions,and structural equation modeling(SEM)have been performed in the IBM SPSS and SmartPLS to find the frequencies and correlations and to predict path coefficients of the constructs in each conceptual model of the studies.The survey questionnaires for both online and face to face interviews were used for all the studies.Adolescents and adults were the targeted respondents.In the first study,557 respondents participated,of which 63.90%were 20-29 years old with 88.7%obtaining university degrees,and 43.30%worked in the private sector with an average income of 175US$ per month.Approximately,68.20%of them admitted consuming alcohol and 33.40%reported getting drunk at least 1-2 times in the past 30 days.The analysis of the path coefficients showed that peer’s drinking behavior and personal drinking experiences were significantly influenced on actual use of alcohol(AUA).Likely,a healthy relationship between AUA and friendship network was significantly verified.In the second study,the majority of students,who used alcohol(27.5%),smoke(6.3%),drugs(3.6%),smoke(6.3%)and had sexual intercourse(11.9%),were male,aged 14-15,and in grade 7-8.These students were very vulnerable to many risky behaviors,including bullying(23.7%),physical attacks(17.1%)and fights(10.9%),unintentional accidents(19.9%),and suicidal attempts(6.7%).The comparison of substance use and risky behaviors among Cambodian high school students and otherstudents in ASEAN member states and China were also presented in this study.Moreover,the drug use significantly mediated relationships between alcohol use and sexual behaviors as well as between alcohol use and victimization.Subsequently,a relationship between alcohol use and victimization was also partially mediated by sexual behaviors.Of the potential mediators examined,drug use is the most important mediator.In the third study,some 72.6%out of 1,041 undergraduate students had ever drunk alcohol,and 22.6%drank alcohol before 18 years old.Approximately,23.9%of them reported getting drunk in the past 12 months,and 4.9%had ever drunk more than four times.At least 13.4%of the students had ever been absent from school due to the alcohol consumption.Moreover,90.8%of the students drove their vehicle to university;but,only 20.0%had a driving license.49.7%of them admitted ever violating the traffic law in the past 30 days,and 26.9%had ever been caught by traffic police in the past 12 months.This study also highlighted that 27.8%and 24.3%of the students had ever driven after drinking and had ever driven by a drunk driver respectively.Furthermore,the 21.7%of the students experienced RTCs in the past 12 months,and the most common RTCs occurred in the evening and at night.Lastly,the models of the study were significantly confirmed.The behavioral intention to use alcohol or drive after drinking was influenced by attitude,subjective norm,perceived behavioral control and moral norm,of which perceived behavioral control and attitude were the most influential factors.The fourth study reviewed the policies and laws on alcohol control and drink-driving prevention in different countries.Most of the policies and laws focus on the restriction of alcohol availability,advertising,legal minimum drinking age,and an increase in prices and taxes.Whereas,the policies and laws on drink-driving prevention poured attention into the legal minimum driving age,lowering BAC level,penalizing the drink-drivers with severity and celerity,license suspension,driving incapacitation,installation of ignition interlocks on the vehicles,and criminalizing if there is a severe damage.The zero-tolerant mechanism for drink-drivers is what most scholars and policymakers recommended.In short,the alcohol use and drink-driving among Cambodian adults were very highly prevalent.The study suggests that educational campaigns and preventive strategies about alcohol,safety driving,and rehabilitative health are urgently needed.The campaigns should frequently be held at the university,high school,and community levels to enhance the awareness of the people.A contribution from the Ministry of Public Works and Transportation to offer a free-driving course to the university students who do not have a driving license would significantly reduce the RTCs among the group.The findings also suggest that protective behavioral strategies and fear-based messages through mass media,social network sites,school information boards,and product-based placements would be very beneficial whereby regulations and policies must be implemented strictly and transparently.Importantly,the contributions from parents and family are also very important because a family history of alcohol use and driving behaviors strongly influence adults’ alcohol use intention and driving.The policy,regulating the alcohol use among adolescents and adults at the renting house and festive rituals,is needed. |
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