title: Unlicensed driving and other related health risk behaviors: a study of Montana high school students.
abstract: OBJECTIVE
  Health risk behaviors tend to cluster in young people, not least among young drivers. Less is known about the health risk profile of young unlicensed drivers. This study investigates health risk behaviors among young unlicensed drivers compared to both their licensed and driving peers, and their non-driving peers.
  
  
  METHODS
  High school students participating in the Youth Risk Behavior Surveillance System in Montana (US) and age-eligible to have a driver's license were studied (n=5985), categorized according to their self-reported car driving and license practice (licensed driving, unlicensed driving, and non-driving). Ten health risk behaviors, of which four were related to car riding/driving, were considered. Multinomial logistic regression was used to compile sex-specific odds ratios (with 95% confidence intervals) of adopting those behaviors using licensed drivers as a reference and adjusting for age and race/ethnicity.
  
  
  RESULTS
  Health risk behaviors tended to be more common among unlicensed drivers than other groups, although some behaviors were prevalent in all groups (i.e., alcohol use and lack of seat belt use). As a consequence, for both male and female students, there was a significant association between unlicensed driving and most health risk behaviors, except for being involved in a physical fight and riding with a drinking driver among female students.
  
  
  CONCLUSIONS
  Young unlicensed drivers are more likely than licensed drivers to adopt several health risk behaviors both in car driving/riding or otherwise, in particular alcohol use and cigarette smoking. This challenges any simplistic approach as unlicensed driving in youth is not an isolated act suggesting public health and traffic safety initiatives.
authors.affiliation: Karolinska Institutet, Department of Public Health Sciences, Division of Global Health/IHCAR, Stockholm, Sweden. goingunlicensed@comcast.net
authors.forename: Christian L
authors.initials: CL
authors.lastname: Hanna
authors.forename: Lucie
authors.initials: L
authors.lastname: Laflamme
authors.forename: Berty
authors.initials: B
authors.lastname: Elling
authors.forename: Jette
authors.initials: J
authors.lastname: Möller
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D001334:Automobile Driving / Q000523:psychology* / Q000706:statistics & numerical data; D003415:Crime / Q000523:psychology* / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D003617:Dangerous Behavior; D005260:Female; D006306:Health Surveys; D006801:Humans; D008004:Licensure; D016015:Logistic Models; D008297:Male; D009009:Montana; D015999:Multivariate Analysis; D016017:Odds Ratio; D011159:Population Surveillance; D057566:Self Report; D012737:Sex Factors