title: The period prevalence of risk behavior co-occurrence among Canadians.
abstract: BACKGROUND
  While the benefits of complying with health recommendations is well documented, a considerable proportion of Canadians engage in multiple modifiable risk behaviors. The purpose of this multi-wave longitudinal study was to identify the individual period prevalence and co-occurrence of multiple modifiable risk behaviors, particularly excessive alcohol consumption, physical inactivity, and tobacco use, within a nationally representative sample of Canadians.
  
  
  METHODS
  Secondary data analysis was conducted on the first seven cycles of the National Population Health Survey. This longitudinal sample included 15,167 Canadians aged 12years of age or older. Gender-specific criteria were employed to define excessive alcohol consumption. Individuals expending <3.0kcal/kg/day during their leisure-time and smoking cigarettes (daily or occasionally) met the criteria for physical inactivity and tobacco use, respectively.
  
  
  RESULTS
  The period prevalence of the Canadian general population that participated in multiple risk behaviors was 21.5% in cycle 7. The most common pairwise combination of co-occurring risk behaviors was physical inactivity and smoking. The proportion of Canadians reporting the co-occurrence of all three risk behaviors in cycle 7 was 2.6%.
  
  
  CONCLUSIONS
  Understanding patterns of modifiable risk behaviors is an initial step in developing and implementing public health interventions. The co-occurrence of these three risk behaviors is a viable concern for one in five Canadians. For these individuals, the likelihood of encountering premature morbidity and mortality is escalated. As the majority of Canadians reported being physically inactive, allocating limited resources towards enhancing leisure-time physical activity levels could have significant population-level implications for improving the health of Canadians.
authors.affiliation: Faculty of Kinesiology & Physical Education, University of Toronto, 55 Harbord Street, Toronto, ON M5S 2W6, Canada; Nicotine Dependence Service, Centre for Addiction and Mental Health, 175 College Street, Toronto, ON, M5T 1P7, Canada. Electronic address: wayne.deruiter@camh.ca.
authors.forename: Wayne K
authors.initials: WK
authors.lastname: deRuiter
authors.affiliation: Department of Family Medicine, McMaster University, 100 Main Street West, 6th Floor, Hamilton, ON L8P 1H6, Canada; Psychiatry & Behavioural Neurosciences and Kinesiology, McMaster University, 100 West 5th Street, Hamilton, ON L8N 3K7, Canada.
authors.forename: John
authors.initials: J
authors.lastname: Cairney
authors.affiliation: School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1, Canada.
authors.forename: Scott
authors.initials: S
authors.lastname: Leatherdale
authors.affiliation: Faculty of Kinesiology & Physical Education, University of Toronto, 55 Harbord Street, Toronto, ON M5S 2W6, Canada; School of Kinesiology, University of British Columbia, 2146 Health Sciences Mall, Vancouver, BC V6T 1Z3, Canada.
authors.forename: Guy
authors.initials: G
authors.lastname: Faulkner
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology*; D002170:Canada / Q000453:epidemiology; D002648:Child; D015897:Comorbidity; D005260:Female; D006306:Health Surveys; D006801:Humans; D007899:Leisure Activities; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012309:Risk-Taking; D057185:Sedentary Behavior; D012907:Smoking / Q000453:epidemiology*; D055815:Young Adult
keywords: Alcohol consumption; Physical activity; Public health; Risk behaviors; Tobacco