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, 14.4 ± 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. 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.

Department of Community and Occupational Health University Medical Center Groningen University of Groningen Ant Deusinglaan 1 9713 AV Groningen The Netherlands

Department of Health Psychology Faculty of Medicine University of Pavol Jozef Safarik Kosice Tr SNP 1 040 11 Kosice Slovak Republic

Department of Social Medicine and Public Health Faculty of Medicine and Dentistry Palacky University Olomouc Olomouc Czech Republic

Graduate School Kosice Institute for Society and Health University of Pavol Jozef Safarik Kosice Tr SNP 1 040 11 Kosice Slovak Republic

Institute of Active Living Faculty of Physical Culture Palacky University Olomouc Trida Miru 115 771 11 Olomouc Czech Republic

OUSHI Olomouc University Social Health Institute Palacky University Olomouc Univerzitni 244 22 771 11 Olomouc Czech Republic

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