Cancer Causes & Control

, Volume 26, Issue 4, pp 519–528 | Cite as

An examination of the co-occurrence of modifiable risk factors associated with chronic disease among youth in the COMPASS study

  • Scott T. LeatherdaleEmail author
Original paper



To examine the prevalence of major modifiable risk factors for cancer, examine risk factor co-occurrence, and examine how demographic and social factors are associated with risk factor co-occurrence among youth in the COMPASS study.


Data from 23,280 grade 9–12 students in Year 1 (2012–2013) of the COMPASS study were used to examine the prevalence of seven different modifiable risk factors and the co-occurrence of these risk factors by gender and by grade. The between-school variance in the number of risk factors was calculated, and a model was developed to examine how demographic and social factors were associated with the number of co-occurring risk factors.


Among youth in this sample, 5.5 % were current smokers, 22.9 % were current binge drinkers, 16.5 % were current marijuana users, 20.0 % were overweight/obese, 53.1 % were physically inactive, 96.7 % were highly sedentary, and 95.1 % had inadequate fruit and vegetable consumption. The mean number of co-occurring risk factors among students was 3.2 (±1.1) and only 0.2 % (n = 42) reported having none of the risk factors and 0.4 % (n = 67) reported having all seven risk factors. Significant between-school random variation in the number of co-occurring risk factors was not identified. The number of risk factors was associated with most of the correlates examined although the effect sizes were generally small.


This research identifies that risk factor co-occurrence is common, most of student characteristics examined are only modestly associated with the likelihood of co-occurrence and that the school environment is not associated with variability in the number of co-occurring risk factors.


Obesity Physical activity Tobacco Alcohol Marijuana Diet Bullying Youth 



The COMPASS study was supported by a bridge grant from the Canadian Institutes of Health Research (CIHR), Institute of Nutrition, Metabolism and Diabetes (INMD) through the “Obesity—Interventions to Prevent or Treat” priority funding awards (OOP-110788; grant awarded to ST. Leatherdale) and an operating grant from the Canadian Institutes of Health Research (CIHR) Institute of Population and Public Health (IPPH) (MOP-114875; grant awarded to ST. Leatherdale). Dr. Leatherdale is a Chair in Applied Public Health funded by the Public Health Agency of Canada (PHAC) in partnership with Canadian Institutes of Health Research (CIHR), Institute of Neurosciences, Mental Health and Addiction (INMHA) and Institute of Population and Public Health (IPPH).

Conflict of interest

The author declares that he has no competing interests.


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Copyright information

© Springer International Publishing Switzerland 2015

Authors and Affiliations

  1. 1.School of Public Health and Health SystemsUniversity of WaterlooWaterlooCanada

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