Prevalence of risk factors of major non-communicable diseases among adolescents in schools of Rapti-Sonari rural municipality of Banke district: a cross-sectional study in Nepal.

Introduction: About 70% of premature adult deaths are linked to health-related behaviours that begin in childhood and adolescence. This study aimed to assess the prevalence of major non-communicable disease (NCD) risk factors and their associated factors among school-going adolescents in Rapti-Sonari Rural Municipality, Banke, Nepal. Methods: A cross-sectional study was conducted among 630 adolescents selected using a two-stage cluster sampling technique. Data were collected through a self-administered questionnaire. Descriptive statistics summarised the data, while the χ² tests, bivariate and multivariate logistic regression identified associated factors. Statistical significance was set at p<0.05 at a 95% CI. Results: The mean age of participants was 15.5±1.3 years. Insufficient fruit and vegetable intake (98.4%) and physical inactivity (83.8%) were highly prevalent. Physical activity was significantly associated with male sex (adjusted OR (AOR): 2.1, 95% CI 1.3 to 3.2) and monthly pocket money >Nepalese Rupee (NRs) 500 (AOR: 1.9, 95% CI 1.2 to 3.0). Current alcohol use (29.0%) and smoking (8.1%) were also reported. Alcohol consumption was significantly associated with male (AOR: 2.6, 95% CI 1.6 to 3.3), Tharu ethnicity (AOR: 2.5, 95% CI 1.3 to 3.6) and pocket money >NRs 500 (AOR: 2.8, 95% CI 1.8 to 4.1). Smoking was significantly associated with male (AOR: 2.7, 95% CI 1.8 to 3.9) and pocket money >NRs 500 (AOR: 2.8, 95% CI 1.8 to 4.3). Conclusions: Nearly all adolescents exhibited at least one behavioural risk factor for NCDs. The findings highlight inadequate diet, insufficient physical activity and substantial levels of alcohol and tobacco use among adolescents. As these behaviours often persist into adulthood, comprehensive interventions, promotion of extracurricular activities and stricter enforcement of alcohol and tobacco regulations in schools are urgently needed.