Open Access Highly Accessed Research article

Loneliness and health risk behaviours among Russian and U.S. adolescents: a cross-sectional study

Andrew Stickley12*, Ai Koyanagi1, Roman Koposov3, Mary Schwab-Stone4 and Vladislav Ruchkin5

Author Affiliations

1 Stockholm Centre on Health of Societies in Transition (SCOHOST), Södertörn University, 141 89 Huddinge, Sweden

2 Department of Human Ecology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan

3 Regional Centre for Child and Youth Mental Health and Child Welfare, UiT The Arctic University of Norway, Tromsø, Norway

4 Child Study Centre, Yale University Medical School, New Haven, CT, USA

5 Department of Social and Forensic Psychiatry, Division of Neuroscience, Karolinska Institute, Huddinge, Sweden

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BMC Public Health 2014, 14:366  doi:10.1186/1471-2458-14-366

Published: 16 April 2014



For some adolescents feeling lonely can be a protracted and painful experience. It has been suggested that engaging in health risk behaviours such as substance use and sexual behaviour may be a way of coping with the distress arising from loneliness during adolescence. However, the association between loneliness and health risk behaviour has been little studied to date. To address this research gap, the current study examined this relation among Russian and U.S. adolescents.


Data were used from the Social and Health Assessment (SAHA), a school-based survey conducted in 2003. A total of 1995 Russian and 2050 U.S. students aged 13–15 years old were included in the analysis. Logistic regression was used to examine the association between loneliness and substance use, sexual risk behaviour, and violence.


After adjusting for demographic characteristics and depressive symptoms, loneliness was associated with a significantly increased risk of adolescent substance use in both Russia and the United States. Lonely Russian girls were significantly more likely to have used marijuana (odds ratio [OR]: 2.28; confidence interval [CI]: 1.17–4.45), while lonely Russian boys had higher odds for past 30-day smoking (OR, 1.87; CI, 1.08–3.24). In the U.S. loneliness was associated with the lifetime use of illicit drugs (excepting marijuana) among boys (OR, 3.09; CI, 1.41–6.77) and with lifetime marijuana use (OR, 1.79; CI, 1.26–2.55), past 30-day alcohol consumption (OR, 1.80; CI, 1.18–2.75) and past 30-day binge drinking (OR, 2.40; CI, 1.56–3.70) among girls. The only relation between loneliness and sexual risk behaviour was among Russian girls, where loneliness was associated with significantly higher odds for ever having been pregnant (OR, 1.69; CI: 1.12–2.54). Loneliness was not associated with violent behaviour among boys or girls in either country.


Loneliness is associated with adolescent health risk behaviour among boys and girls in both Russia and the United States. Further research is now needed in both settings using quantitative and qualitative methods to better understand the association between loneliness and health risk behaviours so that effective interventions can be designed and implemented to mitigate loneliness and its effects on adolescent well-being.

Adolescent; Health risk behaviour; Loneliness; Russia; United States