Research Article Smoking, Alcohol Consumption, and Illegal Substance Abuse among Adolescents in Sri Lanka: Results from Sri Lankan Global School-Based Health Survey 2016 Sameera Senanayake , 1 Shanthi Gunawardena, 2 Mahesh Kumbukage , 3 Champika Wickramasnghe, 3 Nalika Gunawardena , 4 Ayesha Lokubalasooriya, 1 and Renuka Peiris 5 1 Family Health Bureau, Ministry of Health, Sri Lanka 2 Non-Communicable Diseases Unit, Ministry of Health, Sri Lanka 3 Ministry of Health, Sri Lanka 4 World Health Organization, Sri Lanka 5 Ministry of Education, Sri Lanka Correspondence should be addressed to Mahesh Kumbukage; mpkumbukage@gmail.com Received 25 June 2018; Accepted 4 November 2018; Published 25 November 2018 Academic Editor: Carol J. Burns Copyright © 2018 Sameera Senanayake et al. Tis is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Background. Adolescence is defned by the World Health Organization (WHO) as “the transition period from childhood to adulthood”. Increases in autonomy during this period, willingness to experiment, and peer infuence create an environment of taking high-risk decisions infuencing adolescent health, such as substance abuse and smoking. Te current study was conducted to estimate the prevalence of smoking, alcohol consumption, and illegal substance abuse and their determinants on in-school adolescents using data from the Global School-based Student Health Survey, Sri Lanka in 2016. Methods. A cross-sectional survey was conducted among 3,650 students using a self-administered questionnaire in government schools. Weighted prevalence was calculated, and logistic regression analysis was conducted to determine the correlates. Results. Te prevalence of current alcohol, smoking, smokeless tobacco consumption, and substance abuse, 30 days before the survey, was 3.4% (95% CI 2.6 - 4.3), 3.6% (95% CI 2.5-5.0), 2.3% (95% CI 1.5-3.7), and 2.7% (95% CI - 1.7-4.2%). Male sex and involvement in physical fghting were independently associated with increased risk in all four substance categories assessed. Multivariate analysis using multiple logistic regression revealed that only the male sex and involvement in physical fghting were correlates for four substance categories assessed when confounding efects of other variables were accounted for. Being in the 16-17 age category, parents’ tobacco use and seeing actors consuming alcohol on TV increased the risk of alcohol consumption, smoking, and smokeless tobacco. Having ever attempted suicide was positively associated with increased risk for alcohol consumption, smoking, and illegal substance abuse. Conclusion. Alcohol use, smoking, smokeless tobacco use, and illegal substance abuse by students remain a concern in Sri Lanka and implementing life skills-based interventions at schools is recommended. 1. Introduction Adolescence is defned by the World Health Organization (WHO) as “the transition period from childhood to adult- hood”, ranging from ages 10 to 19 years. In Sri Lanka, adoles- cents consist of 16.1% of the total population, with 70% attending school [1]. Adolescence is one of the most rapid phases of human development where biological maturity precedes psychoso- cial maturity [2]. Both individual and the environmental characteristics infuence changes taking place during adoles- cence. Increased autonomy during this period, willingness to experiment, and peer infuence/pressure create an envi- ronment encouraging high-risk decisions which infuence Hindawi Advances in Public Health Volume 2018, Article ID 9724176, 7 pages https://doi.org/10.1155/2018/9724176