Bullying victimization and adverse health behaviors among school-going adolescents in South Asia: Findings from the global school-based student health survey

Background Bullying among adolescents is a global public health issue and has adverse behavioral and mental health consequences, yet a little is known about the relationship between bullying victimization and adverse health behaviors in adolescence in South Asian countries. Methods Data for this cross-sectional analysis were extracted from the global school-based student health survey (GSHS) in Bangladesh (n = 2,989), 2014 and in Nepal (n = 6,529), 2015. Multivariate logistic regression analyses were used to identify the associations between bullying victimization and adverse health behaviors or outcomes: physical violence, sexual history, tobacco use, alcohol use, drug use, suicide ideation, plan, attempt, loneliness, and sleeping difficulty. Results The prevalence of bullying victimization that occurred for a minimum of 1 day during the 30 days preceding the survey was 24.5% in Bangladesh and 50.9% in Nepal. This study observed significant relationships between bullying victimization and several adverse health behaviors/outcomes. For example, in Bangladesh, the odds of attempted suicide were found to be higher in adolescents that experienced bullying for 1-2 (adjusted odds ratio [AOR]: 2.92; 95% confidence interval [CI]: 1.64-5.19), 3-5 (AOR: 3.55; 95% CI: 1.69), 6-9 (AOR: 5.33; 95% CI: 1.24-22.77), or 10 days or more (AOR: 9.83; 95% CI: 4.17-23.16) during the 30 days preceding the survey than who did not. Conclusions Bullying among adolescents in school is common in Bangladesh and Nepal and is associated with several adverse health behaviors. Bullying and its potential health consequences are needed to be addressed in health promotion and programs in these countries.