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YOUNG PEOPLE ARE ASIA’S KEY TO CURBING THE RISE OF NON- COMMUNICABLE DISEASES

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MUNICABLE

MUNICABLE DISEASES , Most Tobacco Use, Cancers, Harmful Use of Alcohol, Diabetes, Insufficient Physical Activity, Chronic Unhealthy Diet Respiratory Diseases s From Noncommunicable Diseases Are More Common in Lowe Countries lth of 24 t 19 is 6 Ages 45 and Older 80 (UN) 16 19 M Myanmar (2011) Tobacco Use is High Among Boys in Much of Asia F ed by the World Health Organization (WHO) as cardiovascular diseases, cancers, diabetes, and chronic respiratory income countries, NCDs in low- and middle-income countries (LMIC) generally claim lives at younger ages, often onomic productivity. In LMIC in Asia, the likelihood of dying prematurely (between ages 30 and 70) from the four 34 2 mpared to 9 percent in high-income countries in the region. Premature deaths from NCDs are projected to increase rcent of the region’s population resides, underscoring the importance of prioritizing NCD prevention. aturely om the cable RISK BEHAVIORS F 1 16 16 Tobacco use is the leading cause of Population preventable Pyramids, South deaths Asia, Southeast around Asia, and East the Asia: world, 2015 and due 2050 Percent of Boys and Girls to illness such as cancers, chronic respiratory diseases, M and heart M 6 13 19 13-15 Years Old in Secondary Indonesia (2014) South Asia Southeast Asia India (2009) East Asia Schools Who Used Tobacco F 3 2 4 diseases. Although tobacco use in Asia has typically been Age most common among Age older males, the tobacco industry has begun to target women Male Female 85+ Male Female 85+ F 2 6 8 Products in the Past 30 Days, Male Female 80-84 80-84 Less than 15% Select Countries M 75-79 75-79 17 and youth more actively, and at the same Ages time, income growth has made tobacco M products 13 more 6 affordable. 19 Consequently, Myanmar (2011) Ages 30 sizeable proportions 15% to 19% 70-74 45 Philippines 70-74 (2011) 45 F 1 6 65-69 65-69 7 and and of boys in many countries are 20% now to 24% 60-64 60-64 F 5 4 9 Cigarettes (and possibly smoking. Older Among 13-to-15-year-old boys in secondary school, Older 55-59 55-59 36 percent other tobacco in products) Indonesia, 30 percent M 6 in Myanmar, 19 25% to 29% 50-54 50-54 M 10 1 11 Nepal (2011) 45-49 45-49 and 25 percent in Nepal currently 30% and more China (2014) use tobacco (defi ned 40-44 as any use in the last 40-4430 days). In general, the rates among girls are substantially F 1 16 lower, 16 F 2 1 2 Other tobacco products only 35-39 35-39 30-34 30-34 M 6 13 19 though they are increasing in some countries. Although 25-29 cigarettes are predominant 25-29 in East Asia and certain countries in Southeast India (2009) Asia, other 20-24 20-24 F 2 6 8 15-19 15-19 tobacco 25 products are more popular throughout much of 10-14South Asia and in other 10-14 parts of Southeast Asia. Percent of Boys and Girls 13-15 Years Old in Secondary Schools Who Used Tobacco Products in the Past 30 Days, Select Countries Percent ble Diseases Country Profi les 2014 (Geneva, WHO, 2014); and PRB analysis of data from the report. Areas, 2014 Cigarettes (and possibly other tobacco products) 36 Indonesia (2014) NCD Risk Factors Among Youth M F FOR Addressing Risk Behaviors Among Young People Today Can Curb M a Growing Indonesia (2014) Noncommunicable Disease Epidemic 5-9 5-9 0-4 0-4 40 20 60 40 80 60 100 80 100 20 15 25 10 30 15 20 25 20 0 30 20 5 0 0 60 20 80 40 40 60 10 5 80 Population (in millions) Population (in millions) Population (in millions) Sources: Toshiko Kaneda and Kristin Bietsch, 2015 World Population Data Sheet (Washington, DC: Population Reference Bureau, 2015); and United Nations (UN) Population Division, World Population Prospects: The 2015 Revision (New York: UN, 2015). 3 2 NONCOMMUNICABLE DISEASES Cardiovascular Diseases, Most Cancers, Diabetes, Chronic Respiratory Diseases 34 2 36 F 3 2 4 Tobacco use is the leading cause of preventable deaths around the world, due to illness such as cancers, chronic respiratory diseases, and heart diseases. Although tobacco use in Asia has typically been most common among older males, the tobacco industry has begun to target women Adolescence and young adulthood are when the four main NCD risk factors—tobacco use, harmful use of alcohol, physical inactivity, and 13 17 and youth more 30 actively, and at the same time, income growth has made tobacco products more affordable. Consequently, sizeable proportions unhealthy diet—are typically initiated or established. These risk behaviors are increasing among young Asians, setting them up for poorer health of boys in many countries are now smoking. Among 13-to-15-year-old boys in secondary school, 36 percent in Indonesia, 30 percent in Myanmar, in adulthood compared to today’s adults. Given that this young cohort is also much larger than the older cohorts 1 they 6 will replace, 7 a window of and 25 percent in Nepal currently use tobacco (defi ned as any use in the last 30 days). In general, the rates among girls are substantially lower, opportunity exists to curb their risk behaviors to shift the projected trajectory of NCDs in Asia. In 2050 when today’s young people ages 10 to 24 though they are increasing in some countries. Although cigarettes are predominant in East Asia and certain countries in Southeast Asia, other have all reached ages 45 and older—the time when NCDs typically hit hardest—the over-45 population is Mprojected 6 to be 2.3 times the size it 19 is tobacco 25 products are more popular throughout much of South Asia and in other parts of Southeast Asia. today in South Asia, 2 times larger in Southeast Asia, and 1.4 times larger in East Asia. Nepal (2011) Total Ages 45 and Older 2015: 1.8 billion 2015: 403 million 2050: 2.4 billion 2050: 930 million Total Ages 45 and Older 2015: 633 million 2015: 163 million 2050: 792 million 2050: 318 million blematic Among Youth Shifts in Diet and Exercise Have Contributed to Overweight and Obesity Among Country in Focus: China Has Seen a Dramatic Increase in Overweight and Obesity © 2016 Population Reference Bureau Young People Across See Asia Technical Notes on page 11 NONCOMMUNICABLE Among Young People DISEASES AMONG YOUNG PEOPLE IN ASIA 4 4 Total Ages 45 and Older 2015: 1.6 billion 2015: 621 million 2050: 1.6 billion 2050: 867 million China (2014) 34 F 2 1 2 2 Population and Youth NCD Mortality NCD Risk Factors Among Youth Probability Age- of Definition Mof Risk Levels 13 17 30 Percent Enrolled in Standardized Premature Youth Ages 19 Secondary School (Gross of Total GNI per Death Rate Deaths Myanmar (2011) High Risk Medium Risk Low Risk Mid-Year Population 10-24, Enrollment Ratio), Population Capita, PPP for All Percent of From NCDs Current Tobacco Use (millions) Percent of 2005/2014 Living in (Current NCDs (per Total Deaths Between Cigarettes Other Products Any Products Current Alcohol Use Physical Inactivity Overweight or Obese Population, Urban International $), 100,000), due to Ages 30-70, Current Tobacco F 1Use 6 7 11 2015 2050 2015 Male Female 2014 2 2012 NCDs, 2012 2012 3 Male Female Male Female Male Female Year Male Female Year Male Female Year Male Female Year Percent using cigarettes/other tobacco products/any products in the past 30 days among 13-15-year-old EAST ASIA 1371.9 1365.7 19 95 97 55 13,170 576 87 19 secondary school students M 6 9 10 2 - - 11 2 2014 18 14 2013 77 82 2010 2010 China 6 19 25 7.3 8.6 15 103 99 100 56,570 - - - 16% or Above 7% to 15% Below 7% 8 8 3 2 10 9 2009 18 2014/15 Nepal (2011) 2011/12 2011/12 China, Hong Kong SAR 1 0.7 0.8 16 97 95 100 120,140 - - - 4 7 4 4 - - 2010 - - - - - - China, Macau SAR 1 126.9 96.9 14 102 102 93 38,120 244 79 9 Current Alcohol Use 9 2 1 - - - - 2012 7 8 2012 2014 2014 Japan F 1 16 25.0 27.0 23 - - 61 - 751 79 27 Percent having any drinks with alcohol in the past 30 days - - - - -16 - - - - - - - Korea, North Other tobacco products only among 13-15-year-old secondary school students 5 9 50.7 48.1 18 98 97 82 33,650 302 79 9 7 2 - - - - 2014 10 7 2014 78 90 2014 2014 Korea, South 40% or Above 20% to 39% Below 20% 3.0 4.4 24 90 92 68 11,120 966 79 32 8 4 - - - - 2013 5 4 2013 59 66 2013 11 12 2013 Mongolia 23.5 20.4 19 - - 73 - - - - M 6 11 13 5 - - - -192012 21 17 2012 63 80 2012 32 16 2012 Taiwan Physical Inactivity India (2009) SOUTHEAST ASIA Percent not engaging in physical activity for at least 9 0.4 0.5 25 99 99 77 72,190 475 80 17 14 4 - - 15 5 2014 4 3 2014 81 95 2014 37 35 2014 Brunei 60 min/day on five out of the last seven days among 15.4 21.3 30 48 41 21 3,080 394 52 18 13-15-year-old secondary F 2school students6 8 0 0 8 5 8 5 2010 8 3 2013 89 92 2013 3 4 2013 Cambodia 255.7 366.5 26 84 81 54 10,190 680 71 23 9 70% or Above 50% to 69% Below 50% 34 3 - - 36 4 2014 4 1 2007 84 83 2007 14 6 2007 Indonesia 9 6.9 10.6 33 60 55 38 5,060 680 48 24 14 1 8 5 19 6 2011 19 21 2015 76 91 2015 11 12 2015 Laos 30.8 42.3 27 - - 74 24,770 563 73 20 Overweight Mor Obese 13 31 5 13 6 35 9192009 9 6 2012 72 85 2012 25 22 2012 Malaysia 9 52.1 56.5 28 51 52 34 - 709 59 24 Percent who are overweight or obese 13 1 28 7 30 7 2011 1 1 2007 81 87 2007 4 6 2007 Myanmar Philippines (2011) 103.0 157.1 30 84 93 44 8,450 720 67 28 among 13-15-year-old secondary school students 5 13 5 10 5 19 9 2011 23 15 2011 85 87 2011 11 9 2011 Philippines 5.5 7.0 19 - - 100 80,270 264 76 10 20% or Above F 10% to 19% 5 Below 10% 4 9 9 4 10 8 - - 2012 2010 80 88 2012 Cigarettes (and possibly 2010 Singapore 9 65.1 66.1 19 83 89 49 14,870 449 71 16 15 5 - - 20 8 2015 21 17 2015 82 93 2015 24 13 2015 Thailand 1.2 2.8 32 70 76 32 5,080 671 44 24 54 11 - - 66 24 2013 - - - - - 2009/10 Timor-Leste Notes: other tobacco products) 91.7 108.2 24 - - 33 5,350 435 73 17 4 1 - - - - 2013 22 10 2013 76 87 2013 8 4 2013 Vietnam Data points for the Mrisk factors appear for countries 10with comparable 1 11 data available from the following surveys: Global Youth Tobacco SOUTH ASIA 9 32.2 64.3 35 71 40 25 2,000 846 37 China 31 (2014) Survey and Global School-Based Student Health Survey (GSHS) 7 4 - - 10 6 2014 - - 91 90 2014 18 13 2014 Afghanistan for tobacco use, and GSHS for alcohol use, physical inactivity, and 9 160.4 201.9 30 56 61 23 3,330 549 59 18 3 0 7 3 9 3 2013 2 0 2014 58 59 2014 10 7 2014 Bangladesh overweight status. For the countries without data from these surveys, F 2 1 2 Other tobacco products only 7, 8 0.8 1.1 29 81 87 38 7,280 573 56 21 data from other sources were used whenever possible to assess 23 7 29 20 39 23 2013 2011 - - - - Bhutan 1314.1 1660.1 28 69 69 32 5,630 682 60 26 risk levels. 6 2 16 7 19 8 2009 2005/06 69 71 2007 9 12 10 2007 India 78.5 99.3 23 89 88 71 16,590 569 76 17 Data points from these other surveys appear only when they are 5 1 32 20 33 20 2007 - - (2013) 9, 10 2011/12 Iran comparable with the data from the above sources. Only the colors 0.3 0.6 28 - - 45 10,920 487 81 16 6 2 13 6 15 7 2011 - - - - 2014 19 16 2014 Maldives representing risk levels are displayed for the countries without 28.0 36.0 33 Note: 65Totals 70 may not 18add up 2,410due to 678 rounding. 60 22 comparable data. Data points underlying all risk levels and sources 6 1 22 16 25 16 2011 2012/13 2012/13 2012/13 Nepal 199.0 344.0 30 Sources: 46 WHO 37 and 38CDC, 5,090 Global Youth 669 Tobacco 50 21 are available in the data appendix at www.prb.org/Publications/ Survey. Datasheets/2016/ncd-risk-youth-asia.aspx. 10 1 - - - - 2009 - - 83 87 2009 5 9 2009 Pakistan 20.9 23.0 23 97 102 18 10,300 501 75 18 3 0 15 5 16 5 2011 - - 83 89 2008 9 5 4 2008 Sri Lanka lable or inapplicable. e most recent data point ve Region. 2 Data prior to 2014 are shown in italics. 3 The estimated probability of dying between ages 30 and 70 years from the four main NCDs—cardiovascular diseases, diabetes, cancers, and chronic respiratory diseases. parts of Asia is relatively low compared to Europe and the Americas, it is increasing as social trends shift and tries with rising economies and sizeable populations of young people with disposable income. Among 13-to-15- tudents, over 20 percent of boys in the Philippines, Thailand, Vietnam, and Taiwan are current alcohol users (defi ned s). The difference between genders is generally smaller than for tobacco use. Binge and heavy drinking are more 4 Based on the Global Youth Tobacco Survey and the Global School-Based Student Health Survey. 5 Based on the Global School-Based Student Health Survey. 6 Data are from Beijing, Shanghai, and Guangzhou. 7 Data are not disaggregated by sex when the columns are not divided. 8 Data are from Thimphu. Asia is shifting away from healthier traditional diets to those high in empty calories, sugar, salt, and saturated fat. Physical activity levels are also declining as the amount of activity needed for work or transportation decreases, and worsening traffi c and air quality, among other factors, make it diffi cult to be active outside. Together, these changes in diet and exercise contribute to overweight and obesity, and consequently, to NCDs Tobacco Use is High Among Boys in Much of Asia M Philippines (2011) F Note: Totals may not add up due to rounding. Sources: WHO and CDC, Global Youth Tobacco Survey. 9 Underlying measure pertains to physical inactivity level in seven (not fi ve) out of the last seven days in this country. 10 Data are from Khoramabad, and year in brackets is publication year for the survey results (data year unknown). M 5 4 13 17 13 6 10 1 11 A large national survey in China among 7-to-18-year-old students showed a dramatic increase in the prevalence of overweight and obesity between 1985 and 2010. In 1985, the prevalence of overweight was only 1 percent among boys and 2 percent among girls, with virtually no obesity. By 2010, 20 percent of boys and 12 percent of girls were overweight or obese; one-third of these boys and girls were obese. 9 34 2 36 36 19 11 Proxy for unhealthy diet. 25 30 Cigarettes (and possibly other tobacco products) Other tobacco products only

t/chp/ (-) Indicates data unavailable or inapplicable. 2 Data prior to 2014 are shown in italics. veys, A date range indicates the most recent data point 3 The estimated probability of dying between ages 30 and 70 ta/ during that RISK time period. BEHAVIORS FOR years from the four main NCDs—cardiovascular diseases, Tobacco Use, Harmful 1 Use Special of Alcohol, Administrative Insufficient Region. Physical Activity, Unhealthy Diet Cardiovascular diabetes, Diseases, cancers, Most Cancers, and Diabetes, chronic respiratory Chronic Respiratory diseases. Diseases e the s ll From list of Noncommunicable Diseases Are More Common in Low- Addressing Risk Behaviors Among Young People Today Can Curb M a Growing 34 Tobacco Use is 2High 36 Among Boys in Much of Asia Indonesia (2014) e Countries Noncommunicable Disease Epidemic ed by the World Health Organization (WHO) as cardiovascular diseases, cancers, diabetes, and chronic respiratory income countries, NCDs in low- and middle-income countries (LMIC) generally claim lives at younger ages, often onomic productivity. In LMIC in Asia, the likelihood of dying prematurely (between ages 30 and 70) from the four mpared to 9 percent in high-income countries in the region. Premature deaths from NCDs are projected to increase rcent of the region’s population resides, underscoring the importance of prioritizing NCD prevention. aturely om the cable ko te; lyst; ociate, B). endy el ollis e for ents. nia El , Hanna Haena er Hu e, NW, 9 USA -3937 rb.org Bdata Alcohol Use Is Problematic Among Youth F 1 16 16 Population Pyramids, South Asia, Southeast Asia, and East Asia: 2015 and 2050 Percent of Boys and Girls M Although alcohol use in many parts of Asia is relatively low compared to Europe and the Americas, it is increasing as social trends shift and M 6 13 19 13-15 Years Old Secondary Indonesia (2014) South Asia Southeast Asia India (2009) East Asia Schools Who Used Tobacco F 3 2 4 Age Age marketing efforts target countries with rising economies and sizeable populations of young people with disposable income. Among 13-to-15- Male Female 85+ Male Female 85+ F 2 6 8 Products in the Past 30 Days, Male Female 80-84 80-84 Less than 15% Select Countries M 75-79 75-79 year-old-secondary-school students, Ages M 13 6 19 Myanmar (2011) over 20 percent of boys in the Philippines, Thailand, Vietnam, Ages 15% to 19% 70-74 and Taiwan are current alcohol users (defi ned 45 70-74 (2011) 45 F 1 6 65-69 65-69 7 and and 20% to 24% 60-64 60-64 F 5 4 9 Cigarettes (and possibly Older Older as any use in the last 30 days). The difference between 55-59 genders is generally 55-59 smaller than for tobacco use. other Binge tobacco products) and heavy drinking M 6 are more 19 25% to 29% 50-54 50-54 M 10 1 11 Nepal (2011) 45-49 45-49 common among youth than adults. 30% and more China (2014) F 1 16 Heavy drinking increases 40-44 many other health 40-44 Frisks, 2 1 2 including road traffi Other c tobacco accidents, products only unprotected sex, violence, 35-39 35-39 30-34 30-34 M 6 13 and poor mental health. Studies also show that people 25-29 who begin drinking in 25-29early adolescence are much more likely to become India (2009) dependent on 20-24 20-24 F 2 6 8 15-19 15-19 alcohol than those who begin drinking in their late adolescence 10-14 or early 20s, 10-14 even after considering family history of alcohol abuse. Percent of Boys and Girls 13-15 Years Old in Secondary Schools Who Had at Least One Drink With Alcohol Percent Enrolled in Percent Standardized in the Secondary Past School (Gross 30 of Days, Total GNI Select per Death Rate Enrollment Ratio), Population Capita, PPP for All Countries 2005/2014 Living in (Current NCDs (per ble Diseases Country Profi les 2014 (Geneva, WHO, 2014); and PRB analysis of data from the report. 5-9 5-9 0-4 0-4 40 20 60 40 80 60 100 80 100 20 15 25 10 30 15 20 25 20 0 30 20 5 0 0 60 20 80 40 40 60 10 5 80 Population (in millions) Population (in millions) Population (in millions) Sources: Toshiko Kaneda and Kristin Bietsch, 2015 World Population Data Sheet (Washington, DC: Population Reference Bureau, 2015); and United Nations (UN) Population Division, World Population Prospects: The 2015 Revision (New York: UN, 2015). NONCOMMUNICABLE DISEASES F 3 2 4 Tobacco use is the leading cause of preventable deaths around the world, due to illness such as cancers, chronic respiratory diseases, and heart diseases. Although tobacco use in Asia has typically been most common among older males, the tobacco industry has begun to target women Adolescence and young adulthood are when the four main NCD risk factors—tobacco use, harmful use of alcohol, physical inactivity, and M 13 17 and youth more 30 actively, and at the same time, income growth has made tobacco products more affordable. Consequently, sizeable proportions unhealthy diet—are typically initiated or established. These risk behaviors are increasing Myanmar among young (2011) Asians, setting them up for poorer health of boys in many countries are now smoking. Among 13-to-15-year-old boys in secondary school, 36 percent in Indonesia, 30 percent in Myanmar, in adulthood compared to today’s adults. Given that this young cohort is also much larger than the older cohorts F 1 they 6 will replace, 7 a window of and 25 percent in Nepal currently use tobacco (defi ned as any use in the last 30 days). In general, the rates among girls are substantially lower, opportunity exists to curb their risk behaviors to shift the projected trajectory of NCDs in Asia. In 2050 when today’s young people ages 10 to 24 though they are increasing in some countries. Although cigarettes are predominant in East Asia and certain countries in Southeast Asia, other have all reached ages 45 and older—the time when NCDs typically hit hardest—the over-45 population is Mprojected 6 to be 2.3 times the size it 19 is tobacco 25 products are more popular throughout much of South Asia and in other parts of Southeast Asia. today in South Asia, 2 times larger in Southeast Asia, and 1.4 times larger in East Asia. Nepal (2011) Total Ages 45 and Older 2015: 1.8 billion 2015: 403 million 2050: 2.4 billion 2050: 930 million Total Ages 45 and Older 2015: 633 million 2015: 163 million 2050: 792 million 2050: 318 million Total Ages 45 and Older 2015: 1.6 billion 2015: 621 million 2050: 1.6 billion 2050: 867 million M Philippines (2011) F Note: Totals may not add up due to rounding. Sources: WHO and CDC, Global Youth Tobacco Survey. Population and Youth NCD Mortality NCD Risk Factors Among Youth Definition of Risk Levels High Risk Medium Risk Low Risk M 10 1 11 China (2014) F 2 1 2 Vietnam (2013) 2014 2 2012 3 Probability 2015 2050 2015 Male Female Areas, 2014 2012 NCDs, 2012 Male Female Male Female Male Female Year Male Female Year Male Female Year Male Female Year Age- of Premature Mid-Year Population Youth Ages 10-24, Percent of Deaths From NCDs Current Tobacco Use (millions) Percent of Total Deaths Between Population, Urban International $), 100,000), due to Ages 30-70, Current Tobacco Use Cigarettes Other Products Any Products Current Alcohol Use Physical Inactivity Overweight or Obese 11 4 B S 5 B 6 D Shifts Young 36 Asia 30 is sh declining it diffi cult such as percent i are incre obesity a Cigarettes (and possibly other tobacco products) Other tobacco products only Percent Girls 13 in Seco Who Ar or Obe Countri EAST ASIA Percent using cigarettes/other tobacco products/any products in the past 30 days among 13-15-year-old 1371.9 1365.7 19 95 97 55 13,170 576 87 19 secondary school students 23 6 9 10 2 - - 11 2 2014 18 14 2013 77 82 2010 2010 China 7.3 8.6 15 103 99 100 56,570 - - - 16% or Above 7% to 15% Below 7% 8 8 3 2 10 9 2009 18 2014/15 22 2011/12 2011/12 China, Hong Kong SAR 1 0.7 0.8 16 97 95 100 120,140 - - - 4 7 4 4 - - 2010 - - - - - - China, Macau SAR 21 21 126.9 96.9 14 102 102 93 38,120 244 79 9 Current Alcohol Use 9 2 1 - - - - 2012 7 8 2012 2014 2014 Japan 25.0 27.0 23 - - 61 - 751 79 27 Percent having any drinks with alcohol in the past 30 days - - - - - - - - - - - - Korea, North among 13-15-year-old secondary school students 17 17 15 9 50.7 48.1 18 98 97 82 33,650 302 79 9 7 2 - - - - 2014 10 7 2014 78 90 2014 2014 Korea, South 40% or Above 20% to 39% Below 20% 3.0 4.4 24 90 92 68 11,120 966 79 32 8 4 - - - - 2013 5 4 2013 59 66 2013 11 12 2013 Mongolia 23.5 20.4 19 - - 73 - - - - 11 5 - - - - 2012 21 17 2012 63 80 2012 32 16 2012 Taiwan Physical Inactivity 10 10 SOUTHEAST ASIA Percent not engaging in physical activity for at least 7 8 7 89 0.4 0.5 25 99 99 77 72,190 475 80 17 14 4 - - 15 5 2014 4 3 2014 81 95 2014 37 35 2014 Brunei 60 min/day on five out of the last seven days among 15.4 21.3 30 48 41 21 3,080 394 52 18 13-15-year-old secondary school students 5 0 0 8 5 8 5 2010 8 3 2013 89 92 2013 3 4 2013 Cambodia 255.7 366.5 26 84 81 54 10,190 680 71 23 70% or Above 50% to 69% Below 50% 34 3 - - 36 4 2014 4 1 9 2007 84 83 2007 3 14 6 2007 Indonesia 6.9 10.6 33 60 55 38 5,060 680 48 24 14 1 8 5 19 6 2011 19 21 2015 76 91 2015 9 11 12 2015 Laos 30.8 42.3 27 - - 74 24,770 563 73 20 Overweight or Obese 31 5 13 6 35 9 2009 9 6 2012 72 85 2012 25 22 2012 Malaysia 9 52.1 56.5 28 51 52 34 - 709 59 24 Percent who are overweight or obese 13 1 28 7 30 7 2011 1 1 2007 81 87 2007 4 6 2007 Myanmar M F M F M F M F M F M F M F 103.0 157.1 30 84 93 44 8,450 720 67 28 among 13-15-year-old secondary school students 5 13 5 10 5 19 9 2011 23 15 2011 85 87 2011 11 9 2011 Philippines 5.5 7.0 19 - - 100 80,270 264 76 Philippines 10 20% or Above Vietnam 10% to 19% Taiwan Below 10% 9 Thailand 4 10 8 South - - Korea 2012 Cambodia 2010 80 88Japan 2012 2010 Singapore 9 65.1 66.1 19 83 89 49 14,870 449 71 16 15 5 - - 20 8 2015 21 17 2015 82 93 2015 24 13 2015 Thailand 1.2 2.8 32 70 76 32 5,080 671 44 24(2011) (2013) (2012) 54 11 (2015) - - 66 (2013) 24 - - (2013) - -(2014) - 2009/10 Timor-Leste Notes: 91.7 108.2 24 - - 33 5,350 435 73 17 4 1 - - - - 2013 22 10 2013 76 87 2013 8 4 2013 Vietnam Data points for the risk factors appear for countries with comparable data available from the following surveys: Global Youth Tobacco SOUTH ASIA 32.2 64.3 35 71 40 25 2,000 846 37 31 Survey and Global School-Based Student Health Survey (GSHS) 7 4 - - 10 6 2014 - - 91 90 2014 9 18 13 2014 Afghanistan for tobacco use, and GSHS for alcohol use, physical inactivity, and 9 160.4 201.9 30 56 61 23 3,330 549 59 18 3 0 7 3 9 3 2013 2 0 2014 58 59 2014 10 7 2014 Bangladesh overweight status. For the countries without data from these surveys, 0.8 1.1 29Sources: 81 WHO 87 and 38 CDC, 7,280 Global School-Based 573 56 Student 21 Health Survey; Bridget F. Grant and Deborah 23 7 A. 29 Dawson, 20 39 “Age 23 2013 at Onset of Alcohol 7, 8 data from other sources were used whenever possible to assess 2011 Use - and - Its Association - - Bhutan 1314.1 1660.1 9 28 69 69 32 5,630 682 60 26 risk levels. 6 2 16 7 19 8 2009 2005/06 69 71 2007 With DSM-IV Alcohol Abuse and Dependence: Results From the National Longitudinal Alcohol Epidemiologic Survey,” Journal of Substance Abuse 9 (1997): 12 10 2007 India 9, 10 78.5 99.3 23 89 88 71 16,590 569 76 17 Data points from these other surveys appear only when they are 5 1 32 20 33 20 2007 - - (2013) 2011/12 Iran comparable with the data from the above sources. Only the colors 0.3 0.6 28103-110; - and - Bridget 45 F. Grant, 10,920 “The 487 Impact 81 of a Family 16 History of Alcoholism on the Relationship 6 Between 2 13 Age 6 at 15 Onset 7 2011 of Alcohol - - Use and DSM-IV - - Alcohol 2014 19 16 2014 Maldives representing risk levels are displayed for the countries without 28.0 36.0 33 65 70 18 2,410 678 60 22 comparable data. Data points underlying all risk levels and sources 6 1 22 16 25 16 2011 2012/13 2012/13 2012/13 Nepal Dependence,” Alcohol Health and Research World 22, no. 2 (1998): 144-48. 199.0 344.0 30 46 37 38 5,090 669 50 21 are available in the data appendix at www.prb.org/Publications/ 10 1 - - - - 2009 - - 83 87 2009 5 9 2009 Pakistan Datasheets/2016/ncd-risk-youth-asia.aspx. 20.9 23.0 23 97 102 18 10,300 501 75 18 3 0 15 5 16 5 2011 - - 83 89 2008 9 5 4 2008 Sri Lanka 5 4 13 17 13 6 9 34 2 16 19 19 25 Note: Tot Source: W lable or inapplicable. e most recent data point ve Region. 2 Data prior to 2014 are shown in italics. 3 The estimated probability of dying between ages 30 and 70 years from the four main NCDs—cardiovascular diseases, diabetes, cancers, and chronic respiratory diseases. 4 Based on the Global Youth Tobacco Survey and the Global School-Based Student Health Survey. 5 Based on the Global School-Based Student Health Survey. 6 Data are from Beijing, Shanghai, and Guangzhou. 7 Data are not disaggregated by sex when the columns are not divided. 8 Data are from Thimphu. 9 Underlying measure pertains to physical inactivity level in seven (not fi ve) out of the last seven days in this country. 10 Data are from Khoramabad, and year in brackets is publication year for the survey results (data year unknown). 11 Proxy for unhealthy diet. blematic Among Youth Shifts in Diet and Exercise Have Contributed to Overweight and Obesity Among Country in Focus: China Has Seen a Dramatic Increase in Overweight and Obesity © 2016 Population Reference Bureau Young People Across See Asia Technical Notes on page 11 NONCOMMUNICABLE Among Young People DISEASES AMONG YOUNG PEOPLE IN ASIA 5 parts of Asia is relatively low compared to Europe and the Americas, it is increasing as social trends shift and tries with rising economies and sizeable populations of young people with disposable income. Among 13-to-15- tudents, over 20 percent of boys in the Philippines, Thailand, Vietnam, and Taiwan are current alcohol users (defi ned s). The difference between genders is generally smaller than for tobacco use. Binge and heavy drinking are more Asia is shifting away from healthier traditional diets to those high in empty calories, sugar, salt, and saturated fat. Physical activity levels are also declining as the amount of activity needed for work or transportation decreases, and worsening traffi c and air quality, among other factors, make it diffi cult to be active outside. Together, these changes in diet and exercise contribute to overweight and obesity, and consequently, to NCDs A large national survey in China among 7-to-18-year-old students showed a dramatic increase in the prevalence of overweight and obesity between 1985 and 2010. In 1985, the prevalence of overweight was only 1 percent among boys and 2 percent among girls, with virtually no obesity. By 2010, 20 percent of boys and 12 percent of girls were overweight or obese; one-third of these boys and girls were obese.

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