PREVALENCE OF HEALTH COMPROMISING BEHAVIORS AMONG TERTIARY EDUCATION STUDENTS IN THE ENUGU STATE OF NIGERIA

compromising are Although peculiar to all ages, gender, economic and social status. There is a growing indication that risky health behavior is more prevalent in adolescents. Notably, there is no known recent data on health-compromising behavior among adolescents in Enugu state. Thus, the current study examined the prevalence of risky behaviors among tertiary education students in Enugu state. Four hundred and eighty-nine undergraduates pooled from tertiary institutions participated in the study. The participants completed a self-report measure assessing their health-compromising behavior. The result showed physical inactivity 53.7% represented the highest rate of risky behavior identified among the students, followed by alcoholic use with an overall rate of 51.9%. Also, smoking 48.6% and self-medication 43.7% assumed an elevated rate of health risk behavior among the prevalence of health-compromising in in between rates of and and a of life on and


853
quality of life (Sun et al., 2021). It might cluster together into a risky lifestyle which influences cognitive performance, emotions, and the overall quality of life (Abdelsalam et al., 2016). The likelihood of adolescents possessing multiple health-compromising behaviors increases throughout development, especiallyduring the teenage years. Thus, experimentation with substances, engaging in physical risks, media exposure, and social conformities are unique sources of adolescents' unhealthy behaviors. Nevertheless, regardless of health promotion campaigns, adolescents continue to engage in high rates of health-compromising behaviors, as described by (Das & Horton, 2012).
Research contends that university students are at high risk of health-risky behaviors that could lead to serious physical complications, social dysfunction, and psychological disturbances (Abdelsalam et al., 2016). Generally, many students enrolled in tertiary institutions in modern-day education are within the adolescent stage of life. These specific populations are vulnerable to potentially harmful activities because of a high propensity for compliance with social norms. Therefore, it is ideal that research continues to establish the patterns and prevalence of this risky behavior within the learning institutions to prevent and manage risky behaviors in adolescents. Perhaps, intimations suggest that numerous types of risky behaviors encompass different aspects of students' lifestyles in the Nigerian context. Behaviors related to alcoholism, unsafe sex, physical fighting, cultism, and smoking are prevalent among students and pose a considerable immediate and longer-term effect on the health and are related to one another.
For example, multiple partnering is associated with unsafe sexual behavior (Ssekamatte et al., 2020) and increased rates of dating violence and sexual abuse. There is a significant concern about the students' level of multi-partnering and sexual behaviors. The probability of engaging in unprotected sexual behaviors is significantly high among the students compared to non-students (Gebresllasie et al., 2017; Shayo & Kalomo, 2019). This is attributed to the pattern of partnering and the consequent sexual outcome. One characteristic of unsafe sexual behavior, for instance, condomless sex, different sexual partners, rape, and so on, is that it is enjoyable to some extent causing the person to want to repeat the behavior. Thus, making it harder for the adolescent to acknowledge the health implications.
In alcoholism, binge drinking combines higher physical fighting and violence (de Carvalho et al., 2018; Svensson & Landberg, 2013). The likelihood of engaging in a violent act such as fighting is usually attributed to drinking. More so, alcohol is the most widely used psychoactive substance globally, and its use remains a significant public health concern (Eze & Uzoeghe, 2015; Olashore et al., 2018). Alcohol use is a risk factor for several diseases and injuries, including non-communicable conditions (Collaborators, 2018). In furtherance, increased alcohol use is associated with study difficulty (Abikoye et al., 2014). Therefore, continued alcohol use among undergraduates calls for more decisive intervention in contemporary society.
Accordingly, the problem behavior theory contends that physical fighting is a positive predictor of multiple risky behaviors, including possession of dangerous weapons (Pickett et al., 2005). Youth violence in schools is a pervasive and persistent problem in many societies. Students engage in physical fights, experience bullying, threatening weapons, and miss classes due to safety concerns. Furthermore, cultism is undeniably one of the social vices in tertiary institutions. Today's most significant and most embarrassing problem facing tertiary institutions in Nigeria is the renewal of the menace and aggressiveness of cult activities. Cultism is said to be the mother of crimes in tertiary institutions. This phenomenon negatively affects the image of institutions, the learning quality, and the integrity of graduates, including loss of lives.
Indeed, excessive smoking is considered the gateway to other health-compromising behaviors like drug use (Patton et al., 2009). Notwithstanding the well-known adverse effects of smoking on human health (Ho, 2017; Kyriakopoulos et al., 2021;Tanimowo et al., 2014), current smoking rates among adolescents remain at unacceptably high levels, with the initiation of smoking occurring at progressively younger ages. The onset of cigarette addiction occurs primarily among children, at an average age of 12. Significantly, the rates of smoking and drinking have remained at high levels even though major intervention programs to prevent youth from initiating these behaviors have been developed. no recent updates about health risky behavior, especially in Enugu state hence the justification for the study. Thus, the present study aims to report the current trend of health-compromising behaviors among tertiary education students in Enugu state.

Method:-
The present study adopted a cross-sectional survey design. The study population comprised students from three higher learning institutions in Enugu State, Nigeria (Enugu State University of Science and Technology, Federal College of Education, and the University of Nigeria). The participants included male-female undergraduates enrolled in various departments in the selected institutions. Demographic information such as age, year of study, parental information, and the department was not included in the study.

Measure:-
Health compromising behavior was assessed using an adapted version of the Youth RiskBehavior Surveillance System (YRBSS) initially developed by the Centers for Disease Control and Prevention (CDC) (1989). The scale was designed to measure health-related risk behaviors, which account for most mortality, morbidity, and social crisis among young people. The YRBSS measures six types of risky health behaviors including, smoking, use of alcohol, and other drug use, unsafe sexual behavior, dietary behaviors, and physical activity. Items in the original scale were modified to fit the current context. The modified 40-item Likert-type instrument is scored in a 5-point response format. The reliability of the scale was ascertained following a pilot study. Observation of the Cronbach's alpha coefficients revealed acceptable levels of internal consistency reliabilities of the instrument, which exceeded the cutoff rules-of-the thumb of .70 as recommended for study purposes (Kaplan & Saccuzzo, 2013).

Procedure:-
Authorization was obtained from the management of the selected institutions. Research assistants were trained for the data collection process. Students were approached between August and November 2021 and asked to participate in the survey. Those who consented were briefed on the purpose of the study, and they were equally informed that participation in the survey was voluntary and that they could withdraw at any point. They also completed the consent form given to them. The questionnaire was administered in a regular classroom setting and took about 20 minutes to complete. The research assistants assisted participants that requested it. In particular, five hundred and twenty-seven (527) questionnaires were administered to the respondents. In all, only 489 copies out of the 527 questionnaires were adequately filled and returned; hence, the remaining 36 were either wrongly filled or unreturned. Table 1 shows the prevalence rate of the six high health-compromising behaviors peculiar to university students. As shown in the table, the result showed that physical inactivity 53.7% represented the highest rate of risky behavior identified among the students, followed by alcoholic use with an overall rate of 51.9%. Also, smoking 48.6% and selfmedication 43.7% assumed an elevated rate of health risk behavior among the cohort, while unsafe sexual behavior 21.4% and fighting 17% were rated the least prevalent health risky behavior among the students. , which reported more male smokers 88(25%) than female smokers 7(2%). The incidence of smoking among young people is of more significant concern in that the associated health implication is made chiefly manifest in later adulthood. Thus, the finding reiterates the need to further action relative to controlling the prevalence of smoking in the institutions of higher learning.

Result:-
Similarly, the result found that alcohol consumption was among the highest health risky behavior prevalent among the cohorts at 51.9%. It was found that the current alcohol consumption commonplace among the students was higher among the male 33.6% than the female 18.3%. The finding is similar to previous studies in Nigeria ( , suggesting that the practice of selfmedication is persistent among university undergraduates in Nigeria. As such, it could be said that undergraduates are more exposed to the dangers of non-prescribed drugs. However, the present finding indicates that males are more likely to engage in self-medication (24.3%) than their female counterparts (19.4%). This probable cause of the high rate of self-medication among the school residents could be attributed to the findings of(Auta et al., 2012), which posits that the prevalence of medicine storage in students' rooms leads to the practice of self-medication. Indeed, having leftover drugs, probably remains of the previous prescription, could motivate a person to continue with the drugs in response to health symptoms. Furthermore, unsafe sexual behavior and fighting are health risk behaviors found to be least prevalent among the cohorts. However, a higher prevalence of dangerous sexual risk behaviors was observed among females, 11.8%, than males, 9.6%. Thus, more females than males reported using condomsand multiple partnering at last sexual intercourse. The result is aligned with a previous study conducted in Enugu state (Okafor & Obi, 2005), which found a higher rate of females in multiple partnering. Although the exact reason for engaging in unsafe sex varies, affection, difficulty negotiating condom use with a partner, perceived trust, and use of contraceptive methods have been cited as barriers to condom use in females (Bauman & Berman, 2005).
Similarly, the prevalence of violent behavior was rated low among the females, 5.9%, and high among the males 11.7%. Consistent with a previous study (Peltzer & Pengpid, 2014), more males than females engage in physical fighting. Indeed, Owoaje and Ndubusi (2010)reported that more males (54.9%) had been involved in physical fights compared to females (39.4%). Violence in adolescents poses a substantial risk to health and well-being and may facilitate mortality among young people. Thus, the present study underscored the incidence of health-compromising behavior in Enugu State and attributed the increased prevalence of smoking and alcoholism to social outcomes facilitatedby social stress, compliance to peer pressure, conformity to situational standards, and modeling. Also, physical inactivity among females may be occasioned by an age-related factor. The young females may perceive themselves as young and, as such, do not find a reason to stress the body. In particular, the observed healthcompromising behaviors among the cohorts are primarily sustained due to inadequate enlightenment programs and exposure to related risk outcomes.

856
Thecross-sectional surveyadopted and the self-reported health-compromising behaviors were limitations of the paper. Due to the cross-sectional design, the causality of health comprising behaviors could not be established. Although social-desirability trait and recall bias may have affected self-report data, the multiple data collection approach may be one of the effective ways toobtain reliable information fromundergraduates. In addition, the instrument of data collection did not define risky health behaviors in adolescents. It is uncertain if the interpretation ofrisky behaviors was uniform acrossall adolescents. Despite these limitations, the results of this report may be generalized to adolescents in Enugu State because those surveyed composed a representative sample of public tertiary institutions inthe state. The findings ofthis study have crucial implications for school health educators and other health professionals who work to promote positive, healthy behavior and prevent other negative behaviors among school students.The preventive interventions in schools should include but not be limited to providing adolescents with skills and support to enhance positive change in theirbehaviors. The study recommends that experts and counselors working with undergraduate populations consider a regular survey of health risk behaviors among undergraduate cohorts. Also, prevention programs shouldbe designed to curtail the prevalence of risky behavior in tertiary institutions.

Conclusion:-
This study is meant to study the prevalence of health-compromising behaviors among tertiary education students. Four hundred and eighty-nine undergraduates were recruited for the study. The analysis of the percentage scores demonstrates a high prevalence of health-compromising behaviors among the cohorts. Physical inactivity and alcohol consumption was the highest risky behavior prevalent in the tertiary institutions in Enugu State. More so, smoking and self-medication were among the health risk behaviors found in an elevated state. In contrast, unsafe sexual behavior and physical fighting were the minor health-compromising behaviors among the cohorts. Although the causes and patterns of these health risk behaviors were not ascertained, the study provided evidence of a high prevalence of health-compromising behavior among the undergraduates in tertiary institutions in Enugu State.