Legal Basis

This survey is carried out pursuant to Article 4 of the Statistics Act.

Background

Health-related behaviors developed in adolescence influence health later in life. In order to understand the prevalence of adolescent health behavior, relating factors, and to develop effective prevention strategies, the Taiwan Youth Health Survey (TYHS) was initiated in 2006. The survey was designed by referring to the Youth Risk Behavior Survey (YRBS), which was conducted every two years since 1990 by the US Centers for Disease Control and Prevention (US CDC), and Global School-Based Student Health Survey (GSHS), which was developed by the World Health Organization (WHO) in collaboration with United Nations’ UNICEF, UNESCO, and UNAIDS; and with technical assistance from CDC.
The GSHS is a school-based cross-sectional survey and targets junior or senior high school student populations in Taiwan. The Health Promotion Administration collaborated with US CDC and launched Taiwan GSHS in 2012. The survey can establish trends in the prevalence of health behaviors and protective factors for use in evaluation of school health and youth health promotion.

Since 2012, the survey was conducted annually on a national representative sample of students selected from the 22 counties/ cities in Taiwan. The survey is conducted every year for the biennium, for one year in junior high schools students and the other year for the senior high schools students.      
The survey results applied to policy prioritizing, program evaluation, and as the reference of the advocate. To better reflect the change in health behavior prevalence, the annual survey was changed to once in two years since 2019. In 2021, the survey was conducted with country representative samples of junior and senior high school students. However, the completion rate was lower than previous years in 2021 due to the COVID-19 pandemic, the completion rate be taken into consideration for data comparison limitation. In keeping with the WHO’s NCD Global monitoring framework aims international trends in public health surveillance, the GYTS and GSHS were integrated as the Adolescent Smoking and Health Behavior Survey in 2023. This integration aims to provide a better understanding of the current status and changing trends of youth smoking and health behaviors, thereby providing valuable insights for relevant agencies in formulating and advancing school-based tobacco control and youth health promotion policies.

Aim of the Survey

To understand the smoking behaviors, perceptions, and attitudes of adolescents in Taiwan, as well as the prevalence of related health behaviors and the status of school tobacco-control policies and their implementation, in order to provide evidence-based references for the government in formulating youth health promotion policies.

Main Organizer and Co-organizers

This survey was organized by the Health Promotion Administration (HPA), Ministry of Health and Welfare, and implemented with the assistance of local government health bureaus. The compilation of survey data, statistical analyses, and preparation of the report were carried out by the HPA. The Ministry of Education served as the supervising authority, while local education bureaus, the K–12 Education Administration of the Ministry of Education, and the participating schools provided the essential administrative collaboration during the implementation of the survey.

Survey Area and Participants

Survey Participants:
The participants were junior high school students and senior high school/vocational high school students, as well as students in five-year junior colleges (years 1–3) in Taiwan.
In the 2025 survey, around 22,000 junior high school students and around 25,000 senior high/vocational school students were included in the sample.
Geographical Scope:
The survey covered Taiwan, including Kinmen County and Lienchiang County (Matsu).

Sampling Design

The sampling was designed by the CDC of the United States, following the protocol of the GSHS to draw a national representative sample. The sampling method was a 2-step “probability proportional to size (PPS)” method, the sample schools was drawn first, and then sample classes in that school was drawn next. All students in the sample classes were invited to join the survey.

Survey Methods

The GSHS survey uses a self-administered, anonymous questionnaire to collect data. To ensure the protection of participants’ rights and the integrity of data protection practices, all procedures related to the collection, processing, and use of personal data in this survey were conducted in strict accordance with the Personal Data Protection Act and the Human Subjects Research Act. These measures were implemented to ensure full compliance with relevant ethical standards and regulatory requirements.

Contents of the Survey 

The contents of the questionnaire are:
● Demographic information   
● Body weight
● Dietary behaviors
● Physical activity
● Health behaviors: Tobacco use, Betel quid chewing and Alcohol use
● Sexual behaviors
● Knowledge of the cervical cancer vaccine
● Hygiene

Survey Period and Implementation Schedule

1. Survey Period
The survey is conducted biennially. In 2025, the survey was carried out from March to June, depending on the actual fieldwork schedule.
2. Implementation Schedule
● January – February 2025: Preparation of the implementation plan and questionnaires, followed by submission to the Directorate-General of Budget, Accounting and Statistics, Executive Yuan, for approval.
● March – June 2025: Field survey implementation.
● August – December 2025: Review and verification of survey data; data processing and quality check.
● January – March 2026: Compilation of statistical analysis and tables.
● June 2026: Announcement of the survey report, depending on the actual timeline.

Survey Result and Data

The survey results are published in the format of survey reports, press releases, and conferences, or journal papers. Some of the statistical indicators are collected and can be accessed from the Statistical Yearbook of Health Promotion. After compilation, the survey data and related documentation are converted into de-identified secondary data, and submit to the Health and Welfare Data Science Center for external release, exclusively for academic research purposes.