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There is an increasing population at risk of hearing loss and tinnitus due to increasing high-volume music listening. To inform prevention strategies and interventions, this study aimed to identify important protection motivation theory-based constructs as well as the constructs 'consideration of future consequences' and 'habit strength' as correlates of adolescents' unsafe discotheque-visiting behavior. We invited 1687 adolescents (12-19 years old) at Dutch secondary schools to complete questionnaires about music-listening behaviors, sociodemographic characteristics and psychosocial determinants of behavior. Over 70% of participants reported to have visited discotheques; 24.6% of them were categorized as visitors at risk for hearing loss due to estimated exposure of 100 dBA for 1.25 hours per week or more without the use of hearing protection. Compared with visitors not at risk for hearing loss, those at risk were more likely not to live with both parents and less likely to consider future consequences and for them visiting high-volume music discotheques was more habitual. Risky exposure to high-volume music in discotheques is associated with several sociodemographic and psychosocial factors, with habit strength being the strongest correlate. Voluntary behavior change among adolescents might be difficult to achieve, because visiting discotheques seems to be strongly linked to current adolescent lifestyle.

Discotheques and the risk of hearing loss among youth: risky listening behavior and its psychosocial correlates