Prevalence of School Bullying and Its Associations with Lifestyle Behaviors: A Cross-Sectional Large-Scale National Study in Greek Adolescents

This study estimated the prevalence of school bullying involvement among Greek adolescents and examined its associations with key lifestyle behaviors, including sleep duration, recreational screen time, physical activity, and energy drink consumption. Gender differences and the impact of combined adherence to multiple health-related behaviors were also assessed. A nationally representative sample of 40,768 students in grades 5 to 9 was surveyed in May 2024 using proportionate stratified sampling. Participants were categorized as victims, bullies, bully-victims, or non-involved using the Revised Olweus Bully/Victim Questionnaire. Prevalence rates were 17.7% for victims, 2.1% for bullies, and 2.9% for bully-victims. Among participants, 40.1% reported sleeping < 8 h per night, 58.9% reported > 2 h of daily recreational screen time, 70.6% engaged in ≤ 5 h of physical activity per week, and 26.3% consumed energy drinks. Only 8% met all recommended health behavior criteria. Multinomial logistic regression analyses, adjusting for sociodemographic characteristics, showed that insufficient sleep duration and excessive screen time were associated with increased odds of being a victim, bully, or bully-victim. Low physical activity was linked to higher victimization risk but a lower likelihood of being a bully. Energy drink consumption was positively associated with both bullying and bully-victim status. These patterns were largely consistent across boys and girls. Meeting all four health behavior recommendations was associated with a reduced likelihood of bullying involvement. The findings highlight the protective role of healthy lifestyle behaviors in bullying prevention and underscore the need for comprehensive health-promoting school interventions in adolescence.