Between 1950 and 2019, transport injuries, unintentional injuries, and interpersonal violence and conflicts accounted for 32.7 % of all teenage deaths worldwide [1]. One of the leading causes of death and disability among teenagers is unintentional serious physical injuries (SPI) [2]. The three leading causes of death among adolescents (15–19 years) in the Philippines in 2005 were transportation accidents 6.2 per 100,000, Pneumonia 4.1 and accidental drowning 2.7 per 100,000 [3]. The frequency of SPI in the past 12 months (SPI) among teenagers in the Philippines rose from 39.1 % in 2003 [4] to 49.3 % in 2015 [5]. The incidence of SPI among teenagers was 42.9 % worldwide in 68 low-and-middle-income countries (LMICs) [5] and 36.9 % in four Southeast Asian nations [5]. The bulk of unintended injuries that children suffered during floods in rural Bangladesh were caused by cuts (38 %), falls (22 %), and near drowning (21 %) [6]; among children of migrant workers in China, 13.4 % had suffered a nonfatal drowning accident (15.2 % for boys, 11.2 % for females) [7]. Drowning has been defined as “death by suffocation after submersion in water” and near-drowning as “survival, at least temporarily, after suffocation by submersion in water” [8]. Between 2008 and 2017, drowning claimed the lives of 27,928 children in the Philippines between the ages of 0 and 14; among those aged 5 to 14, drowning was the cause of 52.7 % of all deaths [9].

According to the LMICs study, traffic-related SPI (11.0 %) and falls (33.1 %) were the two main causes of SPI [5]. Additionally, the two primary SPIs in the LMIC trial were cuts (21.8 %) and fractures/dislocations (22.6 %) [5]. According to a survey conducted among teenagers in four Southeast Asian nations, falls accounted for 10.2 % of reported injuries, followed by motor vehicles (5.8 %), fractures and dislocations (8.1 %), and "cut, puncture or stab wounds" (3.4 %) [5]. The prevalence of SPI, traffic injuries, and near drowning experiences among teenagers in the Philippines are not well documented in recent years. This information on the prevalence and correlations of SPI, traffic accidents, and near-drowning experiences among youth can be useful in designing SPI prevention [10].

According to other reviews [5,[11], [12], [13]], sociodemographic factors such male gender and lower socioeconomic level, psychological distress, substance use, interpersonal violence, and risky behaviour are among the factors linked to unintentional injuries in teenagers. Furthermore, in a multi-country study, adolescent substance use and serious injuries are significantly correlated, with exposure to interpersonal violence acting as a mediating factor [14]. It was hypothesized that interpersonal violence and aggression may be triggered by substance use, which subsequently leads to injuries. Regarding near drowning, in a review 34.9 % of non-fatal drownings involved alcohol [15]. The purpose of this study is to present the association between substance use and SPI among adolescents in the Philippines in 2019, as well as the prevalence and correlates of SPI, road traffic injuries, and near drowning experiences, as well as the mediating role of exposure to interpersonal violence.