Beyond the health risks directly attributed to tattoos and piercings, several studies suggest a possible connection between permanent body art and other types of risk taking among adolescents. These behaviors range from sexual activity to substance abuse.

In 2001 researchers at the University of Rochester Medical Center reported a correlation between teenage risk behavior and tattoos. The following year they linked these behaviors to body piercings. The studies included information from a national sample of 6,072 adolescents that was collected in 1995 and 1996. Youths in the study, who were in junior high or high school, ranged in age from eleven to twenty-one. Overall, about 4.5 percent of the youths had tattoos and piercings, with risk behaviors much more prevalent among those with body art than without. For example, girls with body piercings other than pierced ears were twice as likely as other girls to smoke, skip school, or engage in sexual activity. Pierced girls were also three times more likely to have friends who used drugs or alcohol.

A simply published in 2002 by the Adolescent Medicine Division of the Naval Medical Center San Diego reported similar findings. This study was based on a fifty eight question survey that was offered to teens who came to the center’s adolescent clinic. The survey contained questions about eating behavior, violence, drug abuse, sexual behavior, suicide, tattoos, and body piercings.

The study found that participants with tattoos and/or body piercings were more likely to have engaged in risk taking behaviors, including eating disorders, drug use, sexual activity, and suicide, than those without either. In addition, violence index scores were three times as high in males with tattoos and two times as high in females with body piercings compared with those without tattoos or piercings. Suicide index scores were nearly twice as high in females with tattoos than those without.

Researches are unsure whether the link between tattoos, piercings, and risky behavior exists because teenagers who already engage in risky behavior get tattooed and pierced or if teenagers get tattoos and body piercings and then become engaged in risky behavior. Either way, doctors believe that health professionals who see adolescents should take into consideration whether or not they have tattoos and piercings.