Exposure to alcohol among adolescent students and associated factors

Malta, Deborah Carvalho; Mascarenhas, Márcio Dênis Medeiros; Porto, Denise Lopes; Barreto, Sandhi Maria; Morais Neto, Otaliba Libânio de

doi:10.1590/S0034-8910.2014048004563

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Original Articles • Rev. Saúde Pública 48 (1) • Feb 2014 • https://doi.org/10.1590/S0034-8910.2014048004563 copy

Exposure to alcohol among adolescent students and associated factors

Authorship SCIMAGO INSTITUTIONS RANKINGS

OBJECTIVE

: To describe the prevalence of alcohol consumption among adolescent school students and identify its individual and contextual associated factors.

METHODS

: The present research used data from the 2009 National School Health Survey (PeNSE), which included a sample of 59,699 9^th grade students in Brazilian capitals and the Federal District. The association between regular alcohol consumption and independent explanatory variables was measured by means of the Pearson’s Chi-square test, with a 0.05 significance level. The explanatory variables were divided into four groups based on affinity (sociodemographic; school and family context; risk factors; and protection factors). A multivariate analysis was carried out for each group, always adjusting for age and sex. Variables with p < 0.10 were used in the final multivariate analysis model.

RESULTS

: The highest alcohol consumption in the preceding 30 days was independently associated with pupils aged 15 years (OR = 1.46) and over, female (OR = 1.72), white, children of mothers with higher education, studying in private school, students who had tried smoking (OR = 1.72) and drug use (OR = 1.81), with regular tobacco consumption (OR = 2.16) and those who have had sexual intercourse (OR = 2.37). The factors related to family were skipping school without parental knowledge (OR = 1.49), parents not knowing what children do in their free time (OR = 1.34), having fewer meals with their parents (OR = 1.22), reporting that parents do not care (OR = 3.05), or care little (OR = 3.39) if they go home drunk, and having suffered domestic violence (OR = 1.36).

CONCLUSIONS

: The results reinforce the importance of viewing alcohol consumption among adolescents as a complex, multifactorial and socially determined phenomenon.

Alcohol Drinking; Alcoholic Intoxication; Adolescent; Adolescent Behavior; Dangerous Behavior; School Health

Sociodemographic characteristics		Prevalence (%)	95%CI	OR	95%CI	p	OR adjusted^a	95%CI	p
Total		27.3	26.7;28.8
Sex						0.013			0.000
	Male	26.5	25.6;27.4	1.00			1.00
	Female	28.1	27.2;29.0	1.08	1.02;1.16		1.23	1.14;1.32
Age (years)						0.000			0.000
	< 13	13.9	10.0;19.1	0.63	0.43;0.93		0.66	0.43;1.01
	13	20.4	19.2;21.6	1.00			1.00
	14	24.6	23.7;25.5	1.27	1.16;1.39		1.30	1.18;1.44
	15	35.9	34.3;37.4	2.19	1.97;2.42		2.40	2.14;2.69
	16 and over	42.3	40.3;44.3	2.86	2.56;3.20		3.41	3.0;3.87
Race/Color						0.000			0.000
	White	27.9	26.8;29.0	1.00			1.00
	Black	30.1	28.3;31.9	1.11	1.01;1.23		0.98	0.87;1.10
	Mixed race	25.7	24.7;26.6	0.89	0.83;0.96		0.83	0.76;0.90
	Asiatic	28.6	25.4;32.0	1.03	0.87;.23		0.96	0.80;1.17
	Indigenous	29.9	27.1;32.9	1.10	0.95;1.28		1.02	0.87;1.20
Maternal schooling						0.019			0.000
	Finished university	29.5	28.0;31.1	1.00			1.00
	Did not finish university	28.0	26.7;29.3	0.93	0.84;1.02		0.88	0.79;0.97
	Did not finish high school	25.6	24.0;27.3	0.82	0.73;0.92		0.73	0.64;0.82
	Did not finish elementary	28.2	26.9;29.6	0.94	0.85;1.04		0.76	0.68;0.85
	No schooling	27.3	23.8;31.1	0.90	0.74;1.09		0.63	0.51;0.77

Risk/Protection behavior		Prevalence (%)	95%CI	OR	95%CI	p	OR adjusted^a	95%CI	p
Tried smoking						0.000			0.000
	No	18.6	18.0;19.2	1.00			1.00
	Yes	54.9	53.4;56.3	5.32	4.96;5.72		1.68	1.43;1.98
Regular consumption of cigarettes in the last 30 days						0.000			0.000
	No	19.4	18.7;20.0	1.00			1.00
	Yes	58.8	57.2;60.3	5.94	5.51;6.41		2.35	1.98;2.78
Tried drugs						0.000			0.000
	No	23.8	23.2;24.4	1.00			1.00
	Yes	64.5	62.2;66.7	5.81	5.23;6.46		2.16	1.91;2.45
Sexually active						0.000			0.000
	No	19.2	18.5;19.9	1.00			1.00
	Yes	46.0	44.8;47.3	3.59	3.36;3.84		2.53	2.32;2.75
Does or would do physical activity most days						0.000			0.000
	Do	31.2	29.0;33.5	1.00			1.00
	Would do if possible	26.1	25.3;26.9	0.78	0.69;0.87		0.86	0.76;0.98
	Would not do	28.8	27.6;30.0	0.89	0.79;1.00		1.04	0.91;1.19
Healthy diet
Eating fruit regularly						0.177
	Yes	27.9	26.8;28.9	1.00
	No	26.9	26.2;27.8	0.95	0.89;1.02

School context variables		Prevalence (%)	95%CI	OR	95%CI	p	OR adjusted^a	95%CI	p
Administration						0.000			0.000
	Private	29.5	28.2;30.8	1.00			1.00
	Public	26.8	26.1;27.5	0.87	0.81;0.94		0.65	0.60;0.71
Played truant in the last 30 days						0.000			0.000
	No	23.5	22.9;24.2	1.00			1.00
	One or two days	41.1	39.1;43.1	2.27	2.07;2.48		2.13	1.93;2.34
	Three or more days	52.3	49.1;55.5	3.57	3.12;4.08		3.12	2.72;3.59
Victim of bullying						0.000			0.000
	Never	26.4	25.7;27.2	1.00			1.00
	Rarely/Sometimes	28.8	27.5;30.1	1.12	1.04;1.21		1.16	1.08;1.26
	Most of the time/Always	31.8	28.9;34.8	1.30	1.13;1.49		1.30	1.12;1.52

Domestic context variable		Prevalence (%)	95%CI	OR	95%CI	p	OR adjusted^a	95%CI	p
Family structure						0.000			0.025
	Lives with mother and father	25.3	24.4;26.1	1.00			1.00
	Lives with mother	29.8	28.7;31.0	1.25	1.17;1.34		1.11	1.03;1.20
	Lives with father	31.0	28.1;34.0	1.32	1.14;1.53		1.18	0.99;1.4
	Does not live with either parent	32.4	29.8;35.0	1.41	1.24;1.60		1.04	0.90;1.21
Eats meals with mother or guardian						0.000			0.000
	Every day	24.7	23.9;25.6	1.00			1.00
	At least one day	30.0	28.6;31.5	1.25	1.14;1.38		1.26	1.15;1.38
	Rarely/Never	31.2	29.9;32.5	1.34	1.24;1.44		1.05	0.96;1.14
Parents or guardians know what student was doing in the last 30 days						0.000			0.000
	Always/Mostly	23.2	22.4;24.0	1.00			1.00
	Sometimes/Rarely/Never	32.6	31.6;33.6	1.43	1.33;1.54		1.39	1.29;1.49
Perception of parents’/guardians’ reactions to them drinking						0.000			0.000
	Very bothered	24.6	24.0;25.3	1.00			1.00
	Little bothered	63.6	60.4;66.8	5.36	4.65;6.18		4.65	4.00;5.41
	Not bothered	64.6	58.3;70.5	5.60	4.27;7.34		4.22	3.11;5.73
Domestic violence						0.000			0.000
	No	25.7	25.1;26.4	1.00			1.00
	Yes	42.6	40.4;44.9	2.14	1.94;2.36		1.87	1.68;2.09

Sociodemographic variables, risk/protection behaviors, school and family contexts		Reference category	OR adjusted^a	95%CI	p
Sex		Male	1.00		0.000
	Female		1.72	1.56;1.89
Age (years)		13	1.00		0.000
	< 13		0.74	0.42;1.29
	14		1.10	0.98;1.23
	15		1.46	1.27;1.68
	16 and over		1.64	1.40;1.92
Race/Color		White	1.00		0.001
	Black		0.92	0.80;1.06
	Mixed race		0.80	0.72;0.88
	Asiatic		0.93	0.74;1.18
	Indigenous		0.85	0.69;1.04
Maternal schooling		Finished university	1.00		0.000
	Did not finish university		0.90	0.79;1.03
	Did not finish high school		0.73	0.62;0.85
	Did not finish elementary education		0.76	0.66;0.88
	No schooling		0.59	0.46;0.76
Tried smoking		No	1.00		0.000
	Yes		1.72	1.42;2.09
Regular consumption of cigarettes in the last 30 days		No	1.00		0.000
	Yes		2.16	1.76;2.64
Tried drugs		No	1.00		0.000
	Yes		1.81	1.56;2.11
Sexually active		No	1.00		0.000
	Yes		2.37	2.14;2.63
Does or would do physical activity most days		Does	1.00		0.027
	Would do		0.96	0.82 ;1.12
	Would not do		1.10	0.93;1.30
Administration		Private	1.00		0.000
	Public		0.71	0.63;0.80
Played truant in the last 30 days		No	1.00		0.000
	One or two days		1.49	1.31;1.69
	Three or more days		1.49	1.24;1.79
Victim of bullying		Never	1.00		0.082
	Rarely/Sometimes		1.12	1.01;1.23
	Often/Always		1.10	0.90;1.35
Family structure		Lives with father and mother	1.00		0.424
	Lives with mother		0.95	0.86;1.04
	Lives with father		1.03	0.82;1.30
	Does not live with either parent		0.88	0.73;1.06
Eats meals with mother or guardian		Every day	1.00		0.001
	One day		1.22	1.09;1.36
	Rarely/Never		0.99	0.88;1.10
Parents or guardians know what student did in the last 30 days		Always/Often	1.00		0.000
	Sometimes/Rarely/Never		1.34	1.23;1.46
Perception of parents’ or guardians’ reactions to them drinking		Very bothered	1.00		0.000
	Little bothered		3.39	2.81;4.09
	Not bothered		3.05	2.18;4.26
Domestic violence		No	1.00		0.000
	Yes		1.36	1.18;1.57

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[1] Correspondence
: Deborah Carvalho Malta. Departamento de Vigilância de Doenças e Agravos Não Transmissíveis e promoção da Saúde. Secretaria de Vigilância em Saúde. Ministério da Saúde. SAF Sul, Trecho 02, Lotes 05 e 06, Bloco F, Torre I, Edifício Premium, Térreo, Sala 14. 70070-600 Brasília, DF, Brasil. E-mail: deborah.malta@saude.gov.br