SciELO - Scientific Electronic Library Online

 
vol.21 suppl.1Characteristics associated to a poor self-rated health in Brazilian adolescents, National Adolescent School-based Health Survey, 2015Analysis of sexual and reproductive health indicators of Brazilian adolescents, 2009, 2012 and 2015 author indexsubject indexarticles search
Home Pagealphabetic serial listing  

Services on Demand

Journal

Article

Indicators

Related links

Share


Revista Brasileira de Epidemiologia

Print version ISSN 1415-790XOn-line version ISSN 1980-5497

Rev. bras. epidemiol. vol.21  supl.1 São Paulo  2018  Epub Nov 29, 2018

http://dx.doi.org/10.1590/1980-549720180005.supl.1 

ORIGINAL ARTICLE

Parental supervision and alcohol use among Brazilian adolescents: analysis of data from National School-based Health Survey 2015

Ísis Eloah MachadoI 

Mariana Santos Felisbino-MendesI 

Deborah Carvalho MaltaI 

Gustavo Velasquez-MelendezI 

Maria Imaculada de Fátima FreitasI 

Marco Antonio Ratzsch de AndreazziII 

INursing School, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brazil.

IICoordination of Population and Social Indicators, Research Board, Instituto Brasileiro de Geografia e Estatística - Rio de Janeiro (RJ), Brazil.

ABSTRACT:

Objective:

To evaluate the relation between parental supervision and sociodemographic factors and alcohol use by Brazilian adolescents.

Methods:

This is a cross-sectional study with data from National School-based Health Survey (PeNSE) 2015, which included 16,608 adolescents aged 13 to 17 years, students from Brazilian public and private schools. Variables related to alcohol use, sociodemographic factors and parental supervision were evaluated. In order to analyze the relation between sociodemographic variables, parental supervision and use of alcohol among adolescents, prevalence ratios stratified by sex were used.

Results:

It was observed that 61.4% of the adolescents had tried alcohol, 27.2% had a drunken episode in their lifetime, 9.3% have had problems with alcohol and 29.3% reported alcohol use in last 30 days. The lack of parental supervision was associated with increased use of alcohol. The proportion of alcohol use was higher for girls, and also among those who were older than 16 years, worked, did not live with one or both parents, and lived in the South, regardless of sex.

Conclusion:

The results showed early alcohol experimentation and occurrence of problems due to its use among Brazilian adolescents. In addition, the lack of monitoring by parents and guardians shows a risk of alcohol use in this age.

Keywords: Adolescent; Alcohol drinking; Parent-Child relations; Socioeconomic factors

INTRODUCTION

Alcohol use among adolescents is a social behavior with consequences for the health and life of these individuals, including traffic accidents, violence, depression, school absenteeism, poor school performance, risky sexual behavior, and drug abuse1,2,3. In addition, experimental studies in animal models indicate that alcohol consumption during adolescence causes greater damage when compared to exposure during adulthood4, and research with humans shows that early initiation of alcohol use predisposes to chronic use and addiction in adulthood5.

Because it is a social behavior, alcohol consumption can be influenced by various social factors, such as family, friends, school, the media, both in promoting early experimentation and use and in preventing them1. Adolescence is affirmed as a critical period in which the social context, which includes relations with friends and parents, exerts an important influence on the development and even on health-risk behaviors1,2. It should be emphasized that parental supervision can directly influence the behavior of alcohol use, as well as the choice of friends, which in turn may influence the use of alcohol1.

In the last 10 years, some studies in Brazil have demonstrated the magnitude of this problem among adolescents. A study in a capital of the Northeast showed that 29.8% adolescents aged 14 to 20 years use alcohol6. Another study, conducted in a municipality in the Southeast, revealed a prevalence of 35.6% of heavy episodic drinking among adolescents in 2010, and 39.9% in 20127. In addition, 25% of adolescents aged 15 years belonging to a birth cohort in the Southern Region reported alcohol consumption8. Nationally, the Study of Cardiovascular Risks in Adolescents (ERICA), with students aged 12 and 17 enrolled in public and private schools in 273 Brazilian municipalities, revealed a prevalence of 21.2% of alcohol use in the last 30 days9. Data from the National School-based Health Survey (PeNSE) for 2009, 2012 and 2015 showed a percentage of alcohol use of 27.3, 26.1 and 23.8%, respectively, among students in the 9th year of primary school10,11,12. However, the relation between alcohol consumption among adolescents and the family environment was not explored in these recent investigations, which was the aim of this study with PeNSE data for 2015.

PeNSE is conducted every three years since 2009 by the Brazilian Institute of Geography and Statistics (IBGE), in partnership with the Ministry of Health, together with students from public and private schools. In its 2015 edition, two sample designs were used: the first one included students from the 9th grade, according to previous editions, and the second one included students aged 13 to 17 who attended the 6th through 9th grades of primary school, and the 1st through 3rd grades of secondary school13. The second sample design of the survey explored the possibility of comparison with international studies evaluating health behaviors among adolescents, such as the Global School-Based Student Health Survey (GSHS), which has already been conducted in several countries with the support of the World Health Organization (WHO) and the Center for Disease Control and Prevention (CDC)14.

Therefore, considering estimates that one in four adolescents makes use of alcoholic beverages8,11,15, that most national studies have very particular characteristics in their samples, and that the relationship of parental supervision with alcohol use among adolescents was presented only in some studies3,16 (with conclusions that point to both the protective role of the family and the possibility of it being a promoter of its early use), the present study aimed to estimate the prevalence of alcohol use indicators, and to analyze the relation between sociodemographic factors and the use of alcohol by Brazilian adolescents aged from 13 to 17, of both sexes, with parental supervision indicators based on data from PeNSE 2015.

METHODS

This cross-sectional study used data from Sample 2 of PeNSE 2015. This sample provides results for students aged from 13 to 17 years old, attending the 6th through 9th grades of primary education and the 1st to 3rd grades of secondary education in public and private schools, and is representative of the whole country and Major Regions13. For the calculation of this sample, five geographic strata corresponding to the Major Regions (North, Northeast, Southeast, South, and Midwest) were initially defined. In each of these strata, the schools were chosen as primary sampling units, and then the eligible classes from these schools were chosen as secondary sampling units. All students in the selected classes that were present on the day of data collection composed the sample of students and were invited to participate in the survey13. To calculate the sample size in each stratum, a maximum sampling error of 3% was used to estimate a proportion of 50%, with a 95% confidence level and a mean effect of the sampling plan of 3 in the first stage. At the end of the data collection, the sample was composed of 16,608 students, in 371 schools, and 653 classes throughout the country13.

DATA COLLECTION

Data collection was performed by IBGE collection agents from April to September 2015. The self-administered structured questionnaire addressed to the students was inserted in smartphones, and included questions about socioeconomic aspects, family context, food, physical activity, alcohol consumption, tobacco and drugs, among others13.

VARIABLES

To achieve the objectives of this study, the variables of the PeNSE 2015 database regarding alcohol consumption, sociodemographic factors, and parental supervision indicators were analyzed. The variables related to alcohol consumption used in this study were: trying one dose of alcoholic beverage (equivalent to a beer can or a glass of wine or a dose of cachaça or whiskey, etc.), categorized into yes and no; drunken episode in life, categorized into yes and no; having had alcohol-related problems, categorized into yes - in case the student has ever had any problems with family or friends, missed classes or got into a fight due to alcohol - and no; and recent alcohol use, categorized as yes - if the student has had at least one glass or one serving of alcohol in the last 30 days - and no.

The sociodemographic variables of the students were: sex (male and female); age (in years); skin color (white, black, yellow, brown, and indigenous); work (yes and no); living with parents, (both, only one, or none); maternal schooling (0 to 8, 9 to 11 or 12 years or more of schooling); geographical region (North, Northeast, Southeast, South, and Midwest); and school type (public or private).

The variables related to parental supervision were: missed class without parental permission, categorized into no - if the student had not missed a day of classes without permission in the last 30 days - and yes; parents not aware of free time activities, categorized into no - if the parents were actually aware of their children’s activities in the free time most often or always in the last 30 days - and yes; parents absent from meals, categorized into no -parents usually have lunch or dinner with the child at least once a week - and yes; parents rarely checking homework, categorized into no -parents checked their children’s homework most of the time or always in the last 30 days - and yes; parents did not understand the student’s concerns, categorized into no - when parents understood their children’s concerns most often or always in the last 30 days - and yes. These five indicators were also added, forming a score that went from 0 to 5: adolescents with no parental supervision (yes for all responses) scored 5 and those under intense supervision (no for the five responses) scored 0.

DATA ANALYSIS

The prevalence and the 95% confidence interval (95%CI) of the indicators related to alcohol consumption (trying one dose of alcoholic beverage in life, drunken episode in life, alcohol-related problems, and recent alcohol use in the last 30 days), and its distribution according to demographic and socioeconomic variables, sex, and family context indicators that deal with parental supervision. The absolute number was obtained for all these estimates. The Pearson’s χ2 test was used at a significance level of 5%.

For the comparison of the prevalence of alcoholic beverage use in the last 30 days according to proposed variables, the unadjusted and adjusted prevalence ratios (PR), as well as their respective 95%CI values, were estimated. Unadjusted and multivariate models were stratified by sex. All analyzes were carried out in the Survey module of the Stata 14 software, taking into account the complex sampling design of PeNSE’s Sample 2, which allowed the production of population estimates for school adolescents aged between 13 and 17 years.

ETHICAL CONSIDERATIONS

PeNSE 2015 was approved by the National Commission for Research Ethics (CONEP) of the National Health Council (CNS), which regulates health research involving human beings.

RESULTS

The prevalence of alcohol testing among adolescents was 61.4% (95%CI 59.1 - 63.7), higher among girls (62.9%) than among boys (60.0%) (p = 0.044) (Table 1). Trying alcohol precociously, that is, before the age of 13, had 50.6% (95%CI 47.6 - 53.7%) and there was a higher proportion of boys who experience alcohol earlier than girls (54.4 versus 47.0%) (p < 0.001). Among the adolescents, 27.2% (95%CI 25.4 - 29.0) reported a drunken episode in their lifetime, 9.3% (95%CI 8.5 - 10.2) stated they had problems due to alcohol use and 29.3% (95%CI 27.5 - 31.2) reported recent use, without significant differences between boys and girls (p > 0.05).

Table 1. Prevalences and respective 95% confidence intervals of outcomes related to alcohol consumption, by sex, in students aged 13 to 17 years. National School-based Health Survey, Brazil, 2015. 

Situations related to alcohol consumption Total Sex p- value
Female Male
n % 95%CI % 95%CI % 95%CI
Trying one dose of alcoholic beverage in life 0.044
No 4,312 38.6 (36.3 - 40.9) 37.1 (34.3 - 40) 40.0 (37.4 - 42.7)
Yes 6,593 61.4 (59.1 - 63.7) 62.9 (60 - 65.7) 60.0 (57.4 - 62.6)
Drunken episode in life 0.591
No 8,079 72.9 (71 - 74.6) 73.2 (71.2 - 75) 72.5 (70.2 - 74.8)
Yes 2,835 27.2 (25.4 - 29) 26.8 (25 - 28.8) 27.5 (25.2 - 29.8)
Having had alcohol-related problems 0.102
No 9,949 90.7 (89.8 - 91.5) 91.4 (90.2 - 92.4) 90.1 (88.7 - 91.3)
Yes 969 9.3 (8.5 - 10.2) 8.7 (7.6 - 9.8) 9.9 (8.7 - 11.3)
Recent alcohol use in the last 30 days 0.117
No 7,804 70.7 (68.9 - 72.5) 69.7 (67.5 - 71.8) 71.7 (69.4 - 73.8)
Yes 3,108 29.3 (27.5 - 31.2) 30.3 (28.2 - 32.5) 28.3 (26.2 - 30.6)

95%CI: 95% confidence interval.

Differences in the prevalence of recent alcohol use according to sociodemographic variables were also observed (Table 2). The prevalence of recent alcohol use increased with age in both sexes (p < 0.0001). Young residents in the South Region had a higher prevalence of recent alcohol use, 39.8% for females and 36.7% for males, and those from the North Region had the lowest prevalence (20.4 for females and 19.9% for males) (p < 0.0001). Young women with yellow or indigenous skin color reported a higher prevalence of alcohol use (p = 0.020). Among adolescents who work, a higher prevalence of alcoholic beverages was observed, with 45.7% for females and 46.1% for males (p < 0.0001). Living with the parents had a significant impact on the prevalence of alcohol use, which was higher in the absence of one or both parents, especially for female adolescents (p = 0.030). There were no significant differences according to the skin color and living with the parents for boys, neither according to maternal schooling and school type for both sexes.

Table 2. Prevalences and respective 95% confidence intervals of alcohol use in the last 30 days, by sociodemographic characteristics, in students aged 13 to 17 years. National School-based Health Survey, Brazil, 2015. 

Sociodemographic characteristics n Females Males
% 95%CI p-value % 95%CI p-value
Age (years) < 0.001 < 0.001
13 2,561 18.2 (15.1 - 21.7) 13.8 (11.1 - 17.0)
14 2,133 27.3 (22.3 - 32.9) 22.2 (18.8 - 26.1)
15 2,425 32.7 (28.9 - 36.7) 29.4 (25.4 - 33.7)
16 2,270 35.2 (31.1 - 39.5) 39.0 (34.7 - 43.4)
17 1,537 38.1 (33.0 - 43.4) 39.0 (34.1 - 44.1)
Color or race 0.020 0.235
Black/brown 5,837 28.2 (25.7 - 30.9) 27.3 (24.7 - 30.0)
White 4,300 32.9 (30.0 - 36.1) 29.2 (26.3 - 32.2)
Yellow/indigenous 781 33.5 (27.3 - 40.3) 32.2 (26.3 - 38.7)
Work < 0.001 < 0.001
No 9,112 28.0 (25.8 - 30.2) 23.7 (21.5 - 26.1)
Yes 1,804 45.7 (39.8 - 51.7) 46.1 (42.5 - 49.8)
Living with parents 0.030 0.344
None 707 32.4 (27.0 - 38.4) 30.5 (23.6 - 38.5)
Only one 3,943 32.7 (29.6 - 35.9) 29.7 (26.4 - 33.2)
Both 6,266 28.4 (26.0 - 31.0) 27.3 (24.9 - 29.8)
Maternal schooling (years) 0.857 0.096
0 to 8 2,997 32.9 (29.4 - 36.5) 27.9 (24.8 - 31.2)
9 to 11 2,788 32.3 (28.3 - 36.6) 29.3 (25.6 - 33.2)
12 and more 2,767 31.2 (26.8 - 35.8) 33.3 (29.4 - 37.6)
Geographic region < 0.001 < 0.001
North 2,139 20.4 (17.2 - 24.1) 19.9 (16.5 - 23.9)
Northeast 2,277 22.5 (19.3 - 26.2) 21.4 (17.8 - 25.4)
Southeast 2,083 33.9 (29.9 - 38.2) 32.0 (28.2 - 36.1)
South 2,152 39.8 (35.9 - 43.9) 36.7 (32.9 - 40.7)
Midwest 2,275 33.4 (29.9 - 37.0) 31.2 (27.6 - 35.0)
School type 0.366 0.141
Private 2,639 32.8 (27.1 - 39.1) 32.3 (26.8 - 38.2)
Public 8,287 29.9 (27.6 - 32.3) 27.8 (25.5 - 30.2)

95%CI: 95% confidence interval.

When evaluating the prevalence of recent alcohol use according to the family context, it was observed for all the indicators studied that the lower the parental supervision, the higher the prevalence of alcohol use by adolescents for both sexes (p<0.001) (Table 3).

Table 3. Prevalences and respective 95% confidence intervals of alcohol use in the last 30 days, by parental supervision indicators, in students aged 13 to 17 years. National School-based Health Survey, Brazil, 2015. 

Parental supervision indicators n Females Males
% 95%CI p-value % 95%CI p-value
Missed class without parental permission < 0.001 < 0.001
No 8,364 25.6 (23.6 - 27.8) 24.8 (22.5 - 27.3)
Yes 2,527 44.4 (40.1 - 48.9) 37.0 (33.2 - 41.1)
Parents rarely aware of free time activities < 0.001 < 0.001
No 7,374 26.7 (24.5 - 29.1) 25.0 (22.5 - 27.7)
Yes 3,505 38.9 (35.3 - 42.7) 33.6 (30.8 - 36.5)
Parents rarely presente for meals < 0.001 0.002
No 8,592 27.5 (25.4 - 29.8) 27.2 (24.9 - 29.7)
Yes 2,314 38.4 (34.0 - 42.9) 33.4 (29.7 - 37.4)
Parents rarely checked if homework was done < 0.001 < 0.001
No 3,086 22.0 (19.2 - 25.0) 21.5 (18.4 - 25)
Yes 7,786 33.3 (30.9 - 35.9) 31.4 (29.1 - 33.8)
Parents did not understand their problems and concerns < 0.001 < 0.001
No 4,833 25.0 (22.5 - 27.8) 25.1 (22.5 - 27.9)
Yes 6,031 34.5 (31.8 - 37.3) 31.1 (28.6 - 33.9)
Parental supervision score < 0.001 < 0.001
0 1,344 16.5 (13.4 - 20.3) 15.4 (12 - 19.5)
1 2,538 22.6 (19.4 - 26.3) 23.9 (20.9 - 27.2)
2 3,054 28.8 (25.9 - 31.9) 27.6 (24.1 - 31.3)
3 2,407 35.8 (32.1 - 39.7) 33.3 (29.4 - 37.3)
4 1,186 43.6 (38.7 - 48.6) 38.4 (34.2 - 42.9)
5 279 61.9 (51.0 - 71.7) 42.9 (32.8 - 53.6)

95%CI: 95% confidence interval.

After adjusting for all the factors investigated, the final multivariate model showed that young people aged over 13 years have a higher prevalence of recent alcohol use, and among those who are older (16 years old or more), the prevalence of alcohol use was double of that observed among the youngest (13 years old), still in greater magnitude for males (Table 4). Girls with yellow or indigenous skin color showed a higher prevalence of consumption even after adjustment. Adolescents who work, compared to those who do not work, have predominance of alcohol use ( around 30% and 60% higher for girls and boys, respectively). Living in the Southeast, South and Midwest Regions, in both sexes, increased the prevalence of alcohol use. Studying in public schools was a protective factor for recent use of alcohol for both sexes, and a high level of maternal schooling was associated with alcohol use only for boys (PR = 1.20; 95%CI 1.01 - 1.42). Finally, parental supervision remained associated with recent alcohol use in adolescents, with dose-response effect (p-trend < 0.0001), regardless of sex. Thus, the lower the parental supervision, the higher the prevalence of recent alcohol use, being almost twice as high for boys and three times higher for girls. In the adjusted model, however, living with parents did not remain associated with recent alcohol use.

Table 4. Unadjusted and adjusted prevalence ratios and 95% confidence intervals of alcohol use in the last 30 days, by sociodemographic characteristics and parental supervision, according to sex in students aged 13 to 17 years. National School-based Health Survey, Brazil, 2015. 

Variables Females Males
PRua 95%CI PRa 95%CI PRua 95%CI PRa 95%CI
Age (years)
13
14 1.5 (1.19 - 1.90) 1.45 (1.15 - 1.84) 1.61 (1.25 - 2.08) 1.58 (1.16 - 2.15)
15 1.8 (1.45 - 2.23) 1.6 (1.29 - 1.98) 2.13 (1.66 - 2.74) 2.05 (1.54 - 2.72)
16 1.93 (1.54 - 2.43) 1.7 (1.37 - 2.09) 2.83 (2.22 - 3.59) 2.49 (1.92 - 3.23)
17 2.1 (1.67 - 2.63) 1.77 (1.43 - 2.20) 2.83 (2.22 - 3.60) 2.41 (1.85 - 3.12)
Color or race
Black/brown
White 1.17 (1.04 - 1.31) 1.09 (0.97 - 1.22) 1.07 (0.95 - 1.21) 0.95 (0.83 - 1.08)
Yellow/indigenous 1.19 (0.97 - 1.45) 1.24 (1.03 - 1.49) 1.18 (0.96 - 1.45) 1.04 (0.82 - 1.32)
Work
No
Yes 1.63 (1.40 - 1.91) 1.26 (1.09 - 1.47) 1.95 (1.74 - 2.17) 1.56 (1.38 - 1.75)
Living with parents
None
Only one 1.01 (0.84 - 1.21) 1.1 (0.91 - 1.32) 0.97 (0.73 - 1.29) 0.98 (0.73 - 1.32)
Both 0.88 (0.73 - 1.05) 1.04 (0.86 - 1.27) 0.89 (0.71 - 1.13) 0.89 (0.70 - 1.14)
Maternal schooling (years)
0 to 8
9 to 11 0.98 (0.83 - 1.16) 0.96 (0.82 - 1.11) 1.05 (0.89 - 1.24) 1.06 (0.91 - 1.25)
12 and more 0.95 (0.78 - 1.15) 0.92 (0.76 - 1.11) 1.2 (1.02 - 1.40) 1.19 (1.01 - 1.41)
Geographic region
North
Northeast 1.1 (0.88 - 1.39) 1.23 (0.97 - 1.56) 1.07 (0.83 - 1.39) 1 (0.78 - 1.29)
Southeast 1.66 (1.35 - 2.05) 1.77 (1.43 - 2.18) 1.6 (1.28 - 2.01) 1.51 (1.22 - 1.87)
South 1.95 (1.60 - 2.38) 1.93 (1.56 - 2.39) 1.84 (1.49 - 2.28) 1.77 (1.43 - 2.19)
Midwest 1.63 (1.34 - 2.00) 1.72 (1.38 - 2.13) 1.56 (1.25 - 1.95) 1.52 (1.22 - 1.9)
School type
Private
Public 0.91 (0.75 - 1.11) 0.81 (0.68 - 0.98) 0.86 (0.71 - 1.05) 0.81 (0.67 - 0.96)
Parental supervision score*
0
1 1.37 (1.07 - 1.75) 1.21 (0.95 - 1.54) 1.55 (1.22 - 1.97) 1.44 (1.09 - 1.89)
2 1.74 (1.37 - 2.22) 1.56 (1.23 - 1.98) 1.79 (1.38 - 2.32) 1.6 (1.22 - 2.10)
3 2.17 (1.73 - 2.71) 1.92 (1.52 - 2.41) 2.16 (1.66 - 2.80) 2.13 (1.59 - 2.84)
4 2.64 (2.09 - 3.33) 2.3 (1.81 - 2.93) 2.49 (1.92 - 3.23) 2.3 (1.71 - 3.10)
5 3.75 (2.84 - 4.95) 2.99 (2.22 - 4.04) 2.78 (1.97 - 3.93) 2.46 (1.68 - 3.59)

PRua: unadjusted prevalence ratio; PRa: adjusted prevalence ratio; 95%CI: 95% confidence interval; *p trend <0.001 for both sexes

DISCUSSION

The results of this study show that at least one in three adolescents, approximately, used alcohol. They also show that the proportion of alcoholic beverage experimentation was higher for females. The higher the age, the higher the prevalence of alcohol use for both sexes. In addition, specific groups, such as adolests who work and those who live in the Southern Region, also showed a higher prevalence of recent alcohol use in both sexes. The lack of parental supervision was also associated with greater alcohol use, in which case a dose-response relationship was observed, that is, the lower the supervision, the greater the prevalence of use. There were different factors associated with alcohol use in relation to sex: yellow/indigenous skin color (in females) and maternal schooling of 12 years or more (in males) were significantly associated with a higher prevalence of alcohol use.

The use of alcohol by adolescents in Brazil was similar to that verified by previous studies, including PeNSE estimates with a sample of 9th grade students, emphasizing that in 2009, only school students from Brazilian capitals were included6,10,11,12; and slightly higher than that found by other Brazilian studies8,9. Regarding the international scenario, the frequency of consumption was slightly lower than that found in other countries, as presented in an American study with 2,000 schoolchildren participating in the different waves of the Add Health survey, which showed a prevalence of 40 to 50% of alcohol consumption1 (although the methods used to measure alcohol use differed). A study with similar measure that evaluated data from the GSHS study, including adolescent populations aged 12 to 15 from countries in all WHO regions (Africa, Americas, Europe, Eastern Mediterranean, Western Pacific and Southeast Asia), found a prevalence of alcohol in the last 30 days of 15.7% (12.3 - 19.5), lower than that found in the present study17. However, when comparing only with the Americas, which presented higher prevalence of alcohol use, the estimates were similar: 27.6% (22.7 - 32.9) among male adolescents and 24.7% (19.3 - 30.5) among females17.

Data from the present study and other editions of PeNSE with 9th grade students10,11 show that, among females, the prevalence of alcohol use and experimentation is similar or sometimes slightly higher than in males, different from what can be found in the international literature. Analysis of the GSHS data pool conducted by the WHO found predominance of recent higher alcohol use in males, in relation to females, in all WHO regions17. However, studies with the Brazilian adult population show that, over the years, boys tend to outperform girls in relation to this behavior18,19. Thus, the relationship between alcohol consumption and the gender variable should continue to be monitored, as it may be a cohort effect due to new gender identity tendencies20.

There was a higher prevalence of alcohol use among working adolescents, corroborating the findings of other studies2,12,21. One possible explanation for this association is the fact that working adolescents acquire greater independence and proximity to adult roles21. In addition, the work environment provides coexistence with older people who can introduce alcohol to the adolescents, in addition to stressful situations that predispose to the use of alcohol2,21. A study that analyzed the relationship of other drugs and work also found similar results12, especially the lower commitment to school among these adolescents.

Recent studies have also shown the relationship between alcohol consumption and parental supervision1,3,22,23, corroborating the findings of this study and highlighting the relevance of the parents’ presence and their possible direct relationship with greater discipline and norms, which, consequently, contribute to the development of important social skills for the adoption of protective behaviors to the use of alcohol, such as the choice of friends, recognition of the risks involved, among others1. A study that analyzed the causal network of alcohol use also showed that the greater participation of parents contributed to the increase of adolescents’ self-esteem, which, in turn, contributed to the lower consumption of alcohol23. The present study demonstrated a dose-response relationship of this finding, indicating a potential confirmation of psychosocial mechanisms of the negative effect that the parents’ absence on the daily life and activities of adolescents have on alcohol consumption.

However, there are limitations to this study, such as the possibility of underestimation of actual alcohol use among adolescents, as those who do not attend school can consume more alcoholic beverages. In addition, the associations found must be interpreted with caution with regard to cause and effect relationships, due to the cross-sectional design. However, as few studies have explored the family context, such as parental supervision, and increased alcohol consumption3, it is believed that this study contributes to some evidence in this regard. In addition, the use of a population of adolescents aged 13 to 17 years stands out, allowing greater international comparability.

FINAL CONSIDERATIONS

The results obtained evidenced the experimentation of alcoholic beverages and the occurrence of problems due to the use of the substance at very young ages. The study also showed a high prevalence of alcohol use in both sexes, especially among those who work, aged over 13 years, and residents of the South Region. The characteristics related to the family context showed an association with the use of alcohol by adolescents, and a greater supervision by parents and guardians was protective against the outcome in the age group studied.

ACKNOWLEDGMENTS

To the National Council for Scientific and Technological Development (CNPQ), for the research productivity grant and the junior postdoctoral fellowship.

REFERENCES

1. Wang C, Hipp JR, Butts CT, Jose R, Lakon CM. Alcohol Use among Adolescent Youth: The Role of Friendship Networks and Family Factors in Multiple School Studies. PLoS One. 2015; 10(3): e0119965. DOI: 10.1371/journal.pone.0119965 [ Links ]

2. Liu XC, Keyes KM, Li G. Work stress and alcohol consumption among adolescents: moderation by family and peer influences. BMC Public Health. 2014; 14: 1303. DOI: 10.1186/1471-2458-14-1303 [ Links ]

3. Lipperman-Kreda S, Gruenewald PJ, Grube JW, Bersamin M. Adolescents, alcohol, and marijuana: Context characteristics and problems associated with simultaneous use. Drug Alcohol Depend. 2017; 179: 55-60. DOI: 10.1016/j.drugalcdep.2017.06.023 [ Links ]

4. Carrara-Nascimento PF, Hoffmann LB, Contó MB, Marcourakis T, Camarini R. Ethanol Sensitization during Adolescence or Adulthood Induces Different Patterns of Ethanol Consumption without Affecting Ethanol Metabolism. Front Behav Neurosci. 2017; 11: 46. DOI: 10.3389/fnbeh.2017.00046 [ Links ]

5. McCambridge J, McAlaney J, Rowe R. Adult consequences of late adolescent alcohol consumption: a systematic review of cohort studies, PLoS Med. 2011; 8:e1000413. DOI: 10.1371/journal.pmed.1000413 [ Links ]

6. Gomes BMR, Alves JGB, Nascimento LC. Consumo de álcool entre estudantes de escolas públicas da Região Metropolitana do Recife, Pernambuco, Brasil. Cad Saúde Pública. 2010; 26(4): 706-12. DOI: 10.1590/S0102-311X2010000400013 [ Links ]

7. Jorge KO, Ferreira RC, Ferreira EF, Vale MP, Kawachi I, Zarzar PM. Binge drinking and associated factors among adolescents in a city in southeastern Brazil: a longitudinal study. Cad Saúde Pública. 2017; 33(2): e00183115. DOI: 10.1590/0102-311x00183115 [ Links ]

8. Gonçalves H, Soares ALG, Santos APG, Ribeiro CG, Bierhals IO, Vieira LS, et al. Adverse childhood experiences and consumption of alcohol, tobacco and illicit drugs among adolescents of a Brazilian birth cohort. Cad Saúde Pública. 2016; 32(10): e00085815. DOI: 10.1590/0102-311X00085815 [ Links ]

9. Coutinho ESF, França-Santos D, Magliano ES, Bloch KV, Barufaldi LA, Cunha CF, et al. ERICA: padrões de consumo de bebidas alcoólicas em adolescentes brasileiros. Rev Saúde Pública. 2016; 50(Supl. 1): 8s. DOI: 10.1590/s01518-8787.2016050006684 [ Links ]

10. Malta DC, Mascarenhas MDM, Porto DL, Duarte EA, Sardinha LM, Barreto SM, et al. Prevalence of alcohol and drug consumption among adolescents: data analysis of the National Survey of School Health. Rev Bras Epidemiol. 2011; 14(Supl. 1): 136-46. DOI: 10.1590/S1415-790X2011000500014 [ Links ]

11. Malta DC, Machado IE, Porto DL, Silva MMA, Freitas PC, Costa AWN, et al. Consumo de álcool entre adolescentes brasileiros segundo a Pesquisa Nacional de Saúde Escolar (PeNSE 2012). Rev Bras Epidemiol. 2014; 17(Supl. 1): 203-14. DOI: 10.1590/1809-4503201400050016 [ Links ]

12. Malta DC, Ruscito R, Machado IE, Pinto A, Oliveira-Campos M, Souza MFM, et al. Uso de substâncias psicoativas em adolescentes brasileiros e fatores associados: Pesquisa Nacional de Saúde dos Escolares, 2015. Rev Bras Epidemiol. 2018; 21 Suppl 1: e180004.supl.1 http://dx.doi.org/10.1590/1980-549720180004.supl.1Links ]

13. Instituto Brasileiro de Geografia e Estatística. Pesquisa Nacional de Saúde do Escolar (PeNSE) 2015. Rio de Janeiro: IBGE; 2016. 126 p. [ Links ]

14. Organização Mundial da Saúde. Global school-based Student Health Survey (GSHS) [Internet]. [citado em 3 ago. 2017]. Disponível em: http://www.who.int/chp/gshs/en/Links ]

15. Jackson KM, Merrill JE, Barnett NP, Colby SM, Abar CC, Rogers ML, et al. Contextual influences on early drinking: Characteristics of drinking and nondrinking days. Psychol Addict Behav. 2016; 30(5): 566-77. DOI: 10.1037/adb0000184 [ Links ]

16. Gomes BMR, Alves JGB, Aquino JM, Medeiros SEG, Lima FM. Fatores associados ao consumo de álcool entre estudantes de escolas públicas. Rev Enferm UFPE. 2014; 8(5): 1164-70. DOI: 10.5205/reuol.5863-50531-1-ED.0805201409 [ Links ]

17. Caleyachetty R, Echouffo-Tcheugui JB, Tait CA, Schilsky S, Forrester T, Kengne AP. Prevalence of behavioural risk factors for cardiovascular disease in adolescents in low-income and middle-income countries: an individual participant data meta-analysis. Lancet. 2015 Jul 31; 3(7): 535-44. https://doi.org/10.1016/S2213-8587(15)00076-5Links ]

18. Machado ÍE, Monteiro MG, Malta DC, Lana FCF. Pesquisa Nacional de Saúde 2013: relação entre uso de álcool e características sociodemográficas segundo o sexo no Brasil. Rev Bras Epidemiol. 2017; 20(3): 408-22. http://dx.doi.org/10.1590/1980-5497201700030005Links ]

19. Moura EC, Malta DC. Consumo de bebidas alcoólicas na população adulta Brasileira: características sociodemográficas e tendência. Rev Bras Epidemiol. 2011; 14(Supl. 1): 61-70. DOI: 10.1590/S1415-790X2011000500007 [ Links ]

20. Machado IE, Lana FCF, Felisbino-Mendes MS, Malta DC. Factors associated with alcohol intake and alcohol abuse among women in Belo Horizonte, Minas Gerais State, Brazil. Cad Saúde Pública. 2013; 29(7): 1449-59. DOI: 10.1590/S0102-311X2013000700018 [ Links ]

21. Malta DC, Oliveira-Campos M, Prado RR, Andrade SSC, Mello FCM, Dias AJR, et al. Uso de substâncias psicoativas, contexto familiar e saúde mental em adolescentes brasileiros, Pesquisa Nacional de Saúde dos Escolares (PeNSE 2012). Rev Bras Epidemiol. 2014; 17(Supl. 1): 46-61. DOI: 10.1590/1809-4503201400050005 [ Links ]

22. Handren LM, Donaldson CD, Crano WD. Adolescent Alcohol Use: Protective and Predictive Parent, Peer, and Self-Related Factors. Prev Sci. 2016; 17(7): 862-71. DOI: 10.1007/s11121-016-0695-7 [ Links ]

23. Freitas ES, Ribeiro RCS, Saldanha AAW. O uso de álcool por adolescentes: Uma comparação por gênero. Psicol Argum [Internet]. 2012 [citado em 03 ago. 2017]; 30(69): 287-95. Disponível em: http://www2.pucpr.br/reol/pb/index.php/pa?dd1=5975&dd99=view&dd98=pbLinks ]

Financial support: none.

Received: October 20, 2017; Accepted: November 16, 2017

Corresponding author: Ísis Eloah Machado. Avenida Prof. Alfredo Balena, 190, Santa Efigênia, CEP: 30130-100, Belo Horizonte, MG, Brasil. E-mail: isiseloah@gmail.com

Conflict of interests: nothing to declare

Creative Commons License Este é um artigo publicado em acesso aberto sob uma licença Creative Commons