OF THE ALCOHOL CONSUMPTION PHENOMENON AMONG ADOLESCENTS : STUDY CARRIED OUT WITH ADOLESCENTS IN INTERMEDIATE PUBLIC EDUCATION

Este estudo teve como objectivo a avaliação do fenómeno do consumo de álcool em escolas públicas da cidade de Coimbra (7o, 8o e 9o) para a implementação de um programa de prevenção de uso/abuso de álcool. É um estudo do tipo quantitativo descritivo-correlacional. A amostra incluiu 654 estudantes (51,5% do sexo feminino), com idades compreendidas entre 12 e 18 anos. Utilizou-se para a colheita de dados o Questionário de Expectativas acerca do Álcool Formato Adolescentes (AEQ-A) e o Questionário de Conhecimentos acerca do Álcool. Os resultados mostraram que as expectativas positivas acerca do álcool são discriminativas do consumo e da ocorrência de embriaguez. Essas existem nos adolescentes mesmo antes de experiências significativas com o consumo de álcool, e aumentam com a idade. Reforçando a necessidade de os esforços preventivos terem que ser desenvolvidos precocemente. Esses resultados permitiram o refinamento do programa de prevenção que foi integrado ao curriculum escolar dos estudantes do 7o ano.


INTRODUCTION
Alcohol is one of the most consumed psychoactive substances in the world and the one that causes the most severe consequences to public health, currently considered the main life style-related determinant of health (1) .The burden of diseases and morbidities attributed to alcohol varies between 8 and 10% in countries in the European Union (2) .
Portugal is one of the largest alcohol consumers in the world and has recently changed its consumption patterns.These new patterns are very concerning because they refer to a population group of particular vulnerability and of traditional low consumption: adolescents (3) .In fact, research has showed that the percentage of adolescents who consume alcohol progressively increases with age and that the onset age is 12 years old (4)   .
At the same time, scientific evidence suggests that early onset is associated to future behavioral problems in adolescence, including violence related to alcohol, accidents, driving under influence, absenteeism at school and work and increased risk to use other drugs, and also future alcohol abuse (5) .Because adolescence is an important period of transition, marked by complex biological, physical, behavioral and social transformations, alcoholic behavior in this phase of life results in the developing adolescent's encounter with a substance of harmful effects in a situational and encouraging context that promotes consumption.
On the other hand, there is a relation between adolescents' critical periods of behavioral development and the possibility of implementing effective preventive measures.Thus, it is essential that these are developed before the onset of alcohol consumption (6) .
Research developed in recent years regarding the explicative factors of adolescents' consumption of alcohol and other drugs identifies several risk as well as protective factors (7) , such as: sociocultural (e.g.Historical analysis reveals that prevention programs on the use of substances have been developed in the last decades based on the social influence model, including the development of personal and social competences (8)(9) and the use of one or more of the following components: knowledge on substances, resistance to social pressure, training of personal and social competences, correction of peers' perception on alcohol consumption, safe attitudes and expectancy regarding substances (9) .

o e a c h c o r r e c t s t a t e m e n t ) a n d t h e A l c o h o l
Expectancy Questionnaire -Adolescents form (AEQ-A) (11) , a dichotomous instrument that aimed to evaluate adolescents' expectancy (12-

DISCUSSION
The large majority of students from the 7 th , 8 th and 9 th grades in the study sample, between 12 and 18 years old, average [SD] 13.55 [1.13], had already consumed alcohol and no statistically significant differences were found between boys and girls.These findings confirm results already presented in national research reports on the life styles of Portuguese adolescents (4) and also in the dissemination of research exclusively addressing adolescents' alcohol consumption (12)   .In fact, not only data on general consumption seem to be consistent with these findings, but also partial data related to different variables that characterize the phenomenon, reinforcing findings of other studies (4,12) .Thus, for the Knowledge showed by adolescents in this study reflects important gaps.On the one hand, wrong ideas regarding alcohol, linked to myths and/or false concepts traditionally associated to it, still persist, namely: they believe that "alcohol warms" (64.1%), "kills your thirst" (30.7%) and "aids digestion" (47.6%).On the other hand, a lack of knowledge related to scientific knowledge, associated to the pharmacological effects of alcohol, action and consequences on the organism emerges, for example: they do not know that "the alcohol contained in alcoholic beverages is ethyl" (86.1%), or yet that "when alcohol pass into the blood it first goes to parts of our organism with the highest concentration of water" (49.8%).
T h i s l a c k o f k n o w l e d g e , e s p e c i a l l y regarding the metabolism of alcohol and its relation with the performance of a person under its influence is particularly dangerous.In fact, mistakes likebelieving that "the effect alcohol causes on people depends only on the quantity consumed" (68.5%); "when water or soft drinks are mixed with alcohol, the quantity of alcohol consumed is smaller" (49.1%); "drinking moderately means drinking so as not to feel dizzy or sick" (55.8%), or not knowing that "alcohol effects vary according to gender" (63.3%) are mistakes that can potentially favor diminished perception of risk related to alcohol consumption.
The relation between knowledge on alcohol and its consumption is complex.On the one hand, we verified that adolescents who had more knowledge about alcohol were those who did not report intoxication.Thus, this knowledge is presented as a protection factor.On the other hand, no statistically significant differences were found between level of knowledge on alcohol and its consumption.These results are in agreement with several empirical studies that show that expectancy on alcohol is a mediating factor of consumption (11)(12)(13) .
No differences were found between genders in terms of expectancy, both in the global score and in the majority of factors, which reflects the current tendency of converging behavior between girls and boys.The statistically significant differences found between genders for Factor III -improved cognitive and motor abilities -higher for boys, and for Factor VII -relaxation and tension reduction -higher for girls, reflect some developmental specificity.Some studies in the area appoint that boys have a higher tendency to externalize and girls to internalize (14) .Thus, boys tend to view alcohol as a stimulus for action, while girls see it as a component that promotes relaxation.
It is also worth mentioning that we consistently verified, except for Factor VI (increased arousal), that the oldest adolescents were those who presented the highest positive expectancy regarding alcohol, while the youngest were those who presented the highest negative expectancy.In fact, several researchers appoint the potential role age plays in expectancy regarding alcohol and highlight that expectancy on alcohol increases with age and becomes more homogeneous and stable (11) .
Over more than two decades, several transversal and longitudinal studies (11)(12)(13) evidenced clarifying results on the power of expectancy on alcohol as a predictor of alcohol consumption onset and problems related to alcohol in adolescents.Hence, in the light of these findings, we consider it essential not only to include expectancy on intervention programs in the area, but also that such programs are implemented in an appropriate developmental phase, before expectations become stable and therefore more resistant to change.

CONCLUSION
The results of this study reveal that the majority of adolescents in the sample had already consumed alcohol, although regular consumption is not common among adolescents from the 7 th , 8 th and 9 th grades.However, about one fourth of the participants had already been intoxicated at least once and reported the consumption of more than three sociodemographic factors), family (e.g.alcohol consumption by parents, parental monitoring), involving social environment (e.g.alcohol access, connection to school, mass media influence, peer pressure), expectancy (e.g.attitudes and beliefs regarding alcohol consumption, peers' expectations and perception), social and personal competences (e.g.decision-making, stress management abilities, communication abilities, assertiveness) and psychological (e.g.self-efficacy, self-esteem).The different effects these factors can produce depend on individual characteristics, development phase and environment.
majority of the participants, the first consumption occurred in the family context and/or on a festive occasion; the consumption pattern was occasional for the majority and hard liquor was the chosen beverage to the detriment of beer; one fourth of adolescents reported drinking more than three g l a s s e s o n t h e s a m e o c c a s i o n a n d a l s o t h e occurrence of intoxication.These results reflect changes in consumption patterns and modes, with increased consumption of hard liquor to the detriment of beer, and also increased frequency of intoxication with similar behavior among boys and girls.
drinks in the same occasion.The majority of adolescents initiated alcohol consumption at home with family, in festive occasions.Such pattern of onset consumption in the family context is typical of Mediterranean countries.Although the results point to a complex relation between knowledge on alcohol and its consumption, the identified "mistakes" potentially favor diminished perception of risk in relation to alcohol consumption.Moreover, results suggest altered knowledge (loss of knowledge) due to experiences with alcohol, which appoints the need to include this component in current preventive programs.These results also reveal that positive expectancy regarding alcohol exists even before significant experiences with alcohol consumption and that positive expectancy increases with age, while no differences between genders were found in the global and in the majority of expectancy factors.The need to develop early prevention programs, including both genders, so they are successful is reinforced.Despite the study limitations -only students whose educational responsible gave authorization to participate in the study -the high number of students involved permitted evaluating adolescents' needs, essential to improve a preventive program on alcohol use/abuse, which was later included in the school curricula for 7 th grade students at a public school in Coimbra, Portugal.
After alcohol is consumed, it rapidly passes from stomach to blood (C38) r) One can drink the same quantity of alcohol drinking different alcoholic beverages (C39).
19 years old) in seven dimensions: Factor I -global positive transformations; Factor II -changes in social behavior; Factor III -improved cognitive and motor abilities; Factor IV -sexual enhancement; Factor V -cognitive and motor impairment; Factor VI -increased arousal and Factor VII -relaxation and tension reduction.The AEQ-A global score in the sample under study (n=654) revealed Kuder Richardson value of .90, which shows the instrument's good consistency.However, a great variability was found in the analysis of the instrument factors.Factor V presents good internal consistency (K20=.80),FactorI(K20=.78),RESULTSMostadolescents had already consumed a l c o h o l ( 6 5 . 1 % ) .O f t h o s e w h o r e p o r t e dconsumption of alcohol, 67.1% were female, though there were no significant differences between boys and girls (Chi-square=1.13,1df,p=.29).Regarding a café or a restaurant for 7.5% and a pub for 17.9%.As observed in Figure1, regarding adolescents' knowledge on alcohol, we verified that a high percentage of students incorrectly answered from 17 to 40 items in the questionnaire evaluating knowledge.Figure 1 -Percentage of incorrect answers related to knowledge on alcoholIn the evaluation of knowledge on alcohol, a statistically significant difference was found (t=3.57,652gl,p=.00) according to the age range.The average knowledge on alcohol of the youngest (from 12 to 14 years of age) was superior to the average knowledge of the oldest students (more than 15 years of age).(FactorIII t=3.38, 564.34gl p=.00); (Factor IV t=4.35, 652gl, p=.00); (Factor VI t=4.47, 449.52gl, p=.00) and (Factor VII t=3.86, 652gl, p=.00)].In relation to the occurrence of intoxication, the adolescents who reported the occurrence of intoxication were those who presented significantly higher expectancy on alcohol in the global and in all factors of positive expectancy (t=-6.94,424gl, p=.00; t=-6.