Drinking Practices and Other Health-Related Behaviors Among Adolescents of São Paulo City, Brazil

Abstract

Purpose. (a) detect possible demographic and behavioral differences among young episodic heavy drinkers and other young drinkers; (b) investigate the association of youth drinking patterns with other health-compromising behaviors. Methods. The data presented are part of a health behavior survey, which used a modified version of the Youth Health Risk Behavior Survey (YHRBS) questionnaire. Students from public (n = 993) and private schools (n = 815), from 7^th to 11^th grades were investigated in São Paulo city. Multivariate logistic regression analyses were employed to investigate the association among different drinking practices and the various health-compromising behaviors, controlling for age group, gender, and school system. Odds Ratios (OR) and their 95% Confidence Intervals (CI) were calculated. Episodic Heavy Drinking was defined as having five or more drinks in a 2-hour interval, at least once in the last 30 days. Results. Episodic Heavy Drinkers (EHDs) tend to be older and males and prefer to drink with friends at commercial facilities instead of drinking with their relatives at home. EHDs also reported higher percentages of adverse consequences, such as physical fights, accidents, and school absenteism after drinking. EHDs are more likely to engage in other high-risk behaviors. In the public schools, they were more likely to carry guns (OR = 17.0; CI = 3.9–74.8), get involved in physical fights (OR = 8.9; CI = 4.4–18.0), attempt suicide (OR = 4.2; CI = 2.0–8.7), and use inhalants (OR = 2.7; CI = 1.3–5.7) than abstainers. They are also more likely to use marijuana (OR = 4.7; CI = 2.2–9.9) and smoke cigarettes (OR = 5.3; CI = 2.7–10.4) than moderate drinkers. The results were similar for private schools, with even higher ratios of inhalant use (OR =15.2; CI = 6.2–37.1), when EHDs were compared with abstainers and cigarette (OR = 64.5; CI = 8.6–481.0) and marijuana use (OR = 6.5; CI = 4.3–9.7), when EHDs were compared with moderate drinkers. Conclusions. EHDs display different drinking habits than other adolescents who drink. Also, they are at increased risk for a range of health-compromising behaviors, when compared with both abstainers and moderate drinkers.

• Health-behaviors
• Drinking
• Violence
• Drug use
• Adolescents

Resumen

Objetivos. (a) detectar las posibles diferencias demográficas y de comportamiento entre jovenes bebedores eventuales severos y otros jovenes bebedores; (b) investigar la asociación entre los patrónes de consumo de alcohol en la juventud y otros comportamientos de riesgo para la salud. Métodos. los datos presentados son los resultados que froman parte de una encuesta de comportamientos de salud para lo cual se utilizó una versión modificada del cuestionario Youth Health Risk Behavior Survey (YHRBS). Se analizo el comportamiento de estudiantes pertencentes a las escuelas publicas (n = 993) y privadas (n = 815), grados 7° al 11° de la ciudad de São Paulo. Se utilizaron modelos de Regresión logística multivariada, ajustados por edad, género y tipo de colegio para investigar la asociación entre diferentes prácticas de consumo de alcohol y diversos comportamientos potencialmente de riesgo para la salud. Se calcularon Odds ratios con sus intervalos de confidencia de 95%. Se definio Bebedores Eventuales Severos los que reportaran consumir 5 o más bebidas alcohólicas em menos de 2 horas, por lo menos una vez nos ultimos 30 dias. Resultados. Jovenes Bebedores Eventuales Severos (BES) eran com mas frecuencia de edades superiores y de género masculino, consumian más bebidas destiladas como “pinga” y otras, y preferian consumir bebidas alcohólicas junto a los amigos y en tiendas más que con los familiares en casa. Los BES también presentarón porcentanjes más altos de consecuencias adversas al uso de alcohol como peleas fisicas, accidentes e absentismo escolar. Los BES también se encajan más en otros comportamientos de riesgo para la salud. En escuelas publicas ellos tenian mas probabilidade de levar armas (OR = 17.0; IC = 3.9–74.8), se envolver en peleas fisicas (OR = 8.9; IC = 4.4–18.0), intentos de suicidio (OR = 4.2; IC = 2.0–8.7) y usar substancias inhalantes (OR = 2.7; IC = 1.3–5.7) com respecto a los abstemios. Ellos también tenian mas probabilidade de fumar cigarrilos (OR = 5.3; IC = 2.7–10.4), fumar marihuana (OR = 4.7; IC = 2.2–9.9) com respecto a los bebedores moderados. Los resultados foran similares en escuelas privadas con riesgos ainda más altos de usar substancias inhalantes (OR = 15.2; IC = 6.2–37.1, com respecto a los abstemios) y de fumar cigarrilos (OR = 64.5; IC = 8.6–481.0), y marihuana (OR = 6.5; IC = 4.3–9.7) com respecto a los bebedores moderados. Conclusiones. Los BES presentan hábitos de consumo de alcohol diferentes en relación a los otros jovenes que consumen alcohol. Ellos también presentan una mayor probabilidad de comportamientos de riesgo para la salud cuando se comparan con los abstemios y bebedores moderados.

Résumé

Objectifs. (a) explorer certaines différences démographiques et comportementales entre de jeunes étudiants grands buveurs et d’autres types de jeunes buveurs; (b) examiner l’association entre les comportements de boire et d’autres comportements à risque pour la santé chez de jeunes étudiants. Méthode. Les données sont issues d’une enquête sur les comportements de santé menées auprès d’étudiants du septième au onzième niveaux, provenant d’écoles privées (n = 815) et publiques (n = 993) dans la ville de São Paulo, Brésil. Une version adaptée du questionnaire Youth Health Risk Behavior Survey (YHRBS) est utilisée. La technique de régression logistique est utilisée pour vérifier des associations entre les différents comportements de boire et les comportements à risque pour la santé, en contrôlant pour l’âge, le genre et le système scolaire. Des rapports de chance et les intervalles de confiance associès (95%) ont été calculés. Les grands buveurs sont définis comme ceux qui ont consommé 5 ou plus boissons distillées dans un intervalle de 2 heures, au moins une fois dans les 30 derniers jours. Résultats. Les grands buveurs (GB) sont surtout des hommes, plus agés et qui boivent davantage des boissons distillées par rapport aux autres types de buveurs. Les GB préfèrent aussi boire avec leurs amis dans des lieux publics plutôt qu’avec leurs parents à leur domicile et rapportent dans une plus grande proportion certaines conséquences négatives associées à leur consommation tels des querelles physiques, des accidents de la route et un absentéisme scolaire suite à leur consommation. Les GB ont aussi une plus grande probabilité de s’engager dans autres comportements à risque pour la santé. Dans les écoles publiques, ils présentent une plus grande probabilité de port d’armes (OR = 17.0; IC = 3.9–74.8), de tentatives de suicide (OR = 4.2; IC = 2.0–8.7) et d’inhaler des solvants (OR = 2.7; IC = 1.3–5.7) par rapport aux jeunes abstinents. Ils présentent également une plus grande probabilité de fumer de la marijuana (OR = 4.7; IC = 2.2–9.9) et de la cigarette (OR = 5.3; IC = 2.7–10.4) par rapport aux buveurs modérés. Les résultats sont similaires dans les écoles privées, où les rapports de chance sont plus grands que ceux des écoles publiques. Les GB ont ainsi une plus grande probabilité d’inhaler des solvants (OR = 15.2; IC = 6.2–37.1) par rapport aux jeunes abstinents et de fumer de la marijuana (OR = 6.5; IC = 4.3–9.7) et de la cigarette (OR = 64.5; IC = 8.6–481.0) par rapport aux buveurs modérés. Conclusions. Les étudiants GB rapportent des habitudes de consommation qui se distinguent de celles des autres étudiants. Ils sont davantage à risque pour des comportements à risque pour la santé par rapport aux buveurs modérés et aux jeunes abstinents.

Additional information

Notes on contributors

Beatriz Carlini-Marlatt

Beatriz Carlini-Marlatt currently lives in the United States and is a visiting scholar at the Addictive Behaviors Research Center, at the University of Washington, Seattle. She was born, raised, and educated in Brazil where she still conducts research and prevention activities. She is affiliated with Centro de Atenção a Drogas (PUC) in Curitiba, Paraná and Faculdade de Medicina, Departamento de Fisiopatologia Experimental, Universidade de São Paulo. Her current area of interest is health promotion and substance use prevention using innovative technologies (Internet and other computer-based interventions). Dr. Carlini-Marlatt has a Ph.D. in Social Psychology from the Pontifícia Universidade Católica de São Paulo (PUC-SP) and was a postdoctoral fellow at the Social and Behavioral Sciences Department at Boston University School of Public Health, USA. She has several publications in international and Brazilian peer-reviewed journals on the use and prevention of alcohol, inhalants, and other substances among young people. Most of her papers are under the name of Beatriz Carlini-Cotrim.

Cynthia Gazal-Carvalho

Cynthia Gazal Carvalho graduated from the University of São Paulo School of Medicine in 1993 and finished the Doctoral degree program under the supervision of Dr. Beatriz Carlini-Marlatt in 2002. Her main fields of interest are Injury Epidemiology and Prevention and particularly alcohol-related injuries.

Nelson Gouveia

Nelson Gouveia graduated as a medical doctor and is now an epidemiologist with interests in the area of environmental health. He has been coordinating studies on the health effects due to environmental pollution and collaborated in other studies related to health behaviors. He works at the Department of Preventive Medicine of the University of São Paulo Medical School and maintains close links with different institutions in Brazil and abroad such as the London School of Hygiene and Tropical Medicine in the United Kingdom, the Catholic University in Chile, the Carnegie Mellon University in the United States.

Maria de Fátima Marinho Souza

Maria de Fatima Souza graduated as a medical doctor, has a Ph.D. in epidemiology, with interests in gender, work, and health. She has been coordinating studies on occupational health, emphasizing a gender analysis, and has been collaborating on other studies related to health behaviors. She works at the Department of Preventive Medicine of the University of São Paulo Medical School and maintains close links with the University of Quebec in Montreal, Canada.