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2.  Binge drinking among Brazilian students: a gradient of association with socioeconomic status in five geo-economics regions 
Drug and alcohol dependence  2012;127(0):87-93.
Aims
1) To describe the characteristics of binge drinking (BD) among high school students in Brazil and 2) the association of BD with students' socioeconomic status (SES) in the five different Brazilian macroregions.
Design
A national multistage probabilistic sample of high school students.
Setting
Students were drawn from 789 public and private schools in each of the 27 Brazilian state capitals.
Participants
17,297 high school students, aged 14 to 18 years.
Measurement
Self-report data about BD practices and SES were analyzed via weighted logistic regressions and a funnel plot.
Findings
Almost 32% of the students engaged in BD in the past-year. Being in the highest SES stratum doubled the risk of BD among students in all five Brazilian macroregions. There was a gradient in the association between past-year BD and socioeconomic status: as SES increased; the chance of having recently engaged in BD also increased. In the Brazilian capitals as a whole, boys versus girls (aOR = 1.40 [95% CI 1.26 to 1.58]), being older (aOR = 1.47 [95% CI 1.40 to 1.55] per each additional year of age) and those attending private schools versus public schools (aOR = 1.39 [95% CI 1.18 to 1.62]), were at greater risk for BD.
Conclusions
Contrary to what is observed in developed countries, students living in Brazilian capitals may be at an increased risk of BD when they belong to the highest socioeconomic status. Adolescents growing up in other emerging economies might have the same association between high SES and BD.
doi:10.1016/j.drugalcdep.2012.06.018
PMCID: PMC3654539  PMID: 22771006
binge drinking; socioeconomic status; school survey; adolescents
3.  Nonprescribed use of tranquilizers or sedatives by adolescents: a Brazilian national survey 
BMC Public Health  2013;13:499.
Background
Although the nonprescribed use of tranquilizers or sedatives by adolescents is a cause for concern in many countries, there is a shortage of data from low and middle income countries (LAMIC). The present study aims to estimate the prevalence of nonprescribed use of tranquilizers/sedatives by adolescents in Brazil, and to assess how socioeconomic and demographic circumstances, as well as indicators of access to these substances are associated with their use and with risk perception.
Methods
A cross-sectional study was conducted using a multi-stage probability sample of 18131 high school students from public and private schools from all 27 Brazilian state capitals. A self-reporting questionnaire was used to obtain information on social and economic circumstances, nonprescribed use of tranquilizers or sedatives and risk perception of their use.
Results
Lifetime nonprescribed use of tranquilizers or sedatives was reported by 5% of respondents, more commonly among females (OR: 2.19, 95% CI: 1.75-2.75) and those attending private schools (OR: 1.47, 95% CI: 1.17-1.84). The use of tranquilizers/sedatives by relatives or friends was associated with nonprescribed use by the participant (OR: 4.26, 95% CI: 3.46-5.23) and a majority of lifetime users obtained these substances from a family environment (82%). Previous medical prescription was independently associated with nonprescribed use (OR: 6.61, 95% CI: 4.87-8.98) and with low risk perception (OR: 2.42, 95% CI: 1.12-5.24).
Conclusions
A substantial proportion of Brazilian adolescents use nonprescribed tranquilizers/sedatives. Easy access to these substances seems to play an important role in this use and should be tackled by preventive and treatment interventions.
doi:10.1186/1471-2458-13-499
PMCID: PMC3664606  PMID: 23705991
7.  Social factors associated to binge drinking: a cross-sectional survey among Brazilian students in private high schools 
BMC Public Health  2011;11:201.
Background
Binge drinking (BD) seems to be related to health and social complications among adolescents. Considering that knowledge about BD in developing countries is limited and that in Brazil high socioeconomic status is a risk factor for alcohol abuse, this study sheds light about this phenomenon among adolescents from a different cultural background than prior North-American and European studies.
Methods
Brazilian students (n = 2691) selected through a representative, stratified and clustered sampling method were asked to answer a self-report questionnaire. The questionnaire contained questions about patterns of alcohol consumption, religious beliefs, leisure activities, family structure and relationships. Data were analyzed with basic contingency tables with Chi-square tests followed by a decision tree analysis and weighted logistic regression.
Results
Almost thirty-five percent of the students reported recent binge drinking. BD in the past month was positively associated with older age (aOR = 1.5[1.2-1.7]), male gender (aOR = 1.5[1.2-2.0]) going out with friends almost every night (aOR = 33.9[14.2-80.7]), not living with mother (aOR = 2.4[1.3-4.7]), believing in God with little conviction (aOR = 1.6[1.2-2.0]) and rarely talking to parents about anything (aOR = 1.7[1.3-2.2]) or always about drugs (aOR = 1.8[1.3-2.5]). Factors inversely associated with BD were: paying lower monthly tuition fees (aOR = 0.5[0.4-0.9]), living with people who do not get drunk (aOR = 0.6[0.4-0.7]) and frequent engagement in worships (aOR = 0.7[0.5-0.9]).
Conclusion
The habit of BD in adolescents enrolled in private high schools in Brazil is strongly linked to the frequency with which they go out with friends at night. Factors such as religiosity, expressed by trust in God and participation in worship, and being enrolled in a school with cheaper tuition fees were associated with avoidance of BD in this population.
doi:10.1186/1471-2458-11-201
PMCID: PMC3080304  PMID: 21453510
8.  Adolescent gender differences in the determinants of tobacco smoking: a cross sectional survey among high school students in São Paulo 
BMC Public Health  2010;10:748.
Background
Diverse psychosocial factors have been associated with the use of cigarettes by adolescents. We investigated gender differences in tobacco smoking, and factors correlated with smoking among boys and girls.
Methods
Data was collected on recent cigarette smoking (CS) and related factors, with a focus on religious beliefs, leisure activities, family structure, relationships and parental monitoring from 2,691 private school-attending youths from 28 schools in São Paulo, Brazil, selected via probability sampling. Estimates were derived via weighted hierarchical logistic regression models.
Results
There was no difference in the prevalence of recent cigarette smoking between boys and girls (14.2%). Older age (aORboys = 1.71[1.33-2.21]; aORgirls = 1.73[1.35-2.23]), second-hand smoke exposure at home (aORboys = 1.52[1.00-2.29]; aORgirls = 1.74[1.13-2.68]) and not having a religion (aORboys = 1.99[1.41-2.81]; aORgirls = 1.78[1.14-2.78]) were associated with CS in boys and girls. Adolescents who went out often at night were more likely to be tobacco smokers (aORboys = 8.82[3.96-19.67]; aORgirls = 14.20[6.64-30.37]). For girls, data suggest that CS was also associated with a lack of parental attention and care (aORgirls = 4.37[1.19-16.04]) and no participation in youth religious activities (aORgirls = 2.76[1.49-5.12]). For boys, CS was additionally associated with the loss of one or both parents (aORboys = 3.75[1.78-7.85]).
Conclusions
Although older age, living with smokers at home and lack of religion were common contributing factors to cigarette smoking among all adolescents, girls were influenced to a greater degree by family relationships and religiosity than boys. The study results may be materially important to the development of prevention programs that influence determinants connected to gender and the implementation of single-core models of prevention; gender differences must be considered in order to reduce adolescent CS.
doi:10.1186/1471-2458-10-748
PMCID: PMC3004838  PMID: 21129177

Results 1-8 (8)