Use of licit and illicit substances among adolescents in Brazil — A national survey

Abstract

Objective

We estimate the prevalence of alcohol, tobacco and illegal substance use in a national representative sample of adolescents. We also estimate how socio demographic characteristics, household environment and mental health are associated with substance misuse.

Method

This is a cross-sectional study using data from the first Brazilian National Alcohol Survey, which gathered information on the use of psychoactive substances in 761 participants aged 14 to 19 years old. Weighted logistic regression was used to calculate adjusted odds ratios.

Results

More than half of the adolescents interviewed were regular alcohol users and one out of ten were abusers and/or dependents. Older male adolescents living in urban areas were more likely to present alcohol related disorders and to smoke. Age had an inverse association with illegal substance use. Smokers and those using illegal substances were more likely to report domestic violence while those with alcohol abuse/dependence were more likely to have depression.

Conclusions

The high prevalence of alcohol, tobacco and illicit substance consumption among Brazilian adolescents is staggering. Young males with mood disorders from urban areas are more at risk of developing alcohol disorders while illegal drug use is highly associated to household dysfunction in early life. Brazilian growing economy will possibly lead to increased levels of substance use among adolescents if new prevention measures are not implemented. The intensification of law enforcement strategies to reduce psychotropic substances access is required.

Introduction

Brazil is the fifth most populated country in the world with 20% of its population aged between 15 and 24 years old (IBGE, 2000). No special license is required to sell alcohol in the country, where it is extremely cheap and readily available. There are national laws to prevent the under aged from buying beverages, yet they are scarcely enforced. A slightly different scenario is seen regarding tobacco use. Changes in the law have broadly restricted advertising and innovative anti-smoke campaigns are taking place (Instituto Nacional de Cancer, 2009). However, the increasing gross domestic product (GDP) should negatively affect any possible improvement those campaigns could achieve (Menezes et al., 2009). The World Health Organization (WHO, 2002) reported that not only are increasing numbers of young people in developing countries resorting to licit and illicit substances for recreation and excitement but problems associated with the use of illegal drugs are also on the rise. The use of illegal psychotropic substances among adolescents has also become a major social and health problem in Brazil (Batistoni, Neri, & Cupertino, 2007). Harm reduction strategies are gradually becoming more available in the country, yet the poorly enforced control of drug traffic and ready availability are making the use of illegal substances a major concern in most urban areas (Batistoni et al., 2007, United Nations Office on Drugs and Crime, 2008). The failure on law enforcement combined with the risk taking and impulsive tendencies that are intrinsic to adolescence make this large section of the population more vulnerable to addiction and in need of special attention.

The understanding of the underlying factors associated with use of substances among adolescents is essential as it can inform early interventions, crucial to prevent substance use disorders and its negative impact in adult life. In this study we estimate the prevalence of alcohol, tobacco and illegal substance use in a nationally representative sample of adolescents in Brazil; we describe patterns of alcohol and tobacco use and estimate the association between substance use and socio demographic characteristics, mental disorders (depression and attention deficit hyperactivity disorder) and household environment among adolescents.