Alcohol and Tobacco Use Among Rural Mexican Adolescents: Individual, Familial, and Community Level Factors

doi:10.1016/j.jadohealth.2008.04.014

Journal of Adolescent Health

Volume 43, Issue 5, November 2008, Pages 498-505

https://doi.org/10.1016/j.jadohealth.2008.04.014 Get rights and content

Abstract

Purpose

We investigated the contributions of individual, family, and community-level factors for explaining alcohol use and smoking among rural Mexican adolescents.

Methods

As part of a national survey, 3922 adolescents and their mothers from 333 poor, rural communities in seven Mexican states provided cross-sectional data on family-level, socioeconomic, and psychosocial factors, and individual-level data on substance use and psychological symptoms. Community standard of living was also assessed.

Results

Generalized linear models adjusted for sampling design indicated that adolescents' use of alcohol was associated with being male, older, employment, and having a mother who used alcohol. Being from an indigenous family living in a majority-indigenous community was associated with less alcohol use. Family income, family size, and community standard of living were not directly associated with adolescents' alcohol use. Current smoking was associated with being male, older, and more anxious, having a mother who smoked, and having a mother with higher educational attainment. Further analyses indicated patterns in which adolescents' alcohol use was moderated by gender and ethnicity.

Conclusions

Beyond the contribution of male gender and age as risk factors, maternal substance use uniquely explained variability in alcohol and cigarette use among Mexican adolescents from rural communities. Indigenous ethnicity and living in majority-indigenous community settings appeared to confer protective benefits with respect to alcohol. These findings extend prior research in Mexico and in other countries that identify the combined importance of developmental contexts and individual-level factors for adolescent health.

Section snippets

Use of Alcohol and Tobacco in Mexico

The present study investigates individual-, family-, and community-level factors associated with alcohol and tobacco use within a large sample of rural Mexican adolescents living in poverty. Youth in developing countries are a key population to study given the increasing trajectory of alcohol and tobacco consumption, and the strong marketing efforts targeted toward these youth by producers of alcohol and tobacco [9], [10]. Youth in rural Mexico are of particular interest in light of the growing

Study design and sampling

The present study was conducted with 3922 adolescents (ages 15 to 19; mean age = 16.6 years; SD = 1.3) and their mothers from 333 rural communities as part of the 2003 Mexican National Social Welfare Survey, which was part of the evaluation of the large scale poverty alleviation program Oportunidades (previously Progresa). Cross-sectional data from this survey regarding nutrition and mental health have been published previously [28], [29]. The survey was designed to sample the poorest (income

Results

Frequencies and percentages for study variables are shown in Table 1. As described above, the design was intended to include families in the most economically disadvantaged rural communities. Not surprisingly, the percentage of majority-indigenous communities represented in the sample was high, at 28%. Although the majority of towns had street lighting and a health center or medical personnel, only 18% of communities had the basic infrastructure of a drainage system for waste and water.

Discussion

This study investigated the contributions of individual, family, and community-level characteristics for explaining alcohol and tobacco use among rural Mexican adolescents. Consistent with prior research conducted in other Mexican settings, individual-level characteristics of being older and male were each independently associated with greater use of alcohol and tobacco. This disparity was more striking for smoking than for alcohol. Adolescents' self-reported anxiety symptoms also uniquely

Acknowledgments

This research was supported by the National Institutes of Health Roadmap for Medical Research Initiative #P20RR20817 (PI Paul Gertler), NICHD R01 #HD44146-03 (PI Paul Gertler), NIH KO1 TW006077 (PI Lia Fernald), and the MacArthur Research Network on SES and Health. The authors thank James Manley for assistance in data analysis, and Laura Douglas and Sarah Roberts for their assistance in literature searching.

References (40)

E. Arillo-Santillán et al.
Associations between individual and contextual factors and smoking in 13,293 Mexican students
Am J Prev Med
(2005)
L.C.H. Fernald
Socioeconomic status and body mass index and in low-income Mexican adults
Soc Sci Med
(2007)
J.R. Behrman
The economic rationale for investing in nutrition in developing countries
World Dev
(1993)
The Global Burden of Disease: A Comprehensive Assessment of Mortality and Disability from Diseases, Injuries, and Risk Factors in 1990 and Projected to 2020
(1998)
Gender, Health and Tobacco
(2003)
Evidence-Based Strategies and Interventions to Reduce Alcohol-Related Harm: Global Assessment of Public-Health Problems Caused by Harmful Use of AlcoholReport No. A60/14 Add.1
(2007)
Cigarette Smoking Among Adults—United States, 2002
MMWR
(2004)
D.A. Dawson et al.
The association between stress and drinking: modifying effects of gender and vulnerability
Alcohol Alcohol
(2005)
E.J. Costello et al.
Prevalence and development of psychiatric disorders in childhood and adolescence
Arch Gen Psychiatr
(2003)
Curbing the Epidemic: Governments and the Economics of Tobacco Control
(1999)

National Household Survey on Drug Abuse Report

(2002)

Tobacco use among youth: a cross country comparison

Tob Control

(2002)

D. Jernigan

Alcohol and Young People

(2001)

P. Fletcher et al.

Transnational CommunitiesRural Mexico Research Review

(2007)

C. Bergstrom et al.

Impact of gender disparities in family carework on women's life chances in Chiapas, Mexico

J Comp Fam Stud

(2005)

D. Verner

Activities, Employment, and Wages in Rural and Semi-Urban Mexico

(2005)

M. Romero Mendoza et al.

Alcohol consumption in Mexican women: implications in a syncretic culture

Comision Nacional Para El Desarrollo de los Pueblos Indigenas. Los Pueblos Indigenas en Mexico,...

Encuesta Nacional de Adicciones 2002

(2004)

M.E. Medina-Mora

Mexicans and alcohol: patterns, problems, and policies

Addiction

(2007)

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Original articleAlcohol and Tobacco Use Among Rural Mexican Adolescents: Individual, Familial, and Community Level Factors

Abstract

Purpose

Methods

Results

Conclusions

Section snippets

Use of Alcohol and Tobacco in Mexico

Study design and sampling

Results

Discussion

Acknowledgments

Am J Prev Med

Soc Sci Med

World Dev

The Global Burden of Disease: A Comprehensive Assessment of Mortality and Disability from Diseases, Injuries, and Risk Factors in 1990 and Projected to 2020

Gender, Health and Tobacco

Evidence-Based Strategies and Interventions to Reduce Alcohol-Related Harm: Global Assessment of Public-Health Problems Caused by Harmful Use of AlcoholReport No. A60/14 Add.1

Cigarette Smoking Among Adults—United States, 2002

MMWR

The association between stress and drinking: modifying effects of gender and vulnerability

Alcohol Alcohol

Prevalence and development of psychiatric disorders in childhood and adolescence

Arch Gen Psychiatr

Curbing the Epidemic: Governments and the Economics of Tobacco Control

National Household Survey on Drug Abuse Report

Tobacco use among youth: a cross country comparison

Tob Control

Alcohol and Young People

Transnational CommunitiesRural Mexico Research Review

Impact of gender disparities in family carework on women's life chances in Chiapas, Mexico

J Comp Fam Stud

Activities, Employment, and Wages in Rural and Semi-Urban Mexico

Alcohol consumption in Mexican women: implications in a syncretic culture

Encuesta Nacional de Adicciones 2002

Mexicans and alcohol: patterns, problems, and policies

Addiction

Original article
Alcohol and Tobacco Use Among Rural Mexican Adolescents: Individual, Familial, and Community Level Factors