The Association of Family and Peer Factors with Tobacco, Alcohol, and Marijuana Use Among Chilean adolescents in Neighborhood Context

Perceived Neighbourhood Disorder, Alcohol Consumption and Alcohol-Related Problems in Chile

Background: Alcohol misuse is one of the most important preventable public health risk factors. Empirical research shows that alcohol misuse is related to social and economic losses. Both theoretical and empirical evidence suggests that neighborhood disorder impacts alcohol-related behavior. However, there is limited literature in the context of developing countries. Objectives: The aim of this research is to estimate the association between perceived neighborhood disorder and (1) alcohol-related behavior and (2) alcohol-related problems in the context of the Chilean population. Our contribution focuses on the examination of the perception of disorder in urban neighborhoods and alcohol use patterns in a wide age range and sample of Chilean cities. Results: High levels of neighbor disorder perception are associated with higher levels of drinking and hazardous alcohol use. In addition, perceived neighborhood disorder is directly associated with probability of alcohol-related problems (ranging from 2% to 11%). Conclusions/Importance: The results are consistent with empirical and theoretical frameworks. This research could be used to better guide place-based policies in emerging countries with high levels of alcohol consumption to prevent alcohol risk behaviors and alcohol-related problems.

Transition in Smoking Stages and Its Relationship with Family Psychological Function and Perceived Social Support in Adolescents of Tabriz, Iran

BACKGROUND

There is limited information on the relationship between family psychological functions and perceived social support with progress in cigarette smoking stages in adolescents. This study was aimed to determine the relationship between family psychological function and perceived social support through a transition in different stages of cigarette smoking in adolescents of Tabriz, Iran.

METHODS

In this study, 4,216 students (14-19 years old) from high schools were selected by multistage cluster sampling method. Initially, we used valid and reliable questionnaires for demographic characteristics, risk factors, Iranian family psychological function, and perceived social support. The smoking status questionnaire was administered twice, with an interval of 6 months. Data were analyzed using univariate and multivariate logistic regression analysis.

RESULTS

Overall, 3,968 students with the mean (standard deviation) age of 15.96 (0.75) years completed the questionnaire in the first phase of the study. The results showed that lower levels of family psychosocial function (P < 0.001) and perceived social support (P < 0.001) in the univariate state were significantly associated with progress in cigarette smoking stages. By controlling the potential confounding factors, the weak and moderate family psychological function compared to the strong function increased the chance of progress in the cigarette smoking stages by almost 11 and 4 times, respectively (P < 0.001). The low and moderate level of perceived social support compared to the high level increased the chance of progress in cigarette smoking stages by almost 7 and 2 times, respectively (P < 0.001).

CONCLUSIONS

It is suggested to perform an organized, precise, and operational planning for strengthening the family psychological functions and providing an appropriate social support condition among adolescents to prevent the tendency toward cigarette smoking and its more advanced phases.

Investigating how perceived risk and availability of marijuana relate to marijuana use among adolescents in Argentina, Chile, and Uruguay over time

AIMS

Amid changing marijuana policies in the Southern Cone, we examined relationships between marijuana-related risk factors and marijuana use among adolescents in Argentina, Chile, and Uruguay from 2001 to 2016.

METHODS

Using cross-sectional surveys from 8^th, 10^th, and 12^th graders and weighted time-varying effect models, we estimated associations between perceived risk (no/low risk versus moderate/great risk) and perceived availability (easy/very easy versus difficult/very difficult/not able to obtain) of marijuana, and any past-month marijuana use.

RESULTS

In all countries, marijuana use increased over time and adolescents who perceived no/low risk and easy availability had higher odds of use. In Argentina, the bivariate risk/use association weakened from 2001 (OR = 15.24, 95%CI = 9.63, 24.12) to 2004 [OR = 3.86 (2.72, 5.48)] and strengthened until 2011 [OR = 8.22 (7.56, 10.30)]; the availability/use association strengthened from 2005 [OR = 5.32 (4.05, 6.98)] to 2009 [OR = 20.77 (15.57, 27.70)] and weakened until 2014 [OR = 11.00 (9.11, 13.27)]. In Chile, the risk/use association weakened from 2001 [OR = 7.22 (6.57, 7.95)] to 2015 [OR = 5.58 (4.82, 6.48)]; the availability/use association weakened from 2001 [OR = 5.92 (4.96, 7.06)] to 2015 [OR = 4.10 (3.15, 5.34)]. In Uruguay, the risk/use association weakened from 2003 [OR = 34.22 (22.76, 51.46)] to 2016 [OR = 6.23 (4.96, 7.83)]; the availability/use association weakened from 2005 [OR = 29.13 (13.39, 63.39) to 2007 [OR = 9.42 (3.85, 23.07)], and strengthened until 2016 [OR = 22.68 (12.03, 42.76)].

CONCLUSIONS

Overall, the association between risk and use weakened in all countries, suggesting risk perceptions became a weaker determinant of marijuana use. Perceived availability remained strongly associated with use and may become an increasingly important driver of use (particularly in Uruguay and Argentina).

Uruguayan secondary school students speak up about tobacco: results from focus group discussions in and around Montevideo

This qualitative research study investigated intrapersonal, interpersonal, and environmental factors that shape young adolescent tobacco use behaviors in Uruguay. Focus groups were conducted in the summer of 2012 and fall of 2013 in four secondary schools in Montevideo, Uruguay, including two private schools and two public schools. A total of four focus groups were led in each school, composed of 4-6 students each, 16 focus groups in total. Data analysis utilized NVivo software and included deductive and inductive content analysis. Overwhelmingly, students reported that the onset of smoking occurred in the second year of secondary school. The primary intrapersonal factors that were found to be universal among respondents identified that smoking was a performance in groups, to garner attention from their peers. Students interviewed most often stated that the greatest interpersonal factors for smoking were to look older, as a rite of passage, and for group membership. Environmental factors cited most often indicate that they smoked during unsupervised time, either at night or around the short Uruguayan school day. Focus group interviews revealed that adolescents had easy access to cigarettes for purchase through small family owned grocery stores, even though laws exist preventing the sale of cigarettes to minors. Few differences were cited between strata related to cigarette use in adolescents. The differences that do exist are most apparent across gender, though there were a few observed differences when stratified by public and private school. Findings from this study indicate that key factors across ecological levels (intrapersonal, interpersonal, and environmental) should be taken into consideration when designing tobacco prevention programs for youth in Uruguay. A multiple-component approach which addresses risk factors at all of these levels, implemented in schools, may be particularly well-suited to this setting.

Factors associated with illicit drugs' lifetime and frequent/heavy use among students results from a population survey

Substance use among teenage students and factors associated were investigated through a survey using a questionnaire adapted from the WHO's Program on Research and Reporting on the Epidemiology of Drug Dependence, additional questions on family factors and personal risks, and the Coopersmith Self-Esteem Inventory, adapted to Brazil. The target population consisted of 3891 10-22-year-old students from the city of Embu das Artes, São Paulo, Brazil. The prevalence of lifetime substance use was 26.7%. Most commonly used substances were energy drinks combined with alcohol (19%), solvents (11.2%) and marijuana (4.8%). Almost 60% of the students had already tried alcohol and 18.2% had tried tobacco. Factors associated to lifetime substance use were: lower self-esteem, going to nightclubs at least twice a week, use of alcohol, trying tobacco, bad relationship with the mother, permissive mothers, practicing sports as an obligation, working, and higher socioeconomic level. Concerning frequent/heavy substance use, chances were found to be higher among students who had use tobacco and alcohol, going to nightclubs at least twice a week, and those with lower self-esteem. Preventive actions concerning drug use should focus on avoiding the first experimentation, approaching family relationships, and improving students' self-esteem.

Teenage smoking behaviour following a high-school smoking ban in Chile: interrupted time-series analysis

Objective

To evaluate the effect of a smoking ban in high schools on smoking behaviour among Chilean students.

Methods

We conducted an interrupted time-series analysis, using repeated cross-sectional data from Chile’s school population survey (2000–2011) for high-school students aged 12–18 years and a control group of persons aged 19–24 years. Poisson regression models were used to assess trends in smoking behaviour before and after the policy changes. The outcome measures were self-reported smoking prevalence (any smoking in the past month) and high frequency of smoking (smoking 15 days or more per month).

Findings

From 2005 to 2011, the prevalence of smoking declined among high-school students by 6.8% per year compared with 3.6% decline per year in the control group. The decline in the target group was 2.9% (95% confidence interval, CI: 0.18 to 5.00) greater. We estimated that 5–6 years after enforcing the law, smoking prevalence among high-school students was 13.7% lower as a result of the ban. The impact of the smoking ban was primarily driven by declines in smoking prevalence among students in grades 8 to 10. The smoking ban did not significantly alter the frequency of smoking.

Conclusion

The 2005 school smoking ban reduced smoking prevalence among younger high-school students in Chile. Further interventions targeting older individuals and frequent smokers may be needed.

Substance abuse In Middle Eastern adolescents living in two different countries: spiritual, cultural, family and personal factors

It is estimated that the percentage of students using illicit substances by sixth grade has tripled over the last decade not only in developed countries but in developing countries as well probably due to the transition to a more Western society. Although much has been done to understand the mechanisms underlying substance abuse, few studies have been conducted with minority ethnic and religious groups such as Middle Eastern Youth. The primary goal of this study was to determine whether there are differences in factors contributing to substance abuse in adolescents from Lebanon versus the U.S.A. and to decipher the role of spirituality, religion, and culture among other factors that may influence substance abuse. A correlational cross-sectional design was used with adolescents living in two different countries: Los Angeles, California and Beirut, Lebanon. Muslim adolescents had significantly less rates of alcohol and substance use than Christians in both Lebanon and Los Angeles. More years lived in the U.S.A. increases the likelihood of abuse for both Muslims and Christians. Attachment to God and family was negatively associated with substance abuse. These results among others facilitate a better understanding of the influence of culture, religion, family and personal factors on substance abuse. Culturally sensitive interventions could benefit from the findings of this pilot study.

Variables Associated with the Onset of Cigarette Smoking Among Adolescent Public Middle-School Students in Cartagena, Colombia

Objetivo: determinar la prevalencia y las variables asociadas al inicio del consumo de cigarrillo en adolescentes de media vocacional de Cartagena, Colombia. Materiales y método: estudio analítico observacional transversal con 1.100 estudiantes de básica secundaria de las instituciones educativas oficiales de la ciudad de Cartagena, matriculados durante el año 2012; la información se recolectó a través de la ficha demográfica, el inventario de consumo de cigarrillo y actitudes frente al mismo de la Encuesta Mundial Sobre Tabaquismo en jóvenes (Emta_Joven), la escala Apgar familiar, Rosenberg para autoestima y la escala de Zung de ansiedad. Se realizó análisis estadístico univariado, bivariado y multivariado. Resultados: participaron 1.090 estudiantes (de los 1.100 fueron descartados 10 por estar mal diligenciados) con edades entre 10 y 18 años, media = 12,3; 565 (51,8 %) estudiantes fueron de sexo masculino y 525 (48,2 %) de sexo femenino. El consumo de cigarrillo alguna vez en la vida se asoció a edades entre 13 y 18 años (OR = 2,86; IC95 %: 1,96-4,18), ser de sexo masculino (OR = 2,40; IC95 %: 1,63-3,56) y a alta intención de consumo de sustancias (cigarrillo, alcohol y marihuana) (OR = 3,18; IC95 %: 2,18-4,64). Conclusión: el consumo de cigarrillo alguna vez en la vida en estudiantes de media vocacional de Cartagena, Colombia, se asoció a tener alta intención de consumo de sustancias, ser adolescente y ser de sexo masculino.

Substance use and sexual risk among at-risk adolescents in Juiz de Fora, Minas Gerais State, Brazil

We examined the difference in prevalence of substance use and sexual risk behaviors among at-risk youth participants in programs offered by community-based organizations in Juiz de Fora, Minas Gerais State, Brazil, by gender and organization type (governmental vs. non-governmental). 388 adolescents were recruited from 25 intervention-based organizations servicing at-risk youth between the ages of 12 and 17 in Juiz de Fora. Participants completed a 15-item survey assessing substance use and sexual risk behaviors, along with socio-demographic predictors of these behaviors. Males were more likely to report drug and alcohol use associated with homelessness and abandonment. Females were more likely to report sexual risk taking associated with neighborhood crime. Participants from non-governmental organizations were less likely to engage in all measured risk behaviors. The present analysis points to the need to understand how Brazil’s Child and Adolescent Act is being applied and the implications this has for intervention and the promotion of positive health outcomes for young people.

Ecological factors and adolescent marijuana use: results of a prospective study in Santiago, Chile

Purpose: Despite the growing evidence that ecological factors contribute to substance use, the relationship of ecological factors and illicit drugs such as marijuana use is not well understood, particularly among adolescents in Latin America. Guided by social disorganization and social stress theories, we prospectively examined the association of disaggregated neighborhood characteristics with marijuana use among adolescents in Santiago, Chile, and tested if these relationships varied by sex. Methods: Data for this study are from 725 community-dwelling adolescents participating in the Santiago Longitudinal Study, a study of substance using behaviors among urban adolescents in Santiago, Chile. Adolescents completed a two-hour interviewer administered questionnaire with questions about drug use and factors related to drug using behaviors. Results: As the neighborhood levels of drug availability at baseline increased, but not crime or noxious environment, adolescents had higher odds of occasions of marijuana use at follow up, approximately 2 years later (odds ratio [OR] = 1.39; 95% CI = 1.16–1.66), even after controlling for the study’s covariates. No interactions by sex were significant. Discussion: The findings suggest that “poverty”, “crime”, and “drug problems” may not be synonyms and thus can be understood discretely. As Latin American countries re-examine their drug policies, especially those concerning decriminalizing marijuana use, the findings suggest that attempts to reduce adolescent marijuana use in disadvantaged neighborhoods may do best if efforts are concentrated on specific features of the “substance abuse environment”.