Factores asociados al consumo de alcohol en adolescentes residentes en Lima, Perú / Factors associated with alcohol consumption in adolescents living in Lima, Peru

Introducción: El consumo de alcohol es particularmente alto en América Latina y el Caribe. Los estudios en Perú sobre prevención y consumo de drogas en estudiantes de educación secundaria lo reportan como problema de salud. Objetivo: Determinar las variables del factor personal, familiar y social que están asociadas con el consumo de alcohol en adolescentes de un colegio particular del distrito de Villa María del Triunfo, Lima, en 2016. Material y Métodos: Estudio transversal, con una muestra de 194 adolescentes, se aplicó muestreo aleatorio estratificado, donde los estratos fueron los grados de estudio del primero al quinto grados de secundaria. Se recolectó la información mediante la aplicación de un cuestionario estructurado. Resultados: 47,4 por ciento de los escolares consumió alcohol en el último año; con respecto al factor personal a los estudiantes que les ofrecieron bebida alcohólica tuvieron 11,84 (OR = 11,84; 95 por ciento CI 5,31:26,4; p** <0,001) veces más de probabilidad de consumirla respecto a los estudiantes que no les ofrecieron. Con respecto al factor familiar, los estudiantes que no tienen ningún familiar enfermo en casa tienen 2,21 (OR = 2,21; IC 95 por ciento 1,11:4,36; p** <0,001) veces más de uso de medicamentos. Las variables del factor social no fueron factores de riesgo. Conclusiones: Casi la mitad de los adolescentes consumieron bebidas alcohólicas en el último año y según los factores favorecedores del consumo destaca en primer lugar el factor personal, seguido de familiares; el factor social no estuvo asociado con el consumo de alcohol(AU)

Introduction: Alcohol consumption is particularly high in Latin America and the Caribbean. Studies conducted on drug prevention and use in high school students in Peru report it as a health problem. Objective: To determine the variables related to personal, family and social factors associated with alcohol consumption in adolescents from a private school in the district of Villa María del Triunfo, Lima, in 2016. Material and Methods: Cross-sectional study with a sample of 194 adolescents, using a stratified random sampling where the strata were the study grades from the first to the fifth grades of secondary school. The information was collected by applying a structured questionnaire. Results: Our results show that 47,4 percent of schoolchildren consumed alcohol in the last year; with respect to the personal factor, the students who were offered alcoholic drinks were 11,84 (OR = 11,84; 95 percent CI 5,31:26,4; p** <0,001) times more likely to consume an alcoholic beverage compared to the students who were not offered them. Regarding family factor, the students who did not have a sick family member at home were 2,21 (OR = 2,21; IC 95 percent 1,11:4,36; p** <0,001) times more likely to consume alcoholic beverages compared to students who had a sick family member at home. The variables related to social factor were not risk factors. Conclusions: Almost half of the adolescents consumed alcoholic beverages in the last year and according to the factors favoring consumption, the personal factor stands out in the first place, followed by relatives; the social factor was not associated with alcohol consumption(AU)

Impacto da exposição domiciliar ao tabaco e da composição familiar sobre a precocidade de uso de tabaco e álcool em adolescentes brasileiros / Impact of household exposure to tobacco and family composition on the early onset of alcohol use in Brazilian adolescents

O uso precoce de tabaco e álcool associa-se à maior morbimortalidade e manutenção desse consumo na vida adulta. Esta tese investiga o papel de fatores domiciliares e familiares sobre o início precoce do uso dessas substâncias entre adolescentes. Os dados analisados são do Estudo de Riscos Cardiovasculares em Adolescentes (ERICA), que investigou 74.589 adolescentes de escolas públicas e privadas, com idades entre 12 e 17 anos, residentes de 124 municípios com mais de 100 mil habitantes no país. O primeiro manuscrito teve como objetivo estimar o efeito da presença de fumantes no domicílio sobre o início mais precoce de tabagismo entre adolescentes. O segundo manuscrito teve como objetivo estimar o efeito da composição familiar sobre o início mais precoce de tabagismo e do uso de álcool entre adolescentes. Em ambas as análises foram usados Modelos de Regressão de Cox não ajustados e ajustados por um conjunto de variáveis com intuito de controlar vieses de confundimento. Os Hazard Ratios estimados no manuscrito 1 mostraram um aumento de 51% (IC95%: 31%-65%) na chance de um adolescente não fumante e exposto ao tabaco em casa começar a fumar mais precocemente do que aquele que não convivia com tabagistas no domicílio. Nos resultados do segundo manuscrito observou-se uma influência importante da composição familiar sobre a precocidade de início do uso de tabaco e álcool entre adolescentes. Segundo os Hazard Ratios estimados, houve um aumento de 68% (IC95%: 50%-89%) na chance de um adolescente não fumante que não residia com ambos os pais iniciar o uso de tabaco antes de um adolescente que residia com pai e mãe. Quanto àqueles que residiam apenas com a mãe ou apenas com o pai, esse aumento foi de 46% (IC95%: 32%-60%) e 54% (IC95%: 28%-84%), respectivamente. Em relação ao início do consumo de bebidas alcoólicas, observou-se um aumento de 35% (IC95%: 21%-52%) na chance de um adolescente que não bebe e não reside com pai e mãe de iniciar o uso de álcool mais precocemente do que aqueles que residiam com ambos os pais. Quanto aos adolescentes que residiam apenas com a mãe ou apenas com o pai, esse aumento foi de 22% (IC95%: 17%-28%) e 36% (IC95%: 24%-50%), respectivamente. O terceiro manuscrito teve como objetivo investigar o uso conjunto de tabaco e álcool através de análises de coocorrência e de agrupamento, assim como descrever a relação temporal do início do uso das duas substâncias entre adolescentes tabagistas e usuários de álcool. Para a análise de agrupamento foram obtidas razões entre os valores observados (O) e esperados (E) de uso de tabaco e álcool. Na amostra total a razão O/E foi 3,51 (IC95%: 3,39-3,65) indicando o agrupamento do uso dessas substâncias. Já a Razão de Chances de Prevalência foi de 14,7 (IC95%: 12,4-17,4). A maior parte dos usuários (45,2%) de ambas as substâncias iniciou pelo uso de álcool. Nossos resultados reforçam as propostas de que ações preventivas não devem estar focadas em cada droga isoladamente, e devem incluir não só o adolescente, mas também seu universo familiar.

Early use of tobacco and alcohol is associated with increased morbimortality and maintenance of their use during adulthood. This thesis investigates the role of household and family factors on adolescents' early onset of these substances. The data analyzed are from the Cardiovascular Risk Factors Study (ERICA), which investigated 74,589 adolescents from public and private schools, aged between 12 and 17 years old, living in 124 municipalities with more than 100 thousand inhabitants in the country. The first manuscript aimed to estimate the effect of the presence of smokers in the household on the earlier onset of smoking habit among adolescents. The objective of the second manuscript was to estimate the effect of family composition on the earlier onset of smoking and alcohol use among adolescents. In both analyses, unadjusted and adjusted Cox Regression Models were used to control for confounding variables. The Hazard Ratio estimated in manuscript 1 showed a 51% increase (95% CI: 31%-65%) in the chance that a nonsmoking adolescent exposed to tobacco at home would start smoking earlier than one who did not live with smokers. The results of the second manuscript depicted an important impact of family composition on the early onset of tobacco and alcohol use among adolescents. According to the estimated Hazard Ratios, there was a 68% increased chance (95% CI: 32%-60%) that a nonsmoking adolescent who did not live with both parents would initiate tobacco use earlier than an adolescent living with both parents. As for those who resided with only the mother or only the father, the increase was 46% (95% CI:32%-60%) and 54% (95%CI: 28%-84%), respectively. Regarding the onset of consumption of alcoholic beverages, there was a 35% increase (95% CI:21%-52%) in the chance of an adolescent who does not drink and does not reside with both parents to initiate alcohol use earlier than those living with the mother and the father. As for adolescents living only with the mother or only the father, this increase was 22% (95%CI: 17%-28%) and 36% (95%CI: 24%-50%), respectively. The third manuscript investigated the concurrent use of tobacco and alcohol through co-occurrence and clustering analyses. It also described the temporal relationship between the onset of tobacco and alcohol use among adolescents consuming both substances. For the clustering analysis, we calculated ratios between observed (O) and expected (E) values of tobacco and alcohol use. In the total sample, the O/E ratio was 3.51 (95% CI: 3.39-3.65), indicating the clustering of the use of these substances. The prevalence odds ratio was 14.7 (95% CI: 12.4- 17.4). Most of the users (45.2%) of both substances started with the use of alcohol. Our results reinforce the proposal that preventive actions should not be focused on each drug separately and should include the adolescents and their families.

The sexual and reproductive health needs of school-going young people in the context of COVID-19 in rural KwaZulu-Natal, South Africa

Background: The impact of school closures due to COVID-19 raised widespread concerns about children's health and well-being. We examine the impact on the sexual health needs of learners in the context of COVID-19 related lockdowns in rural KwaZulu-Natal, South Africa.Methods: In july­November 2020 and August­November 2021 we conducted 24 in-depth interviews and 8 group discussions with teachers and learners from 4 schools, community members and key education stakeholders. All interviews were conducted by telephone. We used a thematic analysis approach and Nvivo 12 software to manage the data.Results: Four main themes related to the COVID-19 pandemic emerged from the data: the sexual and reproductive health (SRH) of learners in the lead-up to the pandemic; the impact of COVID-19 on learners' SRH and wellbeing; the opportunities schools provided to support sexual well-being of learners during the pandemic; and the role of schools in supporting SRH for learners during the pandemic. Learners and stakeholders reported that the SRH of young people was affected by alcohol misuse, poor SRH knowledge and few pathways to link learners with services. Stakeholders working with schools reported that a lack of access to biomedical interventions (e.g., contraception) increased learner pregnancies. Gender-based violence in learners' households was reported to have increased during the COVID-19 pandemic related to loss of income. School closures disrupted the provision of a safe space to provide SRH and HIV-education through Life Orientation lessons and school nurse talks. This loss of a safe space also left learners vulnerable to sexual and physical violence. However, once schools re-opened, daily COVID-19 screening in schools provided the opportunity to identify and support vulnerable children who had other social needs (food and uniforms). Conclusion: The COVID-19 pandemic may have increased SRH needs and vulnerability of school-going children in a high HIV-burden rural setting. School shutdowns reduced the opportunity for schools to provide a vital safe space and information to enhance SRH for adolescents. Schools play a vital health promotion and social protection role.

Desordem do espaço urbano e o consumo de álcool entre adolescentes / Urban space disorder and alcohol consumption among adolescents

Atualmente, mais pessoas vivem em áreas urbanas do que em áreas rurais, resultado da intensa urbanização que, muitas vezes, tem ocorrido sem o adequado planejamento. Neste contexto, surge a desordem urbana como determinante da saúde em ambientes urbanos, sendo importante o entendimento sobre seus aspectos físicos e os possíveis impactos na saúde da população, especialmente na qualidade de vida de adolescentes. Desta forma, o estudo objetivou investigar a associação entre a desordem do espaço urbano e o consumo de álcool entre adolescentes brasileiros. O estudo seguiu um desenho transversal, desenvolvido com base nos dados do Estudo de Riscos Cardiovasculares em Adolescentes, realizado no período de 2013 e 2014. A amostra foi composta por 2.384 adolescentes residentes nas capitais Fortaleza, Porto Alegre e Rio de Janeiro, que foram selecionadas pela disponibilidade de dados georreferenciados. Para fins deste estudo, a variável desfecho foi definida pelo consumo de bebidas alcoólicas, avaliado por meio da seguinte pergunta: "Nos últimos 30 dias (um mês), em quantos dias você tomou pelo menos um copo ou uma dose de bebida alcoólica?". A desordem do espaço urbano, enquanto variável de exposição, foi avaliada por meio das características urbanísticas do Censo Demográfico de 2010, conhecidas como: número de domicílios com iluminação pública, pavimentação, arborização nos logradouros públicos, bueiro/boca de lobo, lixo acumulado em vias públicas, esgoto a céu aberto, meio-fio/guia, calçada e rampa para cadeirante. A partir das variáveis contextuais de exposição, aferidas no nível dos setores censitários, foram construídos indicadores do entorno com o propósito de estimar os efeitos para cada indivíduo. Para obtenção destes indicadores, foram definidos buffers (áreas) circulares, considerando raios de 100 e 250 metros, tomando como ponto central as residências dos adolescentes nas capitais selecionadas. O valor de cada indicador foi obtido como uma média ponderada da proporção de domicílios que atendem determinada característica, cujos pesos são proporcionais à área de interseção de cada setor censitário com o buffer. Foram calculadas razões de prevalência e intervalos de 95% de confiança por meio de modelos de regressão de Poisson com variância robusta, ajustados por fatores de confusão. Os resultados demonstraram associações entre adolescentes que vivem em locais com calçada [RP = 1,24 (IC 95% = 1,02 - 1,50)], bueiro [RP = 1,36 (IC 95% = 1,01 - 1,84)], rampa [RP = 0,79 (IC 95% = 0,62 - 0,99)] ou esgoto [RP = 0,8 (IC 95% = 0,66 - 0,97)] e o consumo de álcool. De maneira surpreendente, os achados sugerem que a presença de características desejáveis no entorno dos domicílios dos adolescentes pode contribuir ou não para o consumo de álcool, enquanto que características não desejáveis podem contribuir como fatores de proteção para o consumo de álcool entre adolescentes brasileiros. O consumo de álcool entre adolescentes demanda atenção no cenário da saúde pública e o investimento em estudos que visem o conhecimento sobre fatores contextuais, e suas possíveis relações com o consumo, podem ser uma importante estratégia para a compreensão ampliada do cenário atual de saúde de adolescentes em ambientes urbanos.

Currently, more people live in urban areas than in rural areas, as a result of intense urbanization that has often occurred without adequate planning. In this context, urban disorder appears as a determinant of health in urban environments, and it is important to understand its visual aspects and the possible impacts on the health of the population, especially in the lives of adolescents. Thus, the study aimed to investigate the association between urban space disorder and alcohol consumption among Brazilian adolescents. The study followed a cross- sectional design, based on data from the Study of Cardiovascular Risks in Adolescents, carried out between 2013 and 2014. The sample consisted of 2.384 adolescents residing in the capitals Fortaleza, Porto Alegre and Rio de Janeiro, who were selected by the availability of georeferenced data. For the purposes of this study, the outcome variable was defined by the consumption of alcoholic beverages, evaluated through the following question: "In the last 30 days (one month), on how many days did you have at least one glass or one dose of alcoholic beverage?". The disorder of urban space, as exposure variable, was evaluated through the urban characteristics of the 2010 Demographic Census, known as: number of households with public lighting, paving, afforestation in public places, manhole/wolf mouth, garbage accumulated in public roads, open sewers, curbs/curbs, sidewalk and wheelchair ramp. From the contextual variables of exposure, measured at the level of the census sectors, indicators of the surroundings were constructed with the purpose of estimating the effects for each individual. To obtain these indicators, circular buffers (areas) were defined, considering radii of 100 and 250 meters, taking as a central point the residences of adolescents in the selected capitals. The value of each indicator was obtained as a weighted average of the proportion of households that meet a given characteristic, whose weights are proportional to the area of intersection of each census sector with the buffer. Prevalence ratios and 95% confidence intervals were calculated using Poisson regression models with robust variance, adjusted for confounding factors. The results showed associations between adolescents living in places with sidewalks [PR = 1.24 (CI 95% = 1.02 - 1.50)], manhole [PR = 1.36 (CI 95% = 1.01 - 1 .84)], ramp [RP = 0.79 (CI 95% = 0.62 - 0.99)] or sewage [RP = 0.8 (CI 95% = 0.66 - 0.97)] and the alcohol consumption. Surprisingly, the findings suggest that the presence of desirable characteristics in the surroundings of adolescents' homes may or may not contribute to alcohol consumption, while undesirable characteristics may contribute as protective factors for alcohol consumption among Brazilian adolescents. Alcohol consumption among adolescents demands attention in the public health scenario, and investment in studies aimed at knowledge about contextual factors, and their possible relationships with consumption, can be an important strategy for a broader understanding of the current scenario of adolescent health in urban environments.

Atitudes de adolescentes escolares sobre o consumo de álcool e outras drogas: estudo transversal / Actitudes de los adolescentes en edad escolar sobre el consumo de alcohol y otras drogas: estudio transversal / Attitudes of school adolescents about alcohol and other drug use: cross-sectional study

Objetivo: identificar as atitudes de adolescentes escolares sobre o consumo de álcool e outras drogas. Método: estudo transversal, realizado com 324 adolescentes do ensino médio de escola pública, no período de setembro a dezembro de 2018, utilizando a Escala de Representações Sociais do Consumo de Álcool e Drogas em Adolescentes. Resultados: a maioria dos adolescentes afirmou não consumir álcool (52,2%), tabaco (92,6%) ou drogas ilícitas (91,4%); os que não consumiam drogas apresentaram baixa tendência para usá-las (82,9%), enquanto que, entre os que consumiam, era elevada a tendência para manter essa conduta (77,3%). As atitudes para o consumo mostraram influência do ambiente, de amigos e de familiares, além do tipo de droga a ser consumida; a religião foi identificada como fator protetor. Conclusão: as atitudes de adolescentes escolares sobre o consumo de álcool e outras drogas indicaram que havia uma tendência de reprodução comportamental desse consumo.

Objetivo: identificar las actitudes de los adolescentes en edad escolar sobre el consumo de alcohol y otras drogas. Método: estudio transversal, realizado con 324 adolescentes de bachillerato público, de septiembre a diciembre de 2018, utilizando la Escala de Representaciones Sociales del Consumo de Alcohol y Drogas en Adolescentes. Resultados: la mayoría de los adolescentes reportaron no consumir alcohol (52,2%), tabaco (92,6%) o drogas ilícitas (91,4%); los que no consumieron drogas mostraron una baja tendencia a consumirlas (82,9%), mientras que entre los que las consumieron, la tendencia a mantener esta conducta (77,3%) fue alta. Las actitudes hacia el consumo mostraron influencia del entorno, amigos y familiares, además del tipo de droga a consumir; la religión fue identificada como un factor protector. Conclusión: las actitudes de los adolescentes escolares sobre el consumo de alcohol y otras drogas indicaron que existía una tendencia de reproducción conductual de este consumo.

Objective: to identify the attitudes of school adolescents about the consumption of alcohol and other drugs. Method: cross-sectional study, conducted with 324 adolescents from public high school, from September to December 2018, using the Scale of Social Representations of Alcohol and Drug Consumption in Adolescents. Results: most adolescents reported not consuming alcohol (52.2%), tobacco (92.6%) or illicit drugs (91.4%); those who did not use drugs showed a low trend to use them (82.9%), while among those who consumed them, the trend to maintain this conduct (77.3%) was high. Attitudes towards consumption showed influence of the environment, friends and family, in addition to the type of drug to be consumed; religion was identified as a protective factor. Conclusion: the attitudes of school adolescents about the consumption of alcohol and other drugs indicated that there was a trend of behavioral reproduction of this consumption.

Consumo de alcohol y factores relacionados en estudiantes universitarios cubanos / Factors associated with alcohol consumption in Cuban university students

Introducción: El consumo de alcohol constituye un problema de salud, complejo y multifactorial. Los factores de riesgo y/o protección y la percepción de riesgo pudieran actuar como variables moduladoras del consumo de alcohol. Objetivo: Explorar la relación entre los factores de protección y/o riesgo, la percepción de riesgo y el consumo de alcohol en estudiantes universitarios cubanos. Material y Métodos: Se asumió la metodología cuantitativa con un diseño no experimental transversal (ex-post-facto) con un alcance correlacional. Participaron 1 377 estudiantes universitarios. Se utilizaron como instrumentos el Autorreporte Vivencial, Cuestionario para la evaluación de factores protectores de la salud mental en estudiantes universitarios, Cuestionario para la evaluación de la percepción de riesgo sobre consumo de alcohol y el Cuestionario para la identificación de trastornos asociados con el alcohol. Se empleó la estadística descriptiva e inferencial para analizar las relaciones entre las diferentes variables. Resultados: Los hombres mostraron mayores dificultades en la adecuación de la percepción de riesgo y un mayor consumo de alcohol que las mujeres. Se establecieron relaciones altamente significativas entre la percepción de riesgo, los factores de protección, el consumo de alcohol y otras variables sociodemográficas incluidas en el estudio como el año académico, la condición de ser becado y la zona de residencia. Se encontró una relación directa entre el desarrollo de los factores de protección y la percepción de riesgo y una relación inversa entre esta última y el consumo de alcohol en los estudiantes universitarios. Conclusiones: Se analizó, de forma exploratoria, la relación entre los factores de riesgo y protección, la percepción de riesgo y el consumo de alcohol en estudiantes universitarios(AU)

Introduction: Alcohol consumption is a complex and multifactorial health-related problem. Risk and/or protective factors and risk perception may act as modulating variables of alcohol consumption. Objective: To explore the relationship between protective and/or risk factors, risk perception and alcohol consumption in Cuban university students. Material and Methods: A quantitative non-experimental cross-sectional ex post facto correlation study was conducted. A total of 1,377 university students participated in the study. The instruments used included the Experiential Self-Report, a questionnaire for the evaluation of protective factors of mental health in university students, a questionnaire for the evaluation of risk perception of alcohol consumption, and the Alcohol Use Disorders Identification Test. Descriptive and inferential statistics were used to analyze the relationships between the different variables. Results: Men showed greater difficulties in the adequacy of risk perception and higher alcohol consumption than women. Highly significant relationships were established between risk perception, protective factors, alcohol consumption and other sociodemographic variables included in the study such as academic year, the condition of being granted a scholarship, and area of residence. A direct relationship between the development of protective factors and risk perception and an inverse relationship between the latter and alcohol consumption were found in university students. Conclusions: The relationship between risk and protective factors, risk perception and alcohol consumption in university students was analyzed. Introducción: El consumo de alcohol constituye un problema de salud, complejo y multifactorial. Los factores de riesgo y/o protección y la percepción de riesgo pudieran actuar como variables moduladoras del consumo de alcohol(AU)

Adolescentes em território de grande circulação de substâncias psicoativas: uso e prejuízos / Adolescents in a wide-circulation territory of psychoactive substances: use and losses

Objetivou descrever o perfil de problemas associados ao uso de substâncias entre adolescentes, estudantes de ensino fundamental de uma escola situada em território de intensa circulação de drogas, e verificar as relações com uso e características sociodemográficas. Estudo transversal e correlacional preditivo, com 109 estudantes do nono ano, que responderam ao questionário contendo informações sociodemográficas e o Drug Use Screening Inventory (DUSI). Os dados foram analisados por estatísticas descritivas, testes de associação e cálculo de densidades de problemas investigadas pelo DUSI. Houve maior densidade de problemas para todas as áreas de vida investigadas dentre os escolares que já haviam feito uso de substâncias psicoativas. "Praticar a religião" foi identificado como fator de proteção para o uso de substâncias psicoativas e "trabalhar" como fator de risco para o uso de álcool. Evidenciou-se a necessidade de estratégias preventivas direcionadas ao uso de substâncias e orientadas a esse público.

It aimed to describe the profile of problems associated with substance use among adolescents, elementary school students from a school located in a territory with a high circulation of drugs, and to verify the relationships between use and sociodemographic characteristics. Cross-sectional and predictive correlational study, with 109 ninth-year students, who answered the questionnaire containing sociodemographic information and the Drug Use Screening Inventory (DUSI). The data were analyzed by descriptive statistics, association tests, and calculation of problem densities investigated by the DUSI. There was a greater density of problems for all areas of life investigated among students who had already used psychoactive substances. "Practice religion" was identified as a protective factor for the use of psychoactive substances and "work" as a risk factor for the use of alcohol. The need for preventive strategies directed to the use of substances and directed to this public was evidenced.

Sistema familiar y consumo de alcohol en adolescentes estudiantes de bachillerato de zonas suburbanas / Family system and alcohol consumption in adolescent high school students from suburban areas

Introducción: durante la adolescencia, la familia es pieza fundamental para el desarrollo del ser humano, ya que es una etapa en la que se busca la identidad propia, además de cambios biológicos, psicológicos y sociales. En México, la edad media de inicio del consumo de alcohol ha pasado de 17.9 años en 2008 a 16.7 años en 2016; sin embargo, algunos registros de adolescentes indican que inician el consumo antes de los 12 años. Objetivo: determinar la relación entre sistema familiar y consumo de alcohol en adolescentes estudiantes de bachillerato en zonas suburbanas del estado de Jalisco. Metodología: estudio cuantitativo, correlacional, transversal y prospectivo realizado en una zona suburbana del estado de Jalisco, México. Con una muestra de 317 estudiantes se realizó un muestro bietápico por estratos con método de selección aleatorio simple y afijación proporcional al estrato. Para la obtención de los datos se utilizaron dos instrumentos. Resultados: existe una relación estadísticamente significativa entre el sistema familiar y el consumo de alcohol de -0.282 (rho de Spearman), con una muestra de 317 sujetos de estudio, y se observó una pendiente con correlación inversa. Conclusión: a mayor sistema familiar protector, menor consumo de alcohol.

Introduction: During adolescence, the family is a fundamental piece for the development of the human being; since it is a stage where one's identity is sought in addition to the presence of physical, psychological, biological and social changes. In Mexico, the average age of starting alcohol consumption has gone from 17.9 years in 2008 to 16.7 years in 2016, however, there are records of adolescents who start before the age of 12. Objective: To determine the association between family sys- tem and alcohol consumption in adolescents of a suburban high school in Jalisco. Methods: Quantitative, relational, cross-sectional and prospective study, performed in Jalisco, Mexico. A sample of 317 students was carried out, two-stage sampling by strata with simple random selection method with affixation proportional to the stratum. Two instruments were used to obtain the data. Results: There is a statistically significant relationship be- tween the family system and alcohol consumption of -0.282 Spearman's Rho, with a sample of 317 study subjects, observing a slope with inverse correlation. Conclusion: A greater family protection system, less alcohol consumption.

A primeira vez a gente não esquece: conhecendo as drogas experimentadas por estudantes do ensino médio / The first time we don't forget: knowing the drugs experienced by high school students / La primera vez no se olvida: conociendo las drogas que consumen los estudiantes de secundaria

OBJETIVO: investigar a prevalência do consumo de drogas em escolas de ensino médio de um município referência do estado do Ceará. MÉTODO: estudo exploratório descritivo com abordagem quantitativa. A coleta de dados foi realizada no período de março a julho de 2019 com 562 estudantes. Para tanto, utilizou-se o questionário para triagem do uso de álcool, tabaco e outras substâncias. Na análise, realizou-se estatística analítica por meio do teste de qui-quadrado. RESULTADOS: em relação as substâncias já experimentadas pelos estudantes, o álcool aparece em maior proporção. Além do álcool, os estudantes também já experimentaram outras substâncias psicoativas, em que maconha, tabaco e hipnóticos ou sedativos tiveram destaque entre as já experimentadas. Em relação aos parâmetros, para todas as substâncias, houve uma proporção variando entre (1,5% a 23,2%) de estudantes necessitando de intervenção breve. CONCLUSÃO: estes resultados apresentados contribuem para uma melhor compreensão do fenômeno no que diz respeito às substâncias mais consumidas e padrões de uso nocivo ou dependência, para que possa planejar e implementar programas de prevenção primária e secundária no contexto escolar.

OBJECTIVE: this study aims to investigate the prevalence of drug use in two secondary schools in a reference municipality of the state of Ceará. METHOD: a descriptive and exploratory study with a quantitative approach. Data collection occurred from March to July 2019, with 562 students. For this purpose, we used the questionnaire for screening the use of alcohol, tobacco, and other substances. RESULTS: regarding the substances the students had already tried, alcohol appears in greater proportion. In addition to alcohol, the students had also tried other psychoactive substances such as marijuana, tobacco, and hypnotics or sedatives, which all got emphasis among the substances already tried by the students. Regarding the parameters for all substances, there was a proportion ranging from 1.5% to 23.2% of students presenting need for brief interventions. CONCLUSION: the results presented contribute to a better understanding of the phenomenon regarding the most consumed substances, and of the harmful use or addiction patterns, so that we can plan and implement primary and secondary prevention programs inside the school context.

OBJETIVO: investigar la prevalencia del consumo de drogas en escuelas secundarias de un municipio referencia del estado de Ceará. MÉTODO: estudio exploratorio y descriptivo con enfoque cuantitativo. La recolección de datos se realizó en el periodo de marzo a julio de 2019 con 562 estudiantes. Para ello se utilizó el cuestionario para clasificación del consumo de alcohol, tabaco y otras sustancias. En el análisis se realizó estadística analítica por medio del test de chi-cuadrado. RESULTADOS: en relación a las sustancias ya probadas por los estudiantes, el alcohol aparece en mayor proporción. Además del alcohol, los estudiantes ya probaron otras sustancias psicoactivas, destacándose la marihuana, el tabaco y los hipnóticos o sedantes. En relación a los parámetros para todas las sustancias, se registró una proporción que varió entre 1,5% y 23,2% de estudiantes con necesidad de intervenciones rápidas. CONCLUSIÓN: los resultados presentados ayudan a comprender mejor el fenómeno en relación a las sustancias más consumidas y a los patrones de uso nocivo o de dependencia, para poder planificar e implementar programas de prevención primaria y secundaria en el contexto escolar.

Overweight in adolescents: food insecurity and multifactoriality in semiarid regions of pernambuco / Excesso de peso em adolescentes: insegurança alimentar e multifatorialidade no cenário do semiárido de pernambuco

ABSTRACT Objective: To investigate context of overweight adolescents from the semiarid and rural areas of Pernambuco, considering the multifactorial nature of the determinants of being overweight, and the food and nutritional insecurity conditions of the region. Methods: A population based cross-sectional study was conducted from September to October 2015. The nutritional status of adolescents was assessed by body mass index (BMI) and classified by the BMI/Age indicator, according to sex. To analyze the factors associated with being overweight, the variables were grouped into: socioeconomic, demographic, environmental, lifestyle, psychological, biological and food and nutritional security. Poisson regression was used to verify the association between being overweight and independent variables. Results: The prevalence of excessive weight found was 20.1%, namely: 13.4% overweight and 6.7% obese. After adjusting for the confounding variables, the variables: occupancy situation (rented house), alcohol consumption, food security and light food insecurity, body perception (overweight and obese) and age range (10 to 14 years), were associated with being overweight. High food and nutritional insecurity was identified in 80.4% of the population. The moderate and severe forms were more frequent, and precarious social conditions were still prevalent in the region. Conclusions: The prevalence of being overweight was high, exceeding the expected for a population with better living conditions. The determinants of being overweight were: alcohol consumption, occupancy situation, self-perceived weight, age and food security/mild food insecurity.

RESUMO Objetivo: Investigar o excesso de peso em adolescentes do Sertão e Agreste de Pernambuco, considerando a multifatoriedade dos determinantes do excesso de peso e as condições de insegurança alimentar e nutricional da região. Métodos: Estudo transversal, de base populacional, realizado no período de setembro a outubro de 2015. O estado nutricional dos adolescentes foi avaliado pelo índice de massa corpórea (IMC) e classificado pelo indicador IMC/idade, segundo o sexo. Para analisar os fatores associados ao excesso de peso, as variáveis foram agrupadas em: socioeconômicas, demográficas, ambientais, de estilo de vida, psicológicas, biológicas e segurança alimentar e nutricional. A regressão de Poisson foi utilizada para verificar a associação entre o excesso de peso e as variáveis independentes. Resultados: A prevalência de excesso de peso encontrada foi de 20,1%, sendo 13,4% de sobrepeso e 6,7% de obesidade. Após o ajuste para as variáveis de confusão, as variáveis regime de ocupação (casa cedida, alugada), consumo de álcool, segurança alimentar, insegurança alimentar leve, percepção corporal (sobrepeso e obesidade) e faixa etária (10 a 14 anos) mostraram-se associadas ao excesso de peso. Destaca-se a elevada insegurança alimentar e nutricional, em 80,4% da população, sendo as formas moderadas e graves as mais frequentes, como também as precárias condições sociais ainda prevalentes na região. Conclusões: A prevalência de excesso de peso foi elevada, superando o esperado para uma população com melhores condições de vida. Os determinantes do excesso de peso foram: consumo de álcool, regime de ocupação, autopercepção do peso, faixa etária e segurança alimentar/insegurança alimentar leve.

Estilos parentales y el involucramiento con el consumo de alcohol en adolescentes de secundaria / Parental styles and involvement with alcohol consumption in middle school adolescents / Estilos parentais e envolvimento com o consumo de álcool por adolescentes do ensino médio

Objetivo: determinar la relación de los estilos parentales y el involucramiento con el consumo de alcohol en adolescentes que estudian secundaria. Método: diseño descriptivo-correlacional. Muestra de 389 participantes, se utilizó una cédula de datos personales y de prevalencias de consumo de alcohol y dos instrumentos: escala de estilos de socialización parental en la adolescencia y escala de involucramiento del adolescente con el consumo de alcohol. Resultados: 57.1% de los adolescentes varones y el 54.6% mujeres consumieron alcohol en algún momento de sus vidas. Las mujeres tuvieron mayor prevalencia de consumo en el último mes y año. Con respecto a los estilos de crianza con participación en el consumo de alcohol, existe una relación negativa significativa entre el estilo de crianza autoritario del padre (rs = -137, p = .007) y ambos padres (rs = -.119, p = 019), y una relación positiva significativa del estilo negligente materno (rs = 0.134, p = 0.00), paterno (rs = 0.131, p = 0.010) y ambos (rs = 0.145, p = 0.004) con participación con el consumo de alcohol. Conclusión: cuanto mayor es la percepción del estilo autoritario, menor es la implicación con el consumo de alcohol, en consecuencia, mayor es la percepción del estilo negligente y la mayor implicación con el alcohol.

Objective: to determine the relationship of parental styles and involvement with alcohol consumption in high school adolescents. Method: Correlational descriptive design. With a sample of 389 participants, a personal data and alcohol prevalence certificate and two instruments were used: parent socialization style in adolescence scale and adolescent involvement with alcohol consumption scale. Results: 57.1% of male and 54.6% female adolescents consumed alcohol at some point in their lives. Women had higher prevalence of consumption in the last month and year. With regard to parenting styles with participation in alcohol consumption, there is a significant negative relationship between the father authoritarian style (rs = -137, p = .007) and both parents (rs = -.119, p = 019), and a significant positive relationship of mother negligent style (rs = 0.134, p = 0.00), paternal (rs = 0.131, p = 0.010) and both (rs = 0.145, p = 0.004) with involvement in alcohol consumption. Conclusion: the greater the perception of the authoritarian style, the lower the involvement with alcohol consumption, consequently, the greater the perception of negligent style and the greater the involvement with alcohol.

Objetivo: determinar a relação dos estilos parentais e o envolvimento com o consumo de álcool em adolescentes do ensino médio. Método: desenho descritivocorrelacional. Amostra de 389 participantes, com uso de questionário de dados pessoais e de prevalência de consumo de álcool, e dois instrumentos: escala de estilos de socialização dos pais na adolescência e escala de envolvimento dos adolescentes com o consumo de álcool. Resultados: 57,1% dos adolescentes do sexo masculino e 54,6% feminino consumiram álcool em algum momento de suas vidas. As mulheres apresentaram maiores prevalências de consumo no último mês e ano. Em relação aos estilos parentais com envolvimento com o consumo de álcool, existe uma relação negativa significativa entre o estilo parental autoritário do pai (rs = -.137, p = .007) e de ambos pais (rs = -.119, p =. 019), e uma relação positiva significativa do estilo negligente materno (rs = 0,134, p = 0,00), paterno (rs = 0,131, p = 0,010) e de ambos (rs = 0,145, p = 0,004) com envolvimento com o consumo de álcool. Conclusão: quanto maior a percepção do estilo autoritário, menor envolvimento com o consumo de álcool, consequentemente maior percepção do estilo negligente maior envolvimento com o álcool.

Determinantes sociales del consumo de alcohol en adolescentes del Colegio Daniel Córdova de Cuenca: estudio transversal, 2016 / Social determinants of alcohol consumption in adolescents from Daniel Cordova High School in Cuenca: cross sectional study, 2016

Introduction: the alcohol consumption in adolescence is frequent and it is associated with social determinants. The objective of the study was to determine the prevalence of alcohol consumption in adolescents of the Daniel Córdova High School in Cuenca - Ecuador and its association with some social determinants.Methods: it is a cross-sectional study, with a sample of 218 adolescents. A questionnaire for demo-graphic variables, family structure and migration was used to determine the prevalence of alcohol consumption, the diagnostic criteria of the DSM5 was used to identify the family functioning of the FF-SIL Test and for the lifestyle the FANTASTIC test was applied. The PR was obtained with its confidence intervals to control if the social determinants were a risk or protection factor for the alcohol consumption, and the statistical significance was determined with values of p <0.05.Results: the prevalence of alcohol consumption was 42.2%; a total of 56% of the students come from a "nuclear home", the 55% have a migrant relative, 39% have a good lifestyle and 50% be-long to families qualified as moderately functional. There is a statistically significant association with the fact of having a migrant family member, having a bad lifestyle and belonging to a reconstituted and dysfunctional family.Conclusion: the prevalence of alcohol consumption is higher than those reported in other studies carried out in Cuenca city high schools; It is associated with similar social determinants globally.(AU).

Introducción: el consumo de alcohol en la adolescencia es frecuente y se encuentra asociado a determinantes sociales. El objetivo de nuestro estudio fue determinar la prevalencia de consumo de alcohol en los adoles-centes del colegio "Daniel Córdova" de Cuenca ­ Ecuador y su asociación con algunos determinantes sociales.Métodos: estudio transversal, en una muestra de 218 adolescentes. Se usó un cuestionario para las variables demográficas, estructura familiar y migración; para determinar la prevalencia de consumo de alcohol se usó los criterios diagnósticos del DSM5, para identificar el funcionamiento fa-miliar el Test FF-SIL y para el estilo de vida el test FANTASTIC. Se obtuvo la RP con sus intervalos de confianza para determinar si los determinantes sociales fueron factor de riesgo o de protección para el consumo de alcohol y la significancia estadística se determinó con valores de p<0.05. Resultados: la prevalencia del consumo de alcohol fue del 42.2 %; el 56% de los estudiantes provienen de un "hogar nuclear", el 55% tienen algún fa-miliar migrante, el 39% tienen un buen estilo de vida y el 50% pertenecen a familias calificadas como moderadamente funcionales y existe asociación estadísticamente significativa con el hecho de tener un familiar migrante, poseer un mal estilo de vida y pertenecer a una familia reconstituida y disfuncional. Conclusión: la prevalencia del consumo de alcohol es mayor que los re-portados en otros estudios realizados en colegios de la ciudad de Cuenca y se asocia con determinantes sociales similares a nivel global.(AU).

Contributions of parenting styles and parental drunkenness to adolescent drinking

Objective: To estimate the association of parental drunkenness and parenting style with alcohol consumption among adolescents and the contributions of parental drunkenness and parenting style to the prevalence of binge drinking among adolescents. Method: Cross-sectional survey of a representative sample of secondary students aged 13 to 18 from 27 Brazilian state capitals (n=17,028). Private and public schools were included. A self-report questionnaire collected data on adolescents' alcohol drinking behavior, parenting styles, and parenting and peer models of drunkenness. Results: Non-authoritative parenting style and parental drunkenness are associated with binge drinking among adolescents. Authoritarian, indulgent, and negligent parenting styles were associated with 1.50-, 2.51-, and 2.82-fold increases in prevalence of adolescent binge drinking, and parental drunkenness, with a 1.99-fold increase. The non-authoritative parenting style made a larger contribution than parental drunkenness to adolescent binge drinking. Conclusions: Non-authoritative parenting style and parental drunkenness seem to play an important role in adolescents' binge drinking behavior. At the population level, parenting style appears associated with a greater contribution to this behavior among adolescents. Prevention strategies targeting parental drunkenness may be bolstered if a broader approach including parenting styles is in place.

Propiedades psicométricas y características operativas de la versión adaptada al castellano del cuestionario CRAFFT en adolescentes del conurbano bonaerense / Psychometric properties and operating characteristics of the Spanish-adapted version of the CRAFFT questionnaire in adolescents from Greater Buenos Aires

Introducción. El cuestionario Car, Relax, Alone, Forget, Family and Friends, Trouble (CRAFFT) es un instrumento de tamizaje de riesgo de consumo problemático, abuso o dependencia de alcohol y sustancias en adolescentes. Si bien cuenta con una versión validada y adaptada al castellano para su utilización en adolescentes argentinos (CRAFFTa), su uso no puede generalizarse, ya que no ha sido evaluado en diferentes contextos socioculturales. Objetivo. Evaluar la transferibilidad del CRAFFTa como herramienta de pesquisa de consumo problemático, abuso y dependencia de alcohol y otras sustancias en una población adolescente de bajo nivel socioeconómico. Población y métodos. Se encuestó en forma anónima a una muestra de adolescentes de una localidad de bajos recursos del conurbano bonaerense que concurrían a dos escuelas secundarias. Se aplicó el cuestionario CRAFFT adaptado al español y validado para su uso en Argentina, y se empleó el cuestionario Problem Oriented Screening Instrument for Teenagers substance use and abuse subscale (POSITuas) como prueba de referencia. Resultados. Se obtuvieron 146 cuestionarios completos (tasa de respuesta del 89,6 %). La confiabilidad fue 0,681; validez de criterio: 0,697; sensibilidad: 93,4; especificidad: 72,5; precisión: 0,886. Valor predictivo positivo: 0,898; y negativo: 0,966. La fiabilidad compuesta fue 0,872; varianza media extractada: 0,718. La validez convergente fue aceptable en el análisis factorial confirmatorio, y se empleó una estructura unifactorial. Conclusiones. Las características operativas del CRAFFTa son aceptables para su uso en el rastreo de consumo problemático de alcohol y abuso de sustancias en una población adolescente de bajos recursos.

Introduction: The Car, Relax, Alone, Forget, Family and Friends, Trouble (CRAFFT) questionnaire is an instrument used in the screening for problematic alcohol and substance use, abuse or dependence in adolescents. While there is a Spanish-adapted and validated version for Argentine adolescents (CRAFFTa), it cannot be applied indiscriminately because it has not been assessed in different sociocultural settings. Objective: To assess the transferability of the CRAFFTa as a screening tool for problematic alcohol and drug use, abuse or dependence in an adolescent population of low socio-economic level. Population and methods: An anonymous survey was administered to low-income adolescents living in Greater Buenos Aires and attending two secondary schools. The Spanish-adapted version of the CRAFFT questionnaire, validated for its use in Argentina, was administered, while the Problem Oriented Screening Instrument for Teenagers, substance use and abuse subscale (POSITuas) questionnaire was used as a reference test. Results: A total of 146 questionnaires were completed (completion rate: 89.6 %). Reliability was 0.681; criterion validity: 0.697; sensitivity: 93.4; specificity: 72.5; precision: 0.886; positive predictive value: 0.898; negative predictive value: 0.966. Compound reliability was 0.872; average variance extracted: 0.718. Convergent validity was acceptable in the confirmatory factor analysis, and a single-factor structure was used. Conclusions: The operating characteristics of the CRAFFTa questionnaire are acceptable for its use in the screening for problematic alcohol and substance use, abuse or dependence in a low-income adolescent population.

Consumo de alcohol y drogas ilícitas en adolescentes preuniversitarios / Consumption of alcohol and illicit drugs in high school adolescents

Introducción: El consumo de alcohol y drogas ilícitas tiene efectos perjudiciales para la salud de los adolescentes. Objetivo: Determinar la frecuencia de consumo de alcohol y drogas ilícitas en adolescentes preuniversitarios. Métodos: Estudio descriptivo transversal. Se realizó en una institución preuniversitaria de Lima Norte. El consumo de alcohol fue evaluado mediante el Test de Identificación de los Trastornos Debidos al Consumo de Alcohol. Los datos fueron recogidos en julio del 2018. Resultados: Participaron 815 adolescentes, 63,1 por ciento (n = 514) fueron varones y la diferencia mujeres. De las drogas ilícitas consumidas alguna vez, 1,8 por ciento (n = 15) refirió la cocaína, 7 por ciento (n = 57) marihuana y 0,9 por ciento (n = 7) pasta básica de cocaína. Con relación al consumo de alcohol, 35,3 por ciento (n = 288) consumió alguna bebida alcohólica; de esta fracción, 15,6 por ciento (n = 45) resultó como bebedor de riesgo o dependencia. El consumo problemático de alcohol se presentó principalmente en estudiantes de 15 a 19 años (p = 0,020), consumidores de tabaco (p < 0,001) y drogas ilícitas (p < 0,05). El consumo de marihuana ocurrió predominantemente en los adolescentes procedentes de colegios estatales (p = 0,023) y en usuarios de tabaco (p = 0,001). Conclusiones: En los adolescentes preuniversitarios existen bebedores de riesgo o dependencia. El consumo problemático de alcohol ocurre principalmente en la adolescencia tardía, en usuarios de tabaco y sustancias ilícitas(AU)

Introduction: The consumption of alcohol and illicit drugs has a detrimental effect to the health of adolescents. Objective: To determine the frequency of alcohol and illicit drugs consumption in high school adolescents. Methods: Descriptive, cross-sectional study conducted in a pre-university institution of Lima Norte. The consumption of alcohol was evaluated by means of the Test for the identification of disruptions due to alcohol consumption. Data was collected in July, 2018. Results: The sample included 815 adolescents, 63.1 percent (n=514) were males and the difference were females. Of the other illicit drugs consumed at some time, 1.8 percent (n=15) referred cocaine, the 7 percent (n=57) marijuana, and a 0.9 percent (n=7) cocaine paste. Regarding to the consumption of alcohol, 35.3 percent (n=288) consumed any alcoholic beverage; of this fraction, the 15.6 percent (n=45) turned out to be as high-risk drinking or dependency. The problematic alcohol consumption was mainly in students from 15 to 19 years (p=0.020), tobacco consumers (p < 0.001) and illicit drugs (p < 0.05). Marijuana consumption occurred predominantly in adolescents from state schools (p=0.023) and in tobacco consumers (p=0.001). Conclusions: Among high school adolescents there are high risk or dependency drinkers. The problematic alcohol consumption mainly occurs in late adolescence, in tobacco and illicit substances consumers(AU)

El grupo de rehabilitación de adicciones en la prevención del alcoholismo desde centros escolares / The addictions rehabilitation group in alcoholism prevention from educational institutions

RESUMEN El consumo de bebidas alcohólicas es actualmente uno de los principales factores de riesgo relacionados con el estado de salud de las personas.Los pacientes con prolongada abstinencia y reinsertados socialmente se consideran en líderes formales que contribuyen a la prevención de adicciones, como nos lo confirman la larga experiencia acumulada en terapias grupales de alcoholismo. Se realizó una revisión bibliográfica con el objetivo de lograr la sistematización de los fundamentos teóricos que sustentan la prevención del alcoholismo desde la escuela y elaborar una estrategia para aprovechar las potencialidades de los adictos rehabilitados en la prevención de esta enfermedad.

ABSTRACT Alcohol consumption is currently one of the main risk factors related to the people´s health status. The patients with prolonged abstinence and socially reincorporated are considered formal leaders contributing to prevent addictions, as it is confirmed by the authors´ long experience working with alcohol addicted groups. A bibliographic review was carried out with the aim of systematizing the theoretical background of alcohol prevention from school and elaborating a strategy to take advantage of the rehabilitated addicts in this disease prevention.

Patterns of Drinking Behaviors and Predictors of Class Membership among Adolescents in the Republic of Korea: A Latent Class Analysis / 간호학회지

PURPOSE: Despite the high drinking rates and the complexity of drinking behaviors in adolescents, insufficient attention has been paid to their drinking patterns. Therefore, we aimed to identify patterns of adolescent drinking behaviors and factors predicting the distinct subgroups of adolescent drinking behaviors.METHODS: We analyzed nationally representative secondary data obtained in 2017. Our final sample included 24,417 Korean adolescents who had consumed at least one glass of alcohol in their lifetime. To investigate patterns of drinking behaviors, we conducted a latent class analysis using nine alcohol-related characteristics, including alcohol consumption levels, solitary drinking, timing of drinking initiation, and negative consequences of drinking. Furthermore, we investigated differences in demographics, mental health status, and characteristics of substance use across the latent classes identified in our study. To do so, we used the PROC LCA with COVARIATES statement in the SAS software.RESULTS: We identified three latent classes of drinking behaviors: current non-drinkers (CND), binge drinkers (BD), and problem drinkers (PD). Compared to the CND class, both BD and PD classes were strongly associated with higher academic year, lower academic performance, higher levels of stress, suicidal ideation, lifetime conventional or electronic cigarette use, and lifetime use of other drugs.CONCLUSION: Health professionals should develop and implement intervention strategies targeting individual subgroups of drinking behaviors to obtain better outcomes. In particular, health professionals should consider different characteristics across subgroups of adolescent drinking behaviors when developing the interventions, such as poor mental health status and other substance use among binge and problem drinkers.

Determinação social do uso de álcool e outras drogas na visão dos adolescentes / Social determination of the use of alcohol and other drugs in the view of adolescents

The use of Psychoactive Substances (PAS) is a reality among Brazilian adolescents, who may use alcohol or other illicit drugs as a form of social adaptation or even to be able to live in a fluid and hedonistic society. PASs can be considered commodities in postmodernity, being freely traded, as in the case of alcohol, or sold clandestinely, generating profits for the few. When studying the consumption of these psychoactive substances, generalizations or just blaming the individual for their use should be avoided. The phenomenon must be observed from the perspective of social determination, considering the general, particular and singular dimensions. The aim of this research was to understand the social determination of psychoactive substance use by adolescents enrolled in the 9th grade of Elementary School in Divinópolis, Minas Gerais. For this purpose, we used the sequential transformative mixed method, which was conducted with 9th grade adolescents from public and private elementary schools. In the quantitative axis (n = 303), the modules of general information, use of alcohol and illicit drugs of the 2015 National School Health Survey (PeNSE) were applied. The qualitative axis was preponderant and followed the quantitative, in which semi-structured interviews were conducted with 18 adolescents who had participated in the quantitative axis. As for the analyzes, a descriptive and multivariate analysis was performed for all quantitative variables. In the qualitative axis, the discourses based on dialectical hermeneutics were analyzed and the results of both axes were integrated in the discussion of the results, as recommended by the sequential transformative method. In the analysis of quantitative variables, there was an association in the multivariate analysis between making use of alcohol and intending to study only until high school or technical (p = 0.007), continuing to study and work (p = 0.003), not living with parents (p = 0.010) and have friends who use alcohol (p = 0.009). The quantitative results discuss, complement and agree with the discourses of adolescents on the qualitative axis, demonstrating the importance of a mixed approach on the subject. The use of PASs by adolescents is related to the social imaginary about the phenomenon, in which media, policies and market dictate norms of conduct, as noted in the lack of supervision of the sale of beverages for adolescents, in the relationship between having a job that generates income and have friends who use alcohol. All these factors are related, so that the social space of this adolescent, the place occupied socially by him and his social class will largely dictate the consequences of using PAS. It is concluded that adolescents relate all dimensions of the phenomenon to the choice of whether or not to use PAS, but the overall dimension stands out, mainly due to the economic factor that guides the others, influencing the media, products considered desirable and places. of individuals. By recognizing the main points of social obstacle and risk determinants, the community can debate and propose actions aimed at changes in both the physical space and the psychological field. In the latter case, in the field of subjectivity, actions can be developed that empower young people of their rights and duties to cover improvements of rulers and initiate changes at a singular level, with transformations in their interpersonal relationships. These steps are simultaneous and require time to be realized, because any change occurs with changes in both the behavioral level and the social imaginary. Such changes will awaken opposing forces, mainly at the political and economic levels, however, only through the clash of ideas and paradigms that new forms of organization can emerge.