Academic migration and marijuana use among undergraduate students: evidences from a sample in southern Brazil / Migração acadêmica e uso de maconha entre estudantes de graduação: evidências de uma amostra do sul do Brasil

Abstract The aim of this study was to measure the prevalence of marijuana use in the last month, its associated factors and its relationship with academic migration among undergraduate students of a federal university in southern Brazil. This was a cross-sectional study and data were collected through self-administered questionnaire. A systematic sampling process was conducted. To data analyses, it was used Poisson regression with robust adjust for variance. Overall, 1,423 students participated. The prevalence of marijuana use in the last month was 16.8% (95%CI 14.8% to 18.8%). Data showed that the greater the distance of the city prior to university entry, the higher the prevalence of marijuana use in the last month. Being male, having less age, being single, not having religious practices, having relatives and friends who have used any illicit drug, and having tobacco use in the last month were also risk factors. We understand that academic migration within the country tends to decrease students contact with family and increase vulnerability to peer influence, which may lead to a higher probability of marijuana use in this sample. The results highlights the importance to develop projects of illicit drug use prevention focused on this risky subgroup.

Resumo O objetivo deste estudo foi medir a prevalência de uso de maconha no último mês, seus fatores associados e sua relação com a migração acadêmica entre estudantes de graduação de uma universidade federal do sul do Brasil. Este estudo teve delineamento transversal e os dados foram coletados através de questionário autoaplicável. O método de amostragem foi aleatório sistematizado. Na análise dos dados utilizou-se a regressão de Poisson com ajuste robusto da variância. Participaram do estudo 1.423 graduandos. A prevalência do uso de maconha no último mês foi de 16,8% (IC95% 14,8%-18,8%). Os dados mostraram que quanto maior a distância da cidade anterior ao ingresso na universidade, maior a prevalência de uso de maconha no último mês. Ser do sexo masculino, ter menos idade, estar solteiro, não ter prática religiosa, ter familiar e amigo que já usou alguma droga ilícita e ter usado tabaco no último mês também foram fatores de risco. Entendemos que a migração acadêmica no país tende a diminuir o contato dos alunos com a família e aumentar a vulnerabilidade à influência dos pares, o que pode levar a uma maior probabilidade de uso de maconha nesta amostra. Os resultados ressaltam a importância de desenvolver projetos de prevenção focados neste subgrupo de risco.

Marijuana use associated with worse verbal learning and delayed recall in a sample of young adults / El consumo de marihuana se asocia a una menor capacidad de aprendizaje verbal y memoria tardía en adultos jóvenes

ABSTRACT Background: There is concern about the cognitive consequences of marijuana consumption. Aim: To assess the influence of current and past marijuana use and frequency on verbal learning and memory in a sample of adults aged 21 years old. Material and Methods: Marijuana use was assessed using a clinician administered interview in 654 participants (56% females), who reported frequency of use, age of first use and whether its use led to problems in their lives. The CogState International Shopping List was administered to assess learning and memory. Results: Seventy percent reported ever using marijuana, 46% consuming during the past year and 27% during the past 30 days. The latter scored significantly lower on delayed recall. Current and frequent use were significantly associated with lower accuracy in verbal learning and memory. Conclusions: In this cohort of adults aged 21 years old, marijuana use was prevalent and related to worse verbal memory.

Antecedentes: Existe preocupación acerca de los efectos cognitivos del consumo de marihuana. Objetivo: Estudiar el efecto de consumo de marihuana presente o pasado en la capacidad de aprendizaje verbal y memoria en una muestra de adultos de 21 años. Material y Métodos: El consumo de marihuana fue evaluado mediante una entrevista médica en 654 adultos de 21 años (56% mujeres), quienes informaron acerca de la frecuencia de consumo, edad de comienzo y si el consumo les ha causado problemas en sus vidas. Se les administró el Cogstate International Shopping List para evaluar aprendizaje y memoria. Resultados: El 70% informó haber consumido marihuana alguna vez, 46% la usó durante el último año y el 27% en los últimos 30 días. Estos últimos tuvieron un menor puntaje en memoria tardía. El consumo actual y frecuente se asoció a una menor precisión en la capacidad de aprendizaje verbal y memoria. Conclusiones: En esta cohorte de adultos de 21 años, el consumo de marihuana fue prevalente y relacionado a una menor memoria verbal.

Elementos regulatorios sobre la marihuana, a consideración para la efectiva protección a la salud de la población / Regulatory elements on marijuana, for the effective population health protection

Resumen: Al hablar del abordaje de salud pública al uso de la marihuana se soslaya la complejidad de la protección a la población a través de intervenciones regulatorias rigurosas. Considerando la experiencia de gobiernos donde ya existen estas prácticas, se introduce la regulación como una función esencial de la salud pública, haciendo explícitos siete propósitos para el control de la marihuana. Se detallan luego los elementos técnicos, de capacidad institucional (incluyendo la capacidad técnica y financiera) y de gobernanza que deben cumplirse para cualquier regulación rigurosa de su uso. Se señala la dificultad de regular sustancias psicoactivas considerando que la capacidad de control de otras actualmente legales se ha traducido en su creciente consumo. Se expone también que no debe minimizarse la necesidad del fortalecimiento institucional y gobernanza de la autoridad regulatoria para la regulación efectiva de la marihuana.

Abstract: When discussing the public health approach to the use of marijuana, the complexity of rigorous regulatory interventions for population protection is omitted. Using the experience of governments where these practices already exist, regulation is introduced as an essential public health function, spelling out seven purposes for controlling marijuana. The technical elements of institutional capacity -including the technical and financial capacity- and of governance that must be covered by any rigorous regulation of its use are detailed below. The difficulty of regulating psychoactive substances is addressed when considering the capacity to control other legal substances manifested with their increased consumption. It is concluded that for an effective regulation of marijuana, the need for strengthening the institutional and governance aspects of the regulatory authority should not be minimized.