Tobacco use among the elderly: The first Brazilian National Survey (BNAS).

OBJECTIVE: This study describes the prevalence and pattern of tobacco use among the elderly in Brazil and establishes its association with socio-demographic characteristics, other substance use and depression. METHOD: The analyses were performed in 400 individuals aged 60 years and over who participated in the first Brazilian national alcohol survey (BNAS) in 2000. RESULTS: Nearly 60% of the sample had ever smoked, of them one in three were still smoking at the time of the interview. Most (94.3%) of the tobacco users were smoking everyday and 34.3% consuming more than 20 cigarettes a day. Only 1% of the former smokers had received support to quit. Over half of the current users (65%) would use free treatment to quit if it existed in Brazil, and just under half of them (47.4%) would consider quitting if cigarettes' price were higher. Currently, tobacco users were more likely to be men and alcohol abusers. Prevalence of depression was high regardless participant smoking status (33.0% among non-smokers, 34.7% among current smokers and 39.3% among former smokers). There was no significant association between smoking and depression. CONCLUSION: This study found a disturbingly high proportion of tobacco users among the elderly in Brazil. According to the Global Burden of Disease project, tobacco has the highest mortality risk of all substance use categories, especially for the elderly. This study shows there is an urgent need to develop smoking cessation interventions targeted specifically to the elderly.

Alcohol consumption in late-life--the first Brazilian National Alcohol Survey (BNAS).

To investigate the alcohol consumption in later life in Brazil and its association with socio-demographic characteristics. This study was a cross-sectional analysis of nationally representative survey data. A multistage cluster sampling procedure was used to select 3007 individuals of 14 years of age and older from the Brazilian household population. In this study we analyzed data from all 400 participants who were over 60 years old. Alcohol Abuse and Dependence Syndrome was established according to DSM-IV and Risky Drinking was defined in two ways: heavy drinkers (>7 drinks/week) and as binge drinkers (>3 drinks/one occasion). Twelve percent of participants reported heavy drinking behavior while 10.4% and 2.9% were binge drinkers and alcohol dependent respectively. In the adjusted logistic regression only gender was associated with heavy drinking behavior. Males, the youngest and the wealthiest were more likely to report binge drinking behaviors. In conclusion, alcohol related-problems are common but under recognized among older adults. Health professionals should be aware that common definitions of alcohol abuse and dependence may not apply as readily to older people, who have had biological changes for alcohol tolerance and its effects on the Central Nervous System.

Association between sweet preference and paternal history of alcoholism in psychiatric and substance abuse patients.

BACKGROUND: The relationship between preference for stronger sweet solutions and propensity to excessive alcohol drinking is supported by both animal and human studies. This study was designed to test the hypothesis that sweet preference is associated with the genetic risk of alcoholism as measured by a paternal history of alcoholism. METHODS: Participants were 180 patients admitted to a residential treatment program for the treatment of alcoholism, drug dependence, or psychiatric conditions. In addition to a routine medical examination, patients completed the standard sweet preference test twice (on the 9th and 24th days after admission), and the family history of alcoholism was evaluated. RESULTS: Sweet preference was shown to be stable over time. It was strongly associated with a paternal history of alcoholism, with family history-positive patients approximately 5 times more likely to prefer stronger sweet solutions than family history-negative subjects. Such factors as dependence on alcohol, cocaine, opiates, cannabis, other drugs (including prescription drugs), and tobacco smoking, as well as demographics (gender and age), did not significantly interfere with association between sweet preference and paternal history of alcoholism. CONCLUSIONS: These findings provide some support for the hypothesis that preference for stronger sweet solutions is associated with a genetic predisposition to alcoholism as measured by a paternal history of alcoholism.

Drinking and driving: pre-driving attitudes and perceptions among Brazilian youth.

The aim of this study was to investigate driving under the influence of alcohol (DUI) risk profiles and predictors in a sample of pre-driving Brazilian youth, in the context of Brazil's new Traffic Code. Data were obtained in the Traffic Department in São Paulo from a sample of 2166 individuals. Subjects displayed a low level of knowledge about the laws and few believed the penalties would actually be enforced for those engaging in DUI. Findings suggest that changes in DUI laws in Brazil and elsewhere should be accompanied by enforcement and education in order to enhance levels of knowledge and credibility of the sanctions.

Substance use and driving: the coexistence of risky and safe behaviors.

AIMS: Two risky behaviors (driving after drinking/getting drunk, riding with drinking drivers) and two safe behaviors (deciding not to drive under the influence of alcohol (DUI), preventing someone else from DUI) were examined in relation to use frequency and friends' DUI to determine whether individuals tend to engage in both types of behaviors. DESIGN: Self-report questionnaires were administered to a random sample of 1233 young adults in New Jersey (USA) on two occasions (mean age 21 and mean age 28). Structural equation modeling was used to assess the goodness of fit of a hypothesized model of cross-sectional and longitudinal relationships. FINDINGS: Relationships between the four behaviors were strongly positive for men and women at both occasions and were substantially accounted for by use frequency and friends' DUI. At the later age, however, it was necessary to add non-recursive pathways to the model, which were different for men and women. CONCLUSIONS: Findings suggest that (1) riding with drinking drivers plays an important role in the maintenance of the other behaviors and (2) most individuals vacillate between risky and safe behaviors indicating that drinking contexts are best viewed as risky decision-making situations requiring individuals to choose between riskier and safer courses of action.

A frequency and content analysis of alcohol advertising on Brazilian television.

OBJECTIVE: Two studies were conducted with the objective of analyzing the frequency and content of alcoholic beverage advertising on Brazilian television. METHOD: Study 1 presents a frequency analysis based on 84 hours of TV monitoring in which 1,640 commercials and 243 vignettes were recorded between 8:00 PM and 11:00 PM on the two main stations. Study 2 presents a content analysis of 139 alcoholic and 51 nonalcoholic beverage commercials aired in 1992-93, as evaluated by three trained judges. RESULTS: Study 1 showed the relative frequency of alcoholic beverage commercials (4.6%) to be higher than the frequency of other products such as cigarettes, nonalcoholic beverages and medicines, and lower than that of foods and various other items. Frequency of alcoholic "vignettes" (26.6%) was higher than the frequency of all the other product categories. Frequency data were closely matched by marketing investment data for the period. In Study 2, the most frequent themes and appeals present in alcohol commercials were relaxation, national symbolism, conformity, camaraderie and humor. Human models were present in most ads. Product-related themes such as information, quality or tradition were virtually absent, as were messages to drink moderately. However, 7.2% of the alcohol commercials displayed appeals promoting abusive drinking. CONCLUSIONS: The results seem to reflect the minimal regulation of alcohol advertising in Brazil, and a joint effort by health planners, educators, legislators, alcohol industries and advertising agencies is recommended as a necessary step to reduce alcoholic beverage problems in Brazilian society.

Drug and alcohol use and family characteristics: a study among Brazilian high-school students.

The present work employs a multivariate analysis technique to study, simultaneously, family relations and alcohol/drug consumption among 16,378 Brazilian high-school students. The analysis is centered on the relation between subjective or objective family situations and consumption. Subjective situations are measured by adolescents' perception of their families, that is, the family's environmental "climate"--whether violent situations occur at home, whether there is frequent dialogue about the youngsters' problems, and whether they perceive interest on the part of parents. Objective situations refer to the conjugal status of parents. Results pointed to family violence as the factor most frequently associated with alcohol/drug use behavior. It was also found that the family's environmental climate constitutes a more important factor than the conjugal status of parents, when it comes to the development of drug use behavior. Therefore, the impact of this last variable (whether parents are living together) is determined by environmental conditions: when those conditions are favorable (no violence, problems habitually talked about, parents concerned with their offspring) the fact that parents were effectively living together meant a smaller probability of alcohol/drug use; when these conditions were unfavorable, the same fact was associated with a greater probability of consumption.