Volume 3, Issue 3
The International Front
by Jorge Villatoro Velasquez, Ph.D.
Drug, Alcohol and Tobacco Consumption Associated Factors in High School and College Students
Villatoro Velázquez, J.A.; Sandoval García, A.I.; Moreno López, M.; López Brambila, M.A.; de Lourdes Gutiérrez López, M.; Magaña Méndez, E.N.; Sánchez Pineda, V.; Medina-Mora Icaza, M.E.; Bretón Cirett, M.; Amador Buenabad, N.G.; Gaytán Flores, F.; Bustos Gamiño, M.N.
This article focuses on showing consumption levels of legal, illegal and medical drugs in high school and college students and to acknowledge drug consumption associated factors. Major studies show that drug use rates among adolescents have increased, especially for alcohol, marijuana and methamphetamines. The prevalence of legal and medical drugs is similar in both sexes, and the increase in the prevalence of illegal drugs has been higher in women, approaching men's consumption rates. Nationally, this occurs in different states and particularly in large cities1. Similar studies have been conducted in school populations from 7th to 12th grade; however, carrying out such studies in university populations is more complex, mainly because it is more difficult to ensure the anonymity of the subject and of the university or institution concerned. University populations are also difficult to examine because of the mobility of students between the different class groups, even when there are specific schedules, since enrollment in classes is a free choice. Nonetheless, some studies report that nearly 24% of university students from a university institution have used illegal and medical drugs, primarily marijuana2. Student tobacco and alcohol consumption has also been vigorously examined. Studies show that the prevalence of tobacco and alcohol abuse is higher in men than in women3. Research also shows that nearly 40% of tobacco and alcohol users start using them before age 13. While the onset age for alcohol consumption has declined and consumption of tobacco has remained stable. Additionally, the early onset of the use of these substances increases the likelihood of using other drugs 4,5.
In addition to drug use rates in student populations, it is necessary to explore associated factors that affect an individual's decision to use drugs or engage in criminal or antisocial behaviors. Some studies have identified some of these factors in the social area, such as insecurity, acceptance, and availability of drugs in the community. In the interpersonal area, there are elements of the family, such as environment and family structure, parenting styles, parent involvement, parental monitoring, elusive education, encouragement, and inconsistent discipline6. Peer group relations with favorable attitudes shared by groups they belong to has also been identified as a key factor. Finally, elements such as self-esteem, exposure to stressing situations or events7, self-concept, negative experiences and other behaviors among which suicide attempt8 and sexual abuse9 standout on a personal level. Factors involved in substance use are many and varied, which generates a complicated and interesting phenomenon to study.
To ensure comparability with similar studies carried out in Mexico school populations, the methodology used in this study maintains the basic aspects of other studies conducted in students of 7th to 12th grades in Mexico City1. The unit of analysis on which the information was obtained were students from 10th to 12th grade and university enrolled students in three semester cycles between 2008 and 2009, whose sampling frame was developed based on official records of the university in which the study was conducted. The study utilized a two-staged, clustered stratified design. The stratification variable was the school, with the possibility of post-stratifying by sex in the cases where schools or faculties had similar percentages in both sexes. A non-response rate of 20% was estimated with a confidence level of 95% and an average absolute error of 0.004. The information was obtained through a standardized questionnaire used in other school population studies and previously validated 10,11,12,13, 14. The questionnaire was self-administered, voluntary, and anonymous. After application, for coding purposes, the critical coding group made an additional check to: I) classify the substances reported by students, II) verify the reported substances were drugs and that they were used for intoxication and III) to detect and remove inconsistent questionnaires. To capture and validate the information, the computer program from the National Institute of Psychiatry was adjusted to the needs of this study and to verify the consistency of responses.
Of the students who participated in the survey, 43.9% were from 10th to 12th grades and 56.1% were university students, constituting a total sample of 42.827 subjects. Results showed that 38.9% of the total sample abused alcohol during the month prior to the study. In students from 10th to 12th grades 34.4% of males and 27.3% of females have done so. Last month prevalence between university students was of 54.4% in men and 36.4% in women. The cumulative incidence of drug use was 27.1%, in students of 10th to 12th grades being of 23.2% for men and 18.1% for women. In university students the cumulative incidence was of 39.5% for men and of 25.3% in women (Figure 1).
In a multinomial logistic regression the relationship of different factors and the consumption of drugs are shown, specifying situations of social environment and parenting styles. Situations that increase the likelihood to experiment with drugs or use them regularly are: low socioeconomic level, part time study, having a work, be studying a degree, having been in a serious accident, being threatened with a weapon, suicide attempt, sexual abuse, impulsiveness in decision making, low risk perception of illegal drugs, drug availability, lack of parental involvement, to have a negative monitoring, having friends with antisocial behaviors or friends that use drugs, having someone within the family using drugs, and the acceptance of friends to the use of drugs (Table 1).
Additionally, the death of a close relative, the high stress and low risk awareness of legal drugs are individual factors that explain only the experimental use of drugs. Other predictors of drug use on a regular basis were: being abducted, have been hit or beaten by any an unknown person, having accidentally caused a serious injury or death to another person, and little coexistence with the father, high tolerance for drug use in the family, as well as adults fighting against one another at home (Table 1).
There are many factors related to substance use, but particularly the environment and family relationships are important. Therefore, prevention and intervention options are wide. The success of prevention programs lies in the consideration of aspects that influence an individual’s choice to use drugs. We observed that consumption between friends in the immediate environment, the low perception of risk, and high social tolerance have a large impact on the decision to use drugs, and that these are aspects that could be positively changed and included directly in prevention programs. Data also indicates several areas of importance in preventing drug use. In particular, working with parents, teachers, and mental health professionals since infancy are key factors in the global mental health of individuals. The implementation of programs should not be an isolated event, but part of a comprehensive public policy in the mental health area of future generations. The magnitude of the study in terms of sample size, representativeness and the wide range of issues studied are aspects that give importance to it. However, one must consider that it is not a causal study and that relationships identified here are associations between events that show possible trajectories of mental health problems in adolescents.
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