Incidência de tabaco e álcool em adolescentes brasileiros: fatores contextuais e comorbidades

• Autor(a) principal: Ribeiro, Marcos Vinicius Vieira [UNIFESP]
• Data de Publicação: 2018
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Institucional da UNIFESP
• Texto Completo: https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=6432704; https://repositorio.unifesp.br/handle/11600/52683
• topic: Epidemiology; Tobacco; Adolescents; Epidemiologia; Tabaco; Adolescente; Vizinhança; Transtornos mentais

In 2016, 28.3% of the 12th grade students in the USA reported any use of cigarettes during lifetime. In the USA, tobacco use is the primary source of preventable disease, disability and death. The Center for Diseases Control (CDC) estimates that cigarette use or secondhand exposure are responsible for more than 480.000 premature deaths. In that country, the following factors have been associated with a greater likelihood to smoke or use tobacco: older age (adolescent); being male; being white, multiethnic, AmericanIndian, or Alaska Native; lack of college plans; experiencing highly stressful events and diminished perception of risk. In 2010, about 2.6 million American adolescents (aged 12–17) reported using a tobacco product in the month prior to the survey. In that same year, it was found that nearly 60 percent of new smokers were under the age of 18 when they first smoked a cigarette. Of smokers under age 18, more than 6 million will likely die prematurely from a smokingrelated disease. Though international reports show an increasing trend in the first time use during adolescence , few studies have addressed this issue in Brazil. In 2012, there were 34,745.214 million adolescents in the age range of 1019 years and in students, lifetime prevalence for tobacco and alcohol use were 16.9% and 60.5%, respectively . The oneyear prevalence was 9.8% for tobacco and 41.1% for alcohol consumption. In Brazil, tobacco and alcohol are the most used drugs during adolescence, with an estimated 8.1% prevalence of tobacco use and 43.6% of tobacco in the age range of 1315 years. In developing countries such as Brazil, the following risk factors have been associated with tobacco use during adolescence: male sex, older age, lower socioeconomic status, having a friend or firstdegree relative that smokes, poor academic performance, working job and parental divorce. In Brazil, the 2nd National Adolescent Schoolbased Health Survey (PeNSE) – with a sample of 9th graders from public and private schools – showed that there was a greater likelihood of tobacco experimentation and regular smoking for adolescents that presented the following risk factors: lower parental schooling, public school attending, singleparent family, working at the time of the survey, being around others who smoke and having a positive family perception towards smoking. Low and middleincome countries (LMIC) account for more than two thirds of the children's population and though mental health problems affect 1020% of youth around the globe, a minority of epidemiological studies have a focus in those countries. Though much has been discovered regarding tobacco consumption trends during adolescence, there is a paucity of longitudinal data that explore the associated factors (such as contextual factors) and the possible psychiatric comorbidities that may come along the increasing tobacco use during this period. This study aims to provide detailed information on incidence of tobacco and alcohol use, as well as contextual and comorbid factors associated in a longitudinal Brazilian cohort of schoolattending adolescents. This study is part of the Urbanicity, childhood trauma and comorbid adolescent psychopathology in Brazil, which focus on the possible modifiable risk factors that could contribute to drug use and the development of psychopathology in adolescence. The main aim of this study was to assess the incidence of tobacco alcohol use in a representative sample of 116 13yearolds students from two neighborhoods Capão Redondo and Vila Mariana in the city of São Paulo, Brazil, by means of the DSM5 criteria. We also intended to estimate ODD, CD, GAD, MDD, PTSD and SUD prevalences and to investigate the possible comorbidity pattern in adolescents with tobacco and alcohol use. Furthermore, we explored the possible associations among alcohol and sex, low SES, neighborhood and violence variables. We expect tobacco and alcohol incidence rates to be associated with low socioeconomical status (SES) and neighborhood variables.