ORIGINAL ARTICLE
DOI: 10.11606/issn.1806-6976.smad.2018.000357

 

The influence of relationships and alcohol use by adolescents*

 

La influencia de las relaciones y el uso de alcohol por los adolescentes

 

 

Miria Benincasa^I; Ana Luiza Tavares^I; Vivian Miucha Moura Barbosa^I; Mayara de Paula Lajara^I; Manuel Morgado Rezende^I; Maria Geralda Viana Heleno^I; Eda Marconi Custódio^I

^IUniversidade Metodista de São Paulo, São Bernardo do Campo, SP, Brazil

 

 

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ABSTRACT

Alcohol is a substance that is increasingly present in adolescent consumption. The present study aimed to describe the use of alcohol and the quality of social relations between family and friends to identify how they influence alcohol consumption. It is a cross-sectional study, whose data were collected with a sample of 2423 students, enrolled in High School. The data expresses the significant presence of alcohol in the relationships and the use link with both family and social relationships of peers, regardless of the quality perceived in these relationships. The data are relevant for thinking about the effectiveness of public policy interventions considering family and social ties.

Descriptors: Adolescence; Alcohol; Family; Students; Groups.

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RESUMEN

El alcohol es la sustancia cada vez más presente en el consumo de este estudio fue describir adolescentes. O sobre el consumo de alcohol y la calidad de las relaciones sociales entre los miembros de la familia y amigos para determinar cómo estas influyen en el consumo de alcohol. Trata es un estudio transversal cuyos datos se recogieron con una muestra de 2423 estudiantes matriculados en la escuela secundaria. Os datos expresan la importante presencia de alcohol en las relaciones y el uso de la conexión con las relaciones tanto familiares y sociales parejas, independientemente de las relajones. El dato es relevante para pensar acerca de la efectividad de las intervenciones de política pública, considerando los lazos familiares y sociales.

Descriptores: Adolescencia; Alcohol; La Familia; Estudiantes; Grupos.

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Introduction

Adolescence is characterized by the stage of life with the most significant development changes. The exposure to risk factors at this stage brings the need to expand knowledge about influential and protective factors to these adolescents.

According to the authors⁽¹⁾, adolescence is seen as a phase of greater vulnerability, contributing to the young person being placed in situations of risk and increasing the probability of drug experimentation. Currently, according to the World Health Organization (WHO), the consumption of psychoactive substances (PAS) by adolescents has been one of the most prevalent mental health problems⁽²⁾.

National and international studies say that alcohol is easily spread, reflecting on the precocious and exaggerated consumption. Obviously, this is a risk factor for the development of consumption styles that lead to addiction and its complications. In a survey conducted in 2010 with primary and secondary school students, alcohol is the substance most consumed among adolescents, starting at age 13⁽³⁾.

The acute effects of consumption, such as joy and loquacity, are masks of the inhibitory action of alcohol on the nervous system, as well as anesthetics. Alcohol acts indirectly on the limbic system, which plays a crucial role in the expression of emotions and in the activity of the reward system of the brain, ventral area and nucleus accumbens⁽⁴⁾.

The use of alcohol in adolescents is a subject with much controversy in the social environment and in the Brazilian academic scope. While illegal to sell to children under 18 years old, their intake is accepted and practiced by these young people, whether in the home environment, in festivities or in public environments. There is a social acceptance for consumption that is exposed by advertisements⁽⁵⁾.

Among the questions raised by studies, there are statements about the influence of peers and groups on consumption, considering that both good and bad relationships are influencing factors for consumption^(6-10). The question of precocity and supply being attributed to affective bonds is also another factor indicated to influence the style of consumption of these adolescents^(1,11-12).

The consumption of alcoholic beverages is considered as socially acceptable behavior and according to the research, when this behavior is incorporated in the family relationships, being the consumption allowed or not, another risk factor for the development of consumption style that triggers the issue of dependence emerges^(13-16).

 

Material and Method

This is a cross-sectional study, whose data were collected in 2010 with high school students in the city of São Paulo, on alcohol use and the quality of social relationships between family and friends. This study was carried out with a sample of 2423 students, of which 1059 were male (45.8%) and 1254 (54.2%) female. Regarding the age of the participants, they do not have a significant difference, and the sample for both genders is equal in the age comparison.

Data were collected through a questionnaire of general identification of adolescents and another questionnaire aimed at the question of drug use by adolescents. In the general identification questionnaire, the following data were requested: name, age, gender, series, two questions proposed by ABEP (2007) for economic classification in Brazil and general health information. The presentation of the questions proposed by ABEP in 2007 (Brazil/2008 standard economic classification criterion) follows the model adopted by CEBRID in its VI National Survey on the Use of Psychotropic Drugs among Elementary and Middle School Students in Public and Private Education Networks in the 27 Brazilian Capitals.

The other questionnaire on the use of psychoactive substances, including alcohol use, was proposed by the World Health Organization (WHO) and developed by the WHO - Research and Reporting Project on the Epidemiology of Drug Dependence, in which it identifies the consumption and frequency of use of alcohol and other substances and also questions about the perception of family relationships. This questionnaire was also used in the VI National Survey on the Use of Psychotropic Drugs among Elementary and Middle School Students of Public and Private Education Networks in the 27 Brazilian Capitals.

 

Results and Discussion

Data were collected in 2010 among students enrolled in high school in the city of São Paulo, and started with research on quality of life and drug use, with a sample of 2434 participants, being 1059 males (45.8%) and 1254 females (54.2%). The ages of the participants did not have a significant difference, so the sample for the genders is the same in the age comparison.

Recent international studies have shown a constant in the samples of adolescents under 18 where the alcohol has already been tried or is already part of a consumption that can be of less frequency until an abusive use^{(1,6-7,10,14,16 )}.

A survey of national and international data on alcohol consumption shows that alcohol is the most consumed substance among adolescents aged 14 to 16 and this excessive or abusive use at an early age is often associated as a risk factor for alcohol dependence in adult life^(1,3,8-9).

In the data collected in this research, 82.1% of the sample affirms that they have already used some alcoholic beverage. 71% said that in the current year of the survey they had already used alcohol and in the last month 25.6% reported having consumed a glass or less. The comparison between the data emerges the reality of how much alcohol is present in the consumption of adolescents.

In a survey of 83 participants in Germany, most of the adolescents in the sample aged 16 to 18 reported having excessive drinking behavior. Of this same sample, 32% reported having this behavior at least twice in the month and 28% reported having this behavior three to four times in the month⁽⁶⁾. Another sample describes that the affirmation of excessive drinking is 22% among Portuguese adolescents of the same age group⁽¹¹⁾.

The sample of this research on the behavior of excessive drinking was 63% affirming that they did not have such consumption behavior. The other 32.5% said they had already had excessive drinking behavior. On the same behavior, in the last month, the sample indicates that 81.9% affirm they did not have this recent behavior. The remaining answers indicate that 5.4% of participants reported having drunk too much to the point of drunkenness for less than a week, 3.6% for less than 15 days, and 4.3% for 20 days or more.

Despite the significant difference in size and sample size, in comparison with international surveys^(6,8,11), the behavior of excessive drinking or drunkenness is present in adolescents and more frequently than once a month.

Cultural and legislative issues should be considered in the comparisons between the samples and the data presented by the surveys, the Brazilian legislation does not allow the marketing of alcoholic beverages for children under 18 years old as in other Latin American countries, such regulation also occurs in countries like Norway, in Europe in some places the legislation allows the consumption from the 16 years old, in the USA legal sale is only after 21 years old^(1,6,11,16). However, the constant is that alcohol is at some point part of these adolescents.

The different forms of legalization of alcohol and the persistent independent consumption of these forms suggest that there are other variables that should be considered in the intervention strategies for excessive alcohol consumption by these adolescents.

These variables have the influence of the pairs and family. The first place of consumption identified in surveys is the family environment and friends’ house, and there is a distinction for the female gender in which the first consumption tends to occur in public places. It is also identified that the question of gender roles can be an influence since the consumption of alcohol by men is more accepted than consumption by women⁽¹¹⁾.

About the first contact with alcohol; 30.4% of the participants affirmed that friends offered it for the first time and they represent 17.4% of the girls. In boys, the offer made by friends represents 14.5% (Table 1).

However, this study found that 24.8% of the participants stated that alcoholic beverages were from a family member, of whom 11.8% were male adolescents and 14.4% were female adolescents. That is, the first offer in the family environment becomes representative for the female gender, disregarding the affirmation of family acceptance of drinking attributed to the male gender.

The place where the adolescents were when they first consumed alcohol was 26.6% at home, of these 17.5% were girls and 10.4% boys. There were 21.6% that they were at friends’ homes, and 11.1% of respondents were boys and 11.5% girls. This indicates that the family environment and its relationships enter as an influence to stimulate the first contact with alcohol significantly between the female.

In these data, it is noticed that those responsible for the first drink supply and the place where the first contact for this sample occurred is through social and family ties. Corroborating to what international research points out^{(1,6-7,10-11,16)}, the first contact with the drink occurs through family ties and the first episode of drunkenness occurs outside of the parents’ knowledge, along with friends in parties, but in the case of the girls the family and the family environment appear as the first means of contact.

This consumption in the family environment explains that adolescents who reported being exposed to alcohol consumption behavior in childhood had a tendency to present high-risk consumption in adolescence⁽¹⁶⁾. And the precocity of exposure is accompanied by the statement that this first contact occurred through some close relative^(1,11).

The acceptance of consumption and supply of consumption is present in the most affective and family social relationships is a highly relevant variable to be considered when excessive alcohol consumption by adolescents becomes a risk^{(1,6,10 -11,16)}.

Corroborating with the idea that the accepted consumption is one of the influences for the maintenance of the behavior, the data of this research indicate that the adolescents of the sample affirm that the alcohol consumption tends to occur significantly in bars and night clubs (25%), in the friends´ house (19.8%) and at home (15.4%).

Adolescents say they find reasons for alcohol consumption; being in a group of peers, social acceptance, avoiding or modifying negative emotions and the environment in which they are inserted^(6,11).

The perception of a high support of friends or the perception of good relationships with friends appears as a determinant for the increase of the chances of intoxications in the groups of adolescents⁽¹⁰⁾.

In this study, friends are identified as the main companies during the consumption of alcohol. In the sample, 24.3% of the female participants stated that they drink with friends and 11.3% answered that they consume alcohol with relatives. Among the male participants, 20% say that they usually consume alcohol with their friends and 7.3% in the company of relatives (Table 2).

The behavior of drinking in groups of friends is also indicated with a higher incidence of international research because of the social acceptance of such behavior^(6-7,10-11).

The influence of group consumption also arises in those groups that are described as positive and friendly by adolescents, for example the consumption of alcohol in adolescents is greater among those who practice collective sports than those who practice individual sports activities, implying a variable significant; the influence of groups considered positive on drinking behavior⁽⁶⁾.

Among the factors discussed for a better understanding of the behavior of alcohol consumption by adolescents, social factors such as social acceptance, peer influence, and family influence are cited in the research, but it is necessary to reflect on how much this acceptance does not participate in a family construction, the data present the first contact through the family route, offered by a family member or by their parents.

The percentage of the sample in this study indicates that the consumption with the parents occurs, but it has a lower percentage when compared with the international data (11% of the girls and 7.3% of the boys). Nevertheless, the data indicate that the consumption is accepted and allowed by the family, and for the female gender this occurs in a greater percentage compared with the male gender as the best-accepted consumption.

Adolescents who affirm frequent alcohol consumption with their parents also report in high proportions, episodes of high alcohol consumption (48.4%) and recurrent drunkenness (35.4%), in comparison with those who stated that they did not consume alcohol with their parents. parents (15.5% and 7.1%)⁽¹⁶⁾.

It is relevant to show that the permissive consumption of alcohol in the family is one of the influences to be considered for the correlation between frequent and abusive alcohol consumption in adolescents. The family is a transmitter of values, behavior patterns, traditions and the way the family functioning accepts and deals with alcohol consumption will have a reflection on adolescents’ perception of consumption as well⁽¹⁵⁾.

Indicators in international research enable to identify relationships between alcohol consumption and family relationships. Variations in family relationships and perceptions may be influences for abusive alcohol consumption as well as being indicators of conscious consumption⁽¹²⁾.

When questioned about the perception of the relationship between parents, most of the sample answered that they perceived it as good (30.4% male and 31.8% female). The highest distinction occurred in the response of separated parents, representing 10.9% in adolescents and 6.9% in adolescents.

It was sought to understand if there would be a correlation between the perception of the relationship between parents and overuse, but this sample could not indicate this relation, what the data indicate is that 62.5% of those who responded the frequent consumption of alcohol, they perceive that parents have a good relationship between them. Another fact is that 19.4% of the sample that claims to use frequent alcohol consumption have separated parents.

The quality of the perception of the relationship between adolescents and parents in international research emerges as a variable to be considered for the existence or not of abusive behavior in the use of alcohol. Another variable considered in the international surveys, which revealed a significant association with the variations in alcohol use behavior was to consider the parents’ perception of consumption and if there was control and monitoring of alcohol use in the family environment^{(1,6,10,13,15-16)}. In this research, these aspects were not raised which suggests the need to deepen for a better understanding of the association between parental perception with alcohol use and if indeed the correlation exists.

However, the constant between this research and the other international studies suggests that the family is a considerable influence when it emerges with expressiveness in the first contact with alcohol and when it affirms the social norm of acceptance of the behavior of consuming alcoholic beverages.

The family functioning, as well as influence for the style of consumption, also emerges as a variable the resilience to deal with the problems that comes from excessive consumption. A good family functioning, in which excessive consumption occurs, would then be better able to deal with and provide support for the issues of excessive use of alcohol by adolescents⁽¹⁵⁾.

Therefore, despite not expressing an explicit correlation between the perception of the relationship between parents and the behavior of moderate or excessive use of alcohol, there is an influence of the family for the development of the style of consumption. Considering that in this sample, both for the first experimentation and the environment for consumption and consumer company the family is mentioned, it is inclined to the reflection that it is necessary to consider also the consumption of alcohol and their frequency by their parents and their perception on the consumption of the children to better understand this family space that can both be protective as a risk factor for the development of dependence and the other aggravations of the excessive consumption of alcohol by adolescents.

Final considerations

Adolescence is considered a period of special concern regarding substance use issues. The risks of overuse of health and development of dependencies in adolescents are confronted with public health and social policies in search of interventions that understand the factors associated with this consumption.

Thus, this research sought to focus on the issues of quality of life and substance use, focusing on alcohol consumption, to increase knowledge about the influence factors for the behavior of consumption and excessive consumption by adolescents and factors related issues.

It is worth noting that the first contact with alcohol and the company cited for consumption in the adolescent girls is the family, significantly impacted. This information refers to the reflection on how gender issues within family relationships are influencing the style of alcohol consumption. The family allows and accepts that this consumption of alcohol occurs and also stimulates it to be done in their company. Thus, when this drinking occurring under the eyes of the parents, would it have a protective factor or would indicate that there is a match in accepting drinking behavior for both the female and the male? Under these questions, how would this influence the consumption of adolescents? Is this an indicator for greater understanding of why increased alcohol consumption by women? These questions demonstrate the need to broaden the research and work that brings the factors of consumption and consumption risk considering the gender issues.

The data that indicate the presence of the family in the first contact with alcohol also emphasize that the perception of good relationships associated with alcohol consumption by parents can corroborate so drinking is accepted and taken as a social norm, influencing in the style of consumption of these adolescents, as international and national surveys affirm.

It is understood that to think better interventions with adolescents when the individual is the use of substance is necessary to understand the influences that interfere in the styles of consumption, only the legal prohibitions do not inhibit the use much less the excessive use since this problem is experienced by countries with different minimum age for consumption. It is necessary to consider the cultural issues linked and the very propagation of acceptance of use by the social and family environment, bringing health services closer to the coexistence centers of these adolescents, such as family, school, and leisure.

 

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Received: Jan 16^th 2017
Accepted: July 31^st 2018

Corresponding author:
Ana Luiza Tavares
E-mail: tavares_analuiza@yahoo.com.br
 https://orcid.org/0000-0002-0762-5455

 

 

* Paper extracted from doctoral dissertation "Avaliação da qualidade de vida e uso de drogas em adolescentes do Municipio de São Paulo", presented to Instituto de Psicologia, Universidade de São Paulo, SP, Brazil.