Revista Adolescência e Saúde

Revista Oficial do Núcleo de Estudos da Saúde do Adolescente / UERJ

NESA Publicação oficial
ISSN: 2177-5281 (Online)

Vol. 14 nº 4 - Oct/Dec - 2017

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Páginas 184 a 194


Alcohol consumption in adolescence: a literature review

El consumo de alcohol en la adolescencia: una revisión literaria

O consumo de álcool na adolescência: uma revisão literária

Autores: Gisely Giacometti Valim1; Priscila Simionato2; Maria Rita Polo Gascon3

1. Bachelor of Psychology from the Faculty of Psychology of São Judas Tadeu University (USJT). São Paulo, SP, Brazil
2. Bachelor of Psychology from the Faculty of Psychology of São Judas Tadeu University (USJT). São Paulo, SP, Brazil
3. PhD in Health Sciences by the Health Control Department of the Health Department (CCD-SSP). São Paulo, SP, Brazil. Psychologist at the Hospital das Clínicas of the Medical School of São Paulo (HC / FMUSP). São Paulo, SP, Brazil. Lecturer at São Judas Tadeu University (USJT). São Paulo, SP, Brazil

Correspondência
Maria Rita Polo Gascon
Rua Saturnino dos Santos, 224, Ipiranga
São Paulo, SP, Brasil. CEP: 04124-150
mariaritapolo@yahoo.com.br

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Keywords: Adolescent, alcoholism, self-injurious behavior, drinking behavior.
Palabra Clave: Adolescente, alcoholismo, comportamiento autodestructivo, comportamiento de ingestión de líquido.
Descritores: Adolescente, alcoolismo, comportamento autodestrutivo, comportamento de ingestão de líquido.

Abstract:
OBJECTIVE: The main goal of the present study was to analyze the scientific production about teenage alcohol consumption.
DATA SOURCES: Literature review conducted in September 2016 by searching the SciELO (Scientific Electronic Library Online) and LILACS (Latin American and Caribbean Health Sciences) database, through the keywords: teenager and alcoholism; adolescence and alcoholism; teenager and alcohol; adolescence and alcohol. The inclusion criteria adopted for sample selection were: scientific papers that addressed alcohol consumption in adolescence, as well as abusive use of the substance, fully available electronically, written in Portuguese and published in Brazil between 2006 and September 2016. The exclusion criteria adopted were: scientific papers at odds with the topic of investigation, published in another language and countries, other life phases rather than adolescence, and papers about the use of another substances.
DATA SYNTHESIS: 24 articles that fit the inclusion criteria were found.
CONCLUSION: Alcohol consumption is occurring more and more precocious and has negative consequences and risk behavior. As an attempt to stop this abusive consumption in this population, the present study suggests more parental control, awareness campaigns, more efficient public policy regarding control and supervision of publicity and sale of alcohol.

Resumen:
Objetivo: El objetivo del presente estudio fue analizar la producción científica sobre el consumo de alcohol en la adolescencia.
Fuente de datos: Revisión literaria realizada en el mes de septiembre de 2016 con búsqueda en la base de datos SciELO (Scientific Eletronic Library Online) y LILACS (Literatura Latino-Americana y del Caribe en Ciencias de la Salud), por medio de las palabras clave: adolescente y alcoholismo; adolescencia y alcoholismo; adolescente y alcohol y adolescencia y alcohol. Los criterios de inclusión utilizados para selección de la muestra fueron: artículos científicos que abordaran el consumo de alcohol en la adolescencia así como el uso abusivo y descontrolado de la sustancia, disponibles en la íntegra, electrónicamente, escritos en portugués y publicados en Brasil, en el periodo de 2006 a septiembre de 2016. Los criterios de exclusión utilizados fueron: artículos no condecentes con el tema abordado, que estuviera publicado en otros idiomas y países, otras fases de la vida que no fuera la adolescencia y artículos que contemplaran el consumo de otras drogas.
Síntesis de los datos: Fueron localizados 24 artículos que se encuadraron en os criterios de inclusión.
Conclusión: El consumo de alcohol se da cada vez más precoz y con eso, trae consecuencias negativas y comportamientos de riesgo. Como intento de frenar ese consumo descontrolado y abusivo en esta población, se sugiere mayor control parental, campañas de concientización, políticas públicas más eficaces en lo que se refiere al control y fiscalización del comercio de bebidas alcohólicas y publicidad.

Resumo:
OBJETIVO: O objetivo do presente estudo foi analisar a produção científica sobre o consumo de álcool na adolescência.
FONTES DE DADOS: Revisão literária realizada no mês de setembro de 2016 com busca na base de dados SciELO (Scientific Eletronic Library Online) e LILACS (Literatura Latino-Americana e do Caribe em Ciências da Saúde), por meio das palavraschave: adolescente e alcoolismo; adolescência e alcoolismo; adolescente e álcool e adolescência e álcool. Os critérios de inclusão utilizados para seleção da amostra foram: artigos científicos que abordassem o consumo de álcool na adolescência assim como o uso abusivo e descontrolado da substância, disponíveis na íntegra, eletronicamente, escritos em português e publicados no Brasil, no período de 2006 a setembro de 2016. Os critérios de exclusão utilizados foram: artigos não condizentes com o tema abordado, que estivessem publicados em outros idiomas e países, outras fases da vida que não fosse à adolescência e artigos que contemplassem o consumo de outras drogas.
SÍNTESE DOS DADOS: Foram localizados 24 artigos que se enquadraram nos critérios de inclusão.
CONCLUSÃO: O consumo de álcool se dá cada vez mais precocemente e, com isso, traz consequências negativas e comportamentos de risco. Como tentativa de frear esse consumo descontrolado e abusivo nesta população, sugere-se maior controle parental, campanhas de conscientização, políticas públicas mais eficazes no que se refere ao controle e fiscalização da comercialização de bebidas alcoólicas e publicidade.

INTRODUCTION

Adolescence is the period in which the transformation occurs from child to adult. In this phase the individual undergoes changes in various sectors of life, such as social, physiological, psychological and sexual. Adolescence begins with puberty and ends when the individual establishes his personality, his emotional and economic independence and his insertion in his social environment1.

Although the teenager has already reached a good level of maturity, society still imposes some restrictions, which in turn, cause side effects and often rebel behavior. The consumption of alcohol and tobacco, besides possessing some charm, promises guaranteed satisfaction, as well as, it represents a way of approaching the way of life of the adults that they know and admire2.

Modern times bring a worrying fact: alcohol is the most consumed substance among young people and adolescents. At the same time that the company prohibits the sale of alcohol for children under 18 years of age, we also have a permissiveness regarding alcohol consumption. The drug is widely consumed in several social sites and since children we are directly or indirectly influenced to consume the substance. Alcohol advertisements often have references to relaxation, active social life, and good humor3.

A study indicates significant results of high alcohol consumption among adolescents of the ninth year of elementary school in public and private schools in Brazil. It was found that male students and public schools have the highest percentage of experimentation and drunkenness caused by alcohol. The survey also reveals the easy access these students have to alcohol, where about 40% bought the drink at parties, followed by shopping at supermarkets and shops or bars (20%). It was observed that in the female sex one of the most common ways of obtaining the drink is inside their own homes4.


METHOD

In order to reach the objective of the research, a survey of articles published in the databases SciELO (Scienti fic Electronic Library Online) and LILACS (Latin American and Caribbean Literature in Health Sciences) via Internet access, covering the period from 2006 to September 2016. The keywords used to locate the articles were: adolescents and alcoholism, adolescence and alcoholism, alcohol and adolescence and alcohol and adolescent.

SciELO is a digital library that comprises a collection selected from national scientific journals. The platform has been in operation since 1998 and is the result of a research project of FAPESP (Foundation for Research Support of the State of São Paulo), associated to BIREME (Latin American and Caribbean Center for Health Sciences Information). (Latin American and Caribbean Literature in Health Sciences) is the most comprehensive index of scientific and technical literature in Latin America and contains all relevant literature on health sciences, produced by Latin American authors and published since 1982. It belongs to the BIREME database of the Virtual Health Library (VHL).

From the survey of the articles, the abstracts of the publications were read and the articles consisted of the purpose of the research. The articles were read in full by the researchers and categorized according to the following criteria: number of articles published in the period, research design of the articles and academic training of the researchers. Regarding the theme proposed by the study, the studies considered alcohol consumption in adolescence were considered for the sample. Studies on alcohol consumption in other phases of life were excluded, as were articles that included the use of other substances other than alcohol, as shown in figure 1 below.



Figure 1. Selection method used.



RESULTS

Twenty-four articles were published in the last decade in both databases, 19 (nineteen) in SciELO and five (five) in LILACS. The annual provision of publications in this period is shown in figure 1.

From the bibliographical survey it was observed that in 2011 the largest number of articles published in the period of ten years (2006 to September 2016) was concentrated, which indicates that the publication of articles with the subject in question is relatively recent. The distribution of articles in this period, with the exception of the year 2011, presented little variation, from 0 (zero) to 3 (three) articles per year. The disposition of the studies that approached the consumption of alcohol in adolescence is shown in table 1.




Regarding the area of training of researchers, we noticed a high index of medical professionals, followed by professionals in the area of Nursing and thirdly Psychology professionals, according to table 2. These data were obtained by consulting the Curriculum Lattes of the researchers, accessible on the CNPQ website. All publications are multiple authored.




Studies on alcohol consumption in adolescence are published in several journals in the area of health, nursing and psychology. The layout of publication journals can be seen in table 3.





Graph 1. Number of articles analyzed in the present study from the LILACS and SciELO databases, organized per year.



The journal Saúde Pública presented the largest number of studies on the subject, with 6 (six) publications. Then, Caderno Saúde Pública magazine presented 3 (three) studies with the theme. The studies are scattered in 15 (fifteen) journals.Thus, there is no great concentration of publications in specific magazines or specialized in the subject.

The predominance of research on the subject is expected in the health area, since uncontrolled consumption and excess alcohol in this phase of life has become a public health problem, causing harm to the lives of these individuals, as a greater probability to alcoholism (exposure to sex without a condom, STD contamination - Sexually Transmitted Diseases, traffic accidents, low academic performance, etc.) In the field of public health, all selected studies on alcohol consumption during adolescence demonstrate a preventive and conscientious character, explaining the need for public policies, parental control and supervision of the sale of the substance7-25 .

Most of the studies analyzed were carried out in the southern region of Brazil. However, this did not present a significant difference in the number of publications among the other regions studied. A consensus regarding the economic condition as a propelling factor for alcohol consumption among adolescents was not observed, where four studies did not present a relation between socioeconomic level and alcohol consumption9,11,16,26,27,28 and two studies showed that the greater alcohol consumption is related to the higher socioeconomic level19,30.

Of the total articles surveyed, two are literature reviews published in 2012 and 2014, and 22 are derived from field research. The publications derived from field studies presented mostly large samples (from 100 participants), a study was based on 80 participants29, two articles of the same authors had samples of 40 participants18,20, and four studies presented samples with only 10 participants7.

In the present study, the studies were performed predominantly with participants of both genders. Only one article investigated the female sex only25. There is no agreement between the authors regarding the type that consumes the most alcohol. However, there is a tendency to a higher risk of drinking in males24. Twelve studies had samples with participants in the age group of up to 18 years, two studies with ages up to 19 years, three studies with age range up to 20 years, one study with age group up to 21 years, two studies with an age group up to 25 years and a study with the age group up to 28 years. During the school period that the participants were, more was studied the period of Elementary and Middle School, this period in which the adolescent public is concentrated.

Risk behaviors associated with alcohol consumption and negative consequences due to substance use appeared in nineteen articles surveyed. Among the risks are traffic accidents, risky sexual behavior (STD contamination due to lack of condom use, unwanted pregnancy, violence and academic losses) 5,7,9,14,15,18,19,21,22,24,27.

Another factor of great relevance discussed in the journals found was the influence of the family as a protective or incentive factor for alcohol consumption in adolescence. The family is the first social environment with which we have contact.It is through the family environment that the individual learns ethical, moral values, conduct and skills to face daily adversities. Thus, the family can both protect adolescents from alcohol consumption and expose them to the substance11,14,16,17,19,20,22,25.

Twelve studies have pointed out the relationship between alcohol consumption and the influence of advertising, as well as the easy access adolescents have to acquire the substance7,10-14,16-18,20-22. The adolescent is at a stage more susceptible to new experiences, so when he sees an advertisement spreading pleasure, sexual appeal and happiness, he begins to believe in the truth of what is being advertised, and becomes more prone to alcohol consumption12. There is some concern about the adolescent's easy access to alcohol, even if it is a substance whose sale is prohibited for those under 18 years of age23.

Adolescents have a positive perception of the effects of alcohol, not glimpsing the actual and dangerous effects that the substance can cause. Among the motivating factors for alcohol consumption, adolescents consider the search for autonomystatus , experimentation, feeling of omnipotence, sensation of pleasure and construction of a new identity8.


DISCUSSION AND FINAL CONSIDERATIONS

The scientific literature analyzed in this study suggests that the first contact with alcohol among the adolescent population occurs increasingly early, between 10 and 12 years of age, which makes the issue worrying, since the earlier the consumption of alcohol, the greater the probability of developing dependence and consumption of illicit drugs5,11,14-17,19,21,24.

There is no consensus among the authors about the gender that most consumes the substance, presenting a certain balance between male and female. It was also not possible to identify a concordance among the studies found regarding the socioeconomic level of the adolescents participating in the studies that consume the most alcohol. A study that indicated greater consumption in the best socioeconomic conditions attributed the fact that individuals had more resources for alcohol acquisition14. Contrary to this study, another article showed evidence of a higher frequency of alcohol consumption in lower socioeconomic levels 9 and attributed family influence as an incentive factor to the early consumption of the substance.

The family influence on alcohol consumption among adolescents is undeniable both as a protective factor and as a motivating factor. All articles that discussed this factor agreed that the family is the first social environment and when presenting habits of abusive consumption and transmit normality to the use of alcoholic beverages, children and adolescents who live in this environment tend to have the same belief of normality and consume the alcohol at an earlier stage. On the other hand, families that do not have these habits have a protective influence. Research has shown that the first contact with alcohol often takes place within the adolescents' own homes or on the offer of their parents and relatives or by easy access to drinks11,14,16,17,19,20,22,25.

Easy access to alcohol is also an alarming factor for teen drinking. It was noted that even though the sale of the substance is prohibited for minors under 18 years of age 23 , obtaining alcohol by this population occurs easily and indiscriminately.The lack of adequate supervision and the lack of more effective public policies to combat this practice, which is absurdly harmful to health, are highlighted11,13,14,16,18,20-22.

Advertising of alcoholic beverages can also be an incentive for alcohol consumption by adolescents. As companies convey scenes of joy, fun, relaxation, satisfaction, and sense of well-being related to alcohol consumption in the media, more adolescents are attracted to these images and initiate contact with the drug7,10, 12,14,17. Consumption of alcohol is commonly accepted by society and often alcohol is not even considered as a drug. However, we must consider the various negative consequences that substance use causes. Adolescents who abuse alcohol abusively and uncontrollably tend to exhibit risky behaviors and are more susceptible to dangerous situations such as traffic accidents, fights, reduced academic performance, and engaging in non-condom-free sex, depriving themselves of sexually transmitted diseases. Several are the damages caused by the consumption of alcohol5,7,9,14,15,17-19,21,22,24.

Increased and effective supervision in the marketing of alcohol controlled advertising of alcoholic beverages, awareness of the negative consequences of alcohol consumption within the family and in the school environment are suggestions of protective measures against the consumption of this silent and dangerous drug that affects each more adolescents in Brazil.


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