Revista Adolescência e Saúde

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

NESA Publicação oficial
ISSN: 2177-5281 (Online)

Vol. 16 nº 1 - Jan/Mar - 2019

Original Article Imprimir 

Páginas 13 a 20

Risk factors associated with alcohol consumption among adolescents from a public school

Factores de riesgo asociados al consumo de alcohol entre adolescentes de una escuela de la red pública de enseñanza

Fatores de risco associados ao consumo de álcool entre adolescentes de uma escola da rede pública de ensino

Autores: Eliana Lessa Cordeiro1; Tânia Maria da Silva2; Liniker Scolfild Rodrigues da Silva3; Edinayran Ediluergyla da Silva4; Thamires Fernanda Crystina de Mesquita5; Wangela Pimenta Maia6

1. Master in Neurosciences by the Postgraduate Program in Neuropsychiatry and Behavior Sciences (Posneuro) at the Federal University of Pernambuco (UFPE). Manager of the Couse of graduation in Nursing of the Salgado de Oliveira University (UNIVERSO). Recife, PE, Brazil
2. Master in Education by Federal University of Pernambuco (UFPE). Teacher of the Couse of graduation in Nursing of the Salgado de Oliveira University (UNIVERSO). Recife, PE, Brazil
3. Resident in the Multiprofessional Residency Program in Collective Health by the Pernambuco University (UPE). Teacher, acting as Tutor in the Course of Graduation in Collective Health, by the Medical Sciences College (FCM) at Pernambuco University (UPE). Recife, PE, Brazil
4. Graduation in Nursing by the Salgado de Oliveira University (UNIVERSO). Recife, PE, Brazil
5. Graduation in Nursing by the Salgado de Oliveira University (UNIVERSO). Recife, PE, Brazil
6. Graduation in Nursing by the Salgado de Oliveira University (UNIVERSO). Recife, PE, Brazil

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Keywords: Adolescent; Alcoholism; Nursing; Education.
Palabra Clave: Adolescente; Alcoholismo; Enfermería; Educación.
Descritores: Adolescente; Alcoolismo; Enfermagem; Educação.

OBJECTIVE: Verify the risk factors that may be associated with alcohol consumption among adolescents of a public school in the city of Recife, Pernambuco.
METHODS: For this study, inferential techniques were used using the quantitative evaluation method through a structured model, idealized by the use of alcohol Test Disorder, that is, with scores in the options provided answers. The questionnaires' responses were scored to fit the levels of alcohol consumption highlighted.
RESULTS: Use of Alcohol Use Disorder Identification Test identified that 55.7% adolescents have low risk, 25% have some risk, 17.3% have high risk and 1.9% are likely dependents.
CONCLUSION: Adolescents have made increasingly precocious consumption of alcoholic beverages, in greater quantities and with easy access. It is necessary to intensify preventive campaigns and multidisciplinary incentive that would works in parallel with government programs, school and community, plus awareness of the harm that can come from the consumption of alcoholic beverages.

OBJETIVO: Verificar los factores de riesgo que pueden estar asociados al consumo de alcohol entre adolescentes de una escuela pública de la ciudad de Recife, Pernambuco.
MÉTODOS: Para este estudio fueron utilizadas técnicas de inferencia a través del método de evaluación cuantitativa, por medio de un modelo estructurado, idealizado por el uso del Test de Trastorno del Alcohol, es decir, con score en las respuestas de las opciones provistas. Las respuestas de los cuestionarios fueron puntuadas de acuerdo con los niveles de consumo de alcohol destacados.
RESULTADOS: El Test de Identificación del Trastorno por Uso de Alcohol apuntó que en el 55,7% de los casos los adolescentes tienen bajo riesgo, 25% están en riesgo, 17,3% tienen alto riesgo y 1,9% son probables dependientes.
CONCLUSIÓN: Los adolescentes han consumido de manera cada vez más precoz bebidas alcohólicas, en mayor cantidad y con fácil acceso. Son necesarias la intensificación de campañas preventivas e incentivo multidisciplinario que funcionarían paralelamente a programas gubernamentales, trabajo en las escuelas y comunidad, además de concientización sobre los maleficios que pueden advenir del consumo de bebidas alcohólicas.

OBJETIVO: Verificar os fatores de risco que podem estar associados ao consumo de álcool entre adolescentes de uma escola pública da cidade de Recife, Pernambuco.
MÉTODOS: Para este estudo, foram utilizadas técnicas inferenciais através do método de avaliação quantitativa, por meio de um modelo estruturado, idealizado pelo uso do Teste de Transtorno do Álcool, ou seja, com escores nas respostas das opções fornecidas. As respostas dos questionários foram pontuadas de acordo com os níveis de consumo de álcool destacados.
RESULTADOS: O Teste de Identificação do Transtorno por Uso de Álcool apontou que em 55,7% dos casos os adolescentes tem baixo risco, 25% estão em risco, 17,3% tem alto risco e 1,9% são prováveis dependentes.
CONCLUSÃO: Os adolescentes tem feito consumo cada vez mais precoce de bebidas alcoólicas, em maiores quantidades e com fácil acesso. São necessários a intensificação de campanhas preventivas e incentivo multidisciplinar que funcionariam paralelamente a programas governamentais, trabalho nas escolas e comunidade além de conscientização sobre os malefícios que podem advir do consumo de bebidas alcoólicas.


There is no universal factor to explain the etiology of alcoholism. This is because all those who consume alcoholic beverages present a possibility of becoming dependent, being this possibility greater or less, according to the interaction of vulnerability factors, which may be biological, psychological and social1.

The misuse of alcohol produces psychological, social and economic effects that entail incalculable damages to those who consume it, such as: reduction of the quality of life for the user and family; biopsychosocial disabilities that lead the subject to lose opportunities in the productive, affective and family process; as well as the emergence of practices of antisocial actions2.

In this discussion, it is known that adolescents' access to alcoholic beverages is facilitated, which makes them more susceptible to different risk situations and possible consequences, such as: early alcohol consumption, early pregnancy, STIs, hypertension, accidents, poor school performance, smoking and other drug use, conflict in social, professional and family relationships, among others.

The World Health Organization (WHO) reveals that in both developing and developed countries, alcohol is the drug of choice for young people. It is the most consumed psychoactive substance in any age group and its consumption has been growing among adolescents from 12 to 15 years of age. In Brazil, this reality is no different, although there is a law (No. 9,294, dated July 15, 1996) that establishes a prohibition on the sale of alcoholic beverages under 18 years old4.

According to the V National Survey with Students, conducted by the Brazilian Center for Information on Psychotropic Drugs5, 65.2% of students reported using alcohol at some point in their life; 44.3% in the 30 days prior to the survey; 11.7% reported frequent use; and 6.7% reported constant intake of alcoholic beverages, 20 or more times in the month preceding the investigation6.

Adolescents are still negatively influenced by today's media, such as television, radio, newspaper, and especially the internet, which facilitates access to numerous licit and illicit drugs, pornography, and other grievances7.

Regarding family coexistence, studies show that the quality of adolescents' interaction with their parents is considered as a fundamental milestone for the youngster's approach to alcohol and/or other drugs, since young people who claim to have a regular and / or poor with parents have a higher rate of consumption of alcoholic beverages8.

There is evidence that parents influence their adolescent children to consume alcoholic beverages, either by example of conduct or by a happy marital environment. For when they observe their behavior, they perceive situations of joy and pleasure related to the consumption of alcohol and, consequently, they can repeat them relating them to moments of relaxation, challenge and courage, not seeing as a malice9.

In this sense, nursing care, when dealing with issues related to excessive alcohol consumption among adolescents and young people, should include family members in the participation of individual interviews and support groups for orientation and reception, since the family can be important in the aiding behavior changes and developing a healthier lifestyle2.

Within this discussion, the problem proposed for this study is: what risk factors can be associated with alcohol consumption among adolescents who study at a public school in the city of Recife, Pernambuco. This question becomes relevant, given that the abusive consumption of alcohol among young people seems to be increasing and precocious.

Thus, it is also up to the Nursing professional to highlight, through Health Education actions, the risk factors that can be associated with such consumption, in order to minimize possible problems.


To verify the risk factors that may be associated with alcohol consumption among adolescents of a public school in the city of Recife, Pernambuco.


Quantitative research is considered to be the most adequate to ascertain explicit and conscious opinions and attitudes of the interviewees, since they use standardized instruments (questionnaires) and must be performed when one knows exactly what should be asked to achieve the research objectives10.

In this sense, quantitative-descriptive ones can be carried out that aim at the exact description of certain quantitative characteristics of the population as a whole, organizations or other specific collectivities, and when scrutinizing qualitative aspects such as attitudes and opinions, scales are used that allow quantification11.

In carrying out this research, advanced statistical inferential techniques were used, which can create models capable of predicting whether a person will have a certain opinion or act in a certain way, based on observable characteristics12.

The study population consisted of 52 students who were enrolled in the 3rd year of high school (in the afternoon period) of a school of the Public Education Network located in the city of Recife-PE, in the year 2015. For the choice of the institution, taking into consideration the fact that it is a Reference School and offers easy access as a field of research.

The inclusion criteria that were adopted to carry out this research were: to be under 18 years of age and to be attending the 3rd year of High School. Students who were not present at the time of the researchers' visit and who did not present the terms of assent and the free and informed consent signed by the parents or guardians were excluded from the survey.

A questionnaire designed by the AUDIT (Alcohol Use Disorder Identification Test) was applied, which is structured with scores that appear in the response options, which were added after the adolescents and young people answered the questions. The final scores promoted the framework of the same according to the levels of consumption highlighted below:

• Low risk consumption = 0 to 7 points;

• Risk consumption = 8 to 15 points;

• Harmful use or high risk consumption = 16 to 19 points;

• Probable dependence = 20 or more points (Maximum = 35 points).

Data were collected individually and, afterwards, statistical analysis was performed using tabulations using Statistical Package for Social Sciences (SPSS) and Microsoft Excel® for the presentation of variables.

This study complied with Resolution 466/12 of the National Health Council, which is based on the main international documents that emanate declarations and guidelines on research involving human beings. It was approved by the Research Ethics Committee (CEP) of Salgado de Oliveira University (UNIVERSO), receiving approval opinion nº 1,220,332 and under no. of CAAE: 48544615.2.0000.5289.


The AUDIT test results were presented in the tables, according to the number of alcoholic drinkers, the age of the first experiment, the influence on the beginning of consumption and the frequency of consumption.

Table 1 shows that 61.5% of the students interviewed reported that they never felt ill when drinking alcohol, and 76.9% never stopped performing tasks due to alcohol use. According to the data collected, most of the students interviewed affirm that they have never gone wrong, and that this consumption has never affected their daily activities.

Table 2 shows data related to risk factors associated with alcohol consumption among adolescents, where 53.8% of the adolescents are male and 46.1% are female. Alcohol consumption among adolescents between the ages of 14 years (30.7%) and 16 years (38.4%) was evidenced, showing that consumption of alcohol has been increasing in the daily life of these adolescents.

It was also found that 28.8% of adolescents consume alcohol less than once a month, and can be considered as social drinkers. However, this consumption of alcohol can become abusive and become alcoholism13.

The AUDIT test among adolescents identified the frequency of alcohol consumption as well as factors related to alcohol consumption. As recommended by the World Health Organization for this purpose, the AUDIT test is an instrument of easy application and cross-cultural validation used in different services.

For each test answer there is a score, the sum of the scores of all the questions, gives rise to the final score of each adolescent. The AUDIT test considers that if seven or more points are added there is a possibility that the teenager is consuming alcohol in a dangerous way.

Among the 52 participants in the AUDIT test, 55.7% of adolescents are low-risk (score = 0 to 7), 25% risk score (score = 8 to 15), 17.3% 16 to 19) and 1.9% are likely dependent (score = 20 to 35).


Adolescents should be considered to be in a period of life in which biological, social and psychological changes are taking place, and such changes make them more vulnerable, often including them in the at-risk group. consumption of licit and illicit drugs2-14.

The problematic use of alcohol by adolescents is associated with a number of impairments in the development of adolescence itself and in its later results. The losses resulting from the use of alcohol in an adolescent are different from the damages evidenced in an adult, either by existential specificities of this stage of life, or by neurochemical issues of this moment of cerebral maturation15.

Adolescent alcohol consumption is also associated with a series of school impairments, since memory is a fundamental function in the learning process, and it is committed to alcohol consumption16.

The fall in school performance, in turn, can decrease the self-esteem of the young, which represents a known risk factor for greater involvement with experimentation, consumption and abuse of psychoactive substances. Thus, the consequence of abusive use of alcohol for the adolescent could lead him / her to increase the consumption in a chain of feedback, instead of motivating him/her to diminish or to interrupt the use17. It is incumbent upon the nursing to carry out health education actions, investigate signs and symptoms, alleviate the current level of anxiety and devise strategies to promote effective socialization, in order to minimize future damages to health18.

It was observed that a large part of the young consume alcohol after the age of 14, at which age the consumption of alcoholic beverage is illegal in Brazil. This shows that adolescents have access to the drug in some way, even if the marketing and distribution of alcoholic beverages for children under 18 years of age are prohibited by Law No. 8069 of 1990 of the Statute of Children and Adolescents19.

Another important factor is the strong influence of friends in relation to the beginning of the consumption of alcoholic beverages. This pattern can be explained by the fact that adolescence is the phase in which the search for identity occurs and to be part of the same group to which other adolescents belong, perform practices justified by the need to feel an integral part of the group20.

The nurse has a fundamental role in the preventive actions for this public, as it is a key agent in the process of social transformation. It is necessary, however, the preparation of professionals to work with this clientele, since the care must be turned to the need to diagnose alcohol abuse and the harm caused by it to the adolescent's life18.

Health promotion activities tend to motivate the individual to act positively to achieve a higher level of health and well-being. The activities of disease prevention are designed to motivate the individual to avoid a negative condition, rather than to take positive action with the objective of maintaining the level of health18.

The National Policy on Alcohol has assumptions according to PNAD (National Policies on Alcohol and Other Drugs) 4, the main measures being: to stimulate the conduction of researches that carry out the situational and epidemiological diagnosis on the consumption of alcoholic beverages in Brazil; to make the population aware of the harmful effects of alcohol through educational campaigns; reduce the demand for alcohol in vulnerable populations, such as children and adolescents; to prevent traffic accidents related to alcoholism; and, finally, to encourage the regulation, monitoring and inspection of alcoholic beverages.

Such strategies for prevention and reduction of alcohol consumption by minors should involve public policies, campaigns, schools and interventions in the Emergency Services5.

The educational process, in addition to generating and disseminating knowledge, enables an expansion of knowledge in the human dimension and improvement of the quality of life. In the school environment, one must also "learn to be" and "learn to live". With this, we understand that health promotion is an action with great potential to be implemented in school spaces, since these are places of privileged dialogues to exchange knowledge and expression of cultural diversity, remembering that health education assists in the construction of individuals and collectivities that constitute society17.

In this context, it becomes necessary to analyze the role of the family by the importance it acquires in this phase of life. The family may have different roles, either in the induction of alcohol use or abuse in adolescence, or, on the contrary, as a protective institution for the health of adolescents, welcoming, supporting and guiding them.


The present study evidenced that adolescents have made increasingly precocious consumption of alcoholic drinks, in greater quantities and with easy access. The first use usually occurs at home, in the presence of family members and friends. Adolescents who drink are more likely to behave at risk, such as involvement in fights, accidents, school absenteeism, and risky sexual behavior. It is worth noting that advertising is an important incentive for consumption and that in Brazil there is a need for regulatory measures.

Adolescents should be specially monitored for representing a group that is more vulnerable to experimentation on alcoholic beverages, tobacco, and other drugs. Habits like these, acquired at this stage of life, tend to be fixed in adult life.

Considering the magnitude and complexity of the problem, the importance of the implementation of prevention programs directed at adolescents and their families is notable, and a more effective inspection of the sale of alcoholic beverages occurs, believing that greater awareness is necessary to minimize the ills caused by alcohol abuse over a lifetime.


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