Original Article
Childhood Alcohol Use May Predict Adolescent Binge Drinking: A Multivariate Analysis among Adolescents in Brazil

Portions of this study were presented during the World Psychiatry Association Meeting, March 14-17, 2012, in São Paulo, Brazil.
https://doi.org/10.1016/j.jpeds.2013.01.029Get rights and content

Objectives

To test the hypothesis that first alcohol use during childhood is associated with heavy drinking patterns during adolescence and with parental drinking patterns and parental rules about alcohol consumption.

Study design

A national cross-sectional survey of 17 371 high-school students. Students were drawn from 789 public and private schools in all the Brazilian state capitals using a multistage probabilistic sampling method and a self-report questionnaire. Weighted data were analyzed through logistic regression testing for differences on the associated factors for first use of alcohol during childhood. Survival analysis and Cox proportional hazard models were used to confirm results.

Results

Among the 82% alcohol lifetime users, 11% had first used alcohol before age 12 years. The lack of perception of possible punishment by parents is associated with childhood alcohol use (OR 2.22, 95% CI 1.67-2.95). Adolescents who first used alcohol during childhood compared with those who only used alcohol at later ages are more likely to engage in binge drinking behaviors (OR 1.57, 95% CI 1.17-2.10), to have a pattern of heavy alcohol use (OR 1.98, 95% CI 1.26-3.09), and to have recently used illegal drugs (OR 1.74, 95% CI 1.39-2.16). According to hazard ratios, students with an earlier age of onset were more likely to have used tobacco and any illegal drug in the past year.

Conclusions

Childhood alcohol may be a risk factor for the most dangerous patterns of alcohol use in adolescence and is associated with parental alcohol use. Parental rules about child alcohol use must be clear because perception of punishment might delay the age of first alcohol use.

Section snippets

Methods

Data came from a cross-sectional survey of youths attending school in all the 27 Brazilian state capitals, with classroom survey data collected in 2010 from a sample of the cities’ private and public schools. The study’s target population was designed as a representative multistage probabilistic sample of high school students (10th-12th grades) in these schools, with a 2-step random selection process. A total of 789 schools participated in this study, with a school response rate of 86%. The

Results

Among the 17 366 students who answered the question about lifetime alcohol use, 81.7% (14 146 students) (95% CI 80.5%-82.7%) declared that they have tried alcohol at least once in their lifetime. Among the alcohol lifetime users, 10.9% (95% CI 10.0%-11.8%) had first used alcohol before age 12 years (1080 students).

Descriptive statistics of the 2 groups (alcohol onset before or after 12 years) and bivariate analysis showed an association between earlier age of onset and risky alcohol and other

Discussion

This study indicates that the earlier the onset of alcohol use, the higher is the risk of alcohol misuse (eg, BD and heavy drinking) and other drug use during adolescence. Maternal drinking, private school attendance, and the lack of perception of the possibility of being punished for drunkenness were associated an early onset of alcohol use.

Before detailed discussion of our findings, a few limitations should be mentioned. Due to the fact that a self-report questionnaire was used, the questions

References (45)

  • P.L. Ellickson et al.

    Ten-year prospective study of public health problems associated with early drinking

    Pediatrics

    (2003)
  • T.C. Moreira et al.

    Community violence and alcohol abuse among adolescents: a sex comparison

    J Pediatr (Rio J)

    (2008)
  • M. Soldera et al.

    Heavy alcohol use among elementary and high-school students in downtown and outskirts of Campinas City-São Paulo: prevalence and related factors

    Rev Bras Psiquiatr

    (2004)
  • L. Chassin et al.

    Binge drinking trajectories from adolescence to emerging adulthood in a high-risk sample: predictors and substance abuse outcomes

    J Consult Clin Psychol

    (2002)
  • T. Naimi et al.

    Binge drinking among US adults

    JAMA

    (2003)
  • Greenblatt J. Patterns of alcohol use among adolescents and associations with emotional and behavioral problems. OAS...
  • M. Romano et al.

    Alcohol purchase survey by adolescents in two cities of State of Sao Paulo, Southeastern Brazil

    Rev Saude Publica

    (2007)
  • D.L. Vieira et al.

    Alcohol and adolescents: study to implement municipal policies

    Rev Saude Publica

    (2007)
  • J.C.F. Galduróz et al.

    Trends in drug use among students in Brazil: analysis of four surveys in 1987, 1989, 1993 and 1997

    Braz J Med Biol Res

    (2004)
  • T. Pitkänen et al.

    Age of onset of drinking and the use of alcohol in adulthood: a follow-up study from age 8–42 for females and males

    Addiction

    (2005)
  • H.H. Samson et al.

    The relation of initial alcohol experiences to current alcohol consumption in a college population

    J Stud Alcohol

    (1989)
  • J.D. Sargent et al.

    Does parental disapproval of smoking prevent adolescents from becoming established smokers?

    Pediatrics

    (2001)
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    Funded by the SENAD (National Secretariat for Drug Policies) of the Brazilian Federal Government, which had no role in study design; the collection, analysis, and interpretation of data; the writing of the report, or in the decision to submit the paper for publication. S.M. receives research support from the National Institutes of Health (National Institute on Drug Abuse DA023434 and Eunice Kennedy Shriver National Institute of Child Health and Human Development HD060072). The authors declare no conflicts of interest.

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