Factors associated with alcohol, tobacco and illicit drug use among Brazilian undergraduate students

Simplício, Mayla Paula Torres; Silva, Leonardo Barbosa e; Juvanho, Leidjaira Lopes; Priore, Silvia Eloiza; Franceschini, Sylvia do Carmo Castro

doi:10.1590/0034-7167-2020-1244

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Revista Brasileira de Enfermagem

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Sumário

ORIGINAL ARTICLE • Rev. Bras. Enferm. 74 (3) • 2021 • https://doi.org/10.1590/0034-7167-2020-1244 copy

Factors associated with alcohol, tobacco and illicit drug use among Brazilian undergraduate students

Factores relacionados al uso de alcohol, tabaco y drogas ilícitas en estudiantes de grado brasileños

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objectives:

to analyze the factors associated with the use of alcohol, tobacco and illicit drugs among Brazilian undergraduate students.

Methods:

observational, cross-sectional study, with convenience sampling, conducted in 2014/2015, involving institutional data and a self-completed online questionnaire, analyzed using measures of frequency, central tendency/dispersion and logistic regression.

Results:

among 126,326 students, 62.8% reported alcohol use; 11%, tobacco; and 7.5%, illicit drugs. Several academic factors-such as not residing with family (sororities [alcohol: aOR:2.38;95%CI:2.28-2.48; tobacco: AOR:2.20;95%CI:2.09-2.33; illicit drugs: AOR:2.53;95%CI:2.38-2.70]), acting in university movements (student [alcohol: AOR:1.74;95%CI:1.65-1.83; tobacco: AOR:1.97;95%CI:1.86-2.08; illicit drugs: AOR:2.43;95%CI:2.28-2.59] and religious [alcohol: AOR:0.28;95%CI:0.26-0.29; tobacco: AOR:0.23;95%CI:0.21-0.26; illicit drugs: AOR:0.18;95%CI:0.16-0.21]) and lack of discipline/study habit (alcohol: AOR:1.41;95%CI:1.37-1.45; tobacco: AOR:1.53;95%CI:1.46-1.59; illicit drugs: AOR:1.85;95%CI:1.76-1.94) - were associated with the use of the three categories of substances.

Conclusions:

we identified that a number of academic factors are associated with licit and illicit drug use. These findings may help in designing preventive strategies among college students.

Descriptors:
Public Health; Universities; Alcohol Drinking in College; Tobacco Use; Illicit Drugs

Variables	% (n)
Age (years)	24.0 ± 6.5^a a mean ± standard deviation.
Sex
Male	42.9 (54,147)
Female	57.0 (71,987)
Not declared	0.2 (192)
Color or race
White	44.9 (56,667)
Yellow	2.3 (2,879)
Brown	38.7 (48,846)
Black	9.8 (12,339)
Indigenous	0.6 (764)
Not declared	3.8 (4,831)
Mother's education level
Without formal education	3.7 (4,651)
Incomplete elementar school	22.4 (28,235)
Complete elementar school	10.1 (12,772)
Complete Highschool	34.1 (43,113)
Complete higher education	19.2 (24,196)
Complete post-graduation	10.4 (13,110)
No mother or person who played such a role in the upbringing	0.2 (249)
Marital status
No partner (single, divorced or widowed)	88.4 (111,706)
With partner (married or in a stable union)	11.6 (14,620)
Gross family income per capita
Up to ½ minimum wage	32.6 (41,128)
> ½ up to 1 minimum wage	22.0 (27,798)
> 1 up to 2 minimum wages	24.7 (31,265)
> 2 up to 3 minimum wages	13.8 (17,379)
> 3 up to 4 minimum wages	4.1 (5,195)
> 4 up to 5 minimum wages	0.9 (1,182)
> 5 up to 6 minimum wages	1.2 (1,539)
> 6 up to 7 minimum wages	0.1 (187)
> 7 up to 8 minimum wages	0.1 (109)
> 8 up to 9 minimum wages	0.1 (101)
> 9 up to 10 minimum wages	0.1 (96)
> 10 minimum wages	0.3 (347)
Paid work
No	69.5 (87,827)
Yes	30.5 (38,499)
Children
No	89.0 (112,368)
Yes	11.0 (13,958)
Location
Capital	45.6 (57,644)
Countryside	54.4 (68,682)

Explanatory variables	%	Alcohol		Tobacco		Illicit Drugs
Explanatory variables	%	Crude OR(95%CI)	Adjusted OR(95%CI)^a a adjusted analyses according to age, sex, color/race, maternal education, marital status, gross family income per capita, having paid jobs and children, and university location (capital or interior);	Crude OR(95%CI)	Adjusted OR(95%CI)^a a adjusted analyses according to age, sex, color/race, maternal education, marital status, gross family income per capita, having paid jobs and children, and university location (capital or interior);	Crude OR(95%CI)	Adjusted OR(95%CI)^a a adjusted analyses according to age, sex, color/race, maternal education, marital status, gross family income per capita, having paid jobs and children, and university location (capital or interior);
Academic year	1.8±1.7^b b mean ± standard deviation;	1.11(1.10-1.12)	1.06(1.05-1.07)	1.05(1.04-1.06)	-	1.06(1.05-1.07)	1.02(1.01-1.04)
Area of study
Health Sciences	14.4	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.
Agricultural Sciences	7.0	1.34(1.27-1.41)	1.20(1.13-1.27)	1.68(1.54-1.83)	1.48(1.35-1.62)	1.27(1.14-1.42)	1.08(0.96-1.21)
Biological Sciences	4.7	0.97(0.91-1.03)	1.07(1.00-1.14)	1.30(1.17-1.44)	1.34(1.20-1.49)	1.56(1.39-1.76)	1.64(1.45-1.86)
Exact and Earth Sciences	14.7	0.93(0.89-0.96)	0.82(0.79-0.86)	1.21(1.12-1.31)	1.01(0.93-1.09)	1.07(0.98-1.18)	0.89(0.81-0.99)
Applied Social Sciences	20.7	1.21(1.16-1.26)	1.09(1.05-1.15)	1.71(1.60-1.83)	1.48(1.37-1.59)	1.79(1.65-1.93)	1.53(1.40-1.67)
Human Sciences	15.4	1.07(1.03-1.12)	1.12(1.06-1.17)	2.28(2.13-2.44)	2.19(2.03-2.37)	2.44(2.25-2.64)	2.55(2.34-2.78)
Engineering	15.8	1.49(1.43-1.56)	1.08(1.04-1.14)	1.41(1.31-1.52)	1.00(0.93-1.08)	1.30(1.19-1.42)	0.84(0.77-0.93)
Linguistics, Letters and Arts	7.4	0.84(0.80-0.88)	0.87(0.82-0.92)	1.99(1.84-2.16)	1.85(1.70-2.03)	2.00(1.81-2.20)	1.99(1.79-2.21)
Campus
Headquarters	72.3	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.
Advanced	27.7	0.82(0.80-0.84)	0.79(0.76-0.82)	0.76(0.73-0.79)	0.80(0.76-0.85)	0.66(0.63-0.70)	0.82(0.77-0.87)
Shift
Full time	43.1	Ref.	Ref.	Ref.	Ref.	Ref.	-
Day	28.2	0.77(0.75-0.79)	0.94(0.91-0.97)	0.97(0.93-1.01)	0.94(0.90-0.99)	0.98(0.94-1.04)	-
Night	28.7	0.90(0.88-0.93)	1.06(1.02-1.09)	1.15(1.10-1.20)	1.04(0.99-1.09)	1.00(0.95-1.05)	-
Admission modality
Broad competition	66.5	Ref.	Ref.	Ref.	Ref.	Ref.	-
Quota	33.5	0.78(0.77-0.80)	1.04(1.01-1.07)	0.78(0.75-0.81)	0.93(0.89-0.97)	0.76(0.73-0.80)	-
Time spent out of class studying
Up to 5 hours/week	32.5	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.
> 5 to 10 hours/week	29.6	1.08(1.05-1.11)	1.05(1.01-1.08)	0.92(0.88-0.96)	0.94(0.90-0.98)	0.91(0.86-0.96)	0.90(0.85-0.95)
> 10 to 15 hours/week	14.8	1.05(1.02-1.09)	1.01(0.97-1.05)	0.82(0.77-0.87)	0.83(0.78-0.88)	0.78(0.73-0.83)	0.75(0.70-0.80)
> 15 to 20 hours/week	10.1	0.97(0.93-1.01)	0.92(0.88-0.96)	0.77(0.72-0.82)	0.80(0.75-0.86)	0.66(0.60-0.71)	0.64(0.59-0.71)
> 20 to 25 hours/week	6.1	0.84(0.80-0.89)	0.81(0.76-0.85)	0.66(0.60-0.71)	0.71(0.65-0.78)	0.62(0.56-0.68)	0.63(0.56-0.71)
> 25 hours/week	6.8	0.75(0.72-0.79)	0.68(0.65-0.72)	0.64(0.59-0.69)	0.67(0.61-0.73)	0.55(0.50-0.61)	0.55(0.49-0.61)
Participation in academic activities or programs^c c junior enterprise, internship, PET (Tutorial Education Program) or teaching activities/programs (monitoring, PIBID, PLI etc.), extension (PIBEXT, PEIC etc.) and research (PIBIC, PIBIT etc.);
No	50.7	Ref.	Ref.	Ref.	-	Ref.	Ref.
Yes (Unpaid)	17.1	1.43(1.38-1.47)	1.15(1.11-1.19)	1.20(1.14-1.26)	-	1.31(1.23-1.39)	0.98(0.92-1.04)
Yes (Paid)	32.1	1.31(1.28-1.34)	1.14(1.11-1.18)	1.15(1.10-1.20)	-	1.41(1.34-1.47)	1.11(1.05-1.17)
Enrolled in a course that corresponds to your first choice
Yes	84.9	Ref.	-	Ref.	Ref.	Ref.	-
No	15.1	0.91(0.88-0.94)	-	1.05(1.00-1.10)	1.08(1.03-1.14)	0.96(0.90-1.02)	-
Intention to change course
Yes	61.4	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.
No	20.2	0.91(0.89-0.94)	1.01(0.98-1.04)	1.13(1.08-1.18)	1.14(1.09-1.20)	1.10(1.04-1.16)	1.14(1.07-1.20)
Doesn't know	18.4	1.12(1.09-1.16)	1.13(1.09-1.17)	1.23(1.17-1.28)	1.19(1.14-1.25)	1.26(1.19-1.33)	1.17(1.10-1.24)
Type of housing
With family (parents, spouse or relatives)	65.9	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.
Alone	10.2	1.68(1.61-1.75)	1.38(1.32-1.45)	1.63(1.54-1.73)	1.42(1.33-1.51)	1.46(1.36-1.57)	1.39(1.29-1.50)
University housing	2.6	1.74(1.61-1.88)	1.82(1.68-1.98)	1.81(1.65-2.00)	1.83(1.64-2.05)	2.30(2.07-2.56)	2.53(2.23-2.87)
Communal living	15.0	2.68(2.58-2.78)	2.38(2.28-2.48)	2.18(2.09-2.28)	2.20(2.09-2.33)	2.37(2.26-2.50)	2.53(2.38-2.70)
Other (boarding house, hotel, boarding house, rooming house or in a friend's house)	6.2	1.33(1.26-1.39)	1.47(1.39-1.55)	1.20(1.11-1.30)	1.33(1.23-1.45)	1.34(1.23-1.47)	1.62(1.47-1.79)
Participation in student assistance psychological consultations
No	91.0	Ref.	-	Ref.	Ref.	Ref.	Ref.
Yes	9.0	1.23(1.16-1.30)	-	1.50(1.40-1.62)	1.22(1.12-1.32)	1.36(1.28-1.46)	1.33(1.21-1.46)
Participation in student health care services
No	95.3	Ref.	Ref.	Ref.	Ref.	Ref.	-
Yes	4.7	1.29(1.24-1.34)	1.12(1.06-1.18)	1.33(1.26-1.41)	1.10(1.03-1.18)	1.69(1.55-1.83)	-
Participation in a student care program in the area of culture
No	90.6	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.
Yes	9.4	1.36(1.31-1.42)	1.16(1.11-1.22)	1.60(1.52-1.69)	1.25(1.18-1.33)	1.87(1.77-1.99)	1.29(1.21-1.38)
Participation in a student care program in the area of sports and leisured
No	96.2	Ref.	-	Ref.	-	Ref.	-
Yes	3.8	1.39(1.31-1.48)	-	1.32(1.21-1.43)	-	1.54(1.40-1.69)	-
Provision, by the university, of conditions for the realization of some of its physical activities
No	75.8	Ref.	Ref.	Ref.	-	Ref.	Ref.
Yes	24.2	1.36(1.33-1.40)	1.17(1.13-1.20)	1.20(1.16-1.25)	-	1.32(1.26-1.39)	1.07(1.02-1.13)
Preferred medical care network
Public, informal help from friends or family, or none	53.9	Ref.	Ref.	Ref.	-	Ref.	Ref.
Private network (no health insurance plan)	4.8	1.24(1.18-1.31)	1.05(0.99-1.12)	1.00(0.91-1.09)	-	0.94(0.84-1.05)	0.85(0.75-0.95)
Private network (with health insurance plan)	38.1	1.60(1.56-1.64)	1.15(1.12-1.19)	1.22(1.17-1.27)	-	1.41(1.35-1.47)	1.00(0.95-1.06)
Health services offered by the university itself	3.2	1.52(1.42-1.63)	0.97(0.89-1.05)	1.39(1.27-1.53)	-	1.63(1.47-1.82)	1.05(0.93-1.19)
Participation in an artistic-cultural movement
No	95.3	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.
Yes	4.7	1.72(1.62-1.82)	1.52(1.42-1.62)	3.17(2.98-3.37)	2.03(1.89-2.18)	4.29(4.02-4.57)	2.45(2.27-2.65)
Participation in ecological movement
No	98.0	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.
Yes	2.0	1.50(1.37-1.63)	1.13(1.03-1.25)	2.33(2.12-2.57)	1.34(1.20-1.49)	3.43(3.11-3.78)	1.87(1.66-2.10)
Participation in student movement
No	91.4	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.
Yes	8.6	2.04(1.95-2.14)	1.74(1.65-1.83)	2.77(2.64-2.91)	1.97(1.86-2.08)	3.84(3.64-4.05)	2.43(2.28-2.59)
Participation in religious movement
No	91.7	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.
Yes	8.3	0.29(0.28-0.31)	0.28(0.26-0.29)	0.25(0.22-0.28)	0.23(0.21-0.26)	0.21(0.18-0.24)	0.18(0.16-0.21)
Participation in political party
No	97.9	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.
Yes	2.1	2.08(1.90-2.28)	1.70(1.54-1.88)	2.79(2.55-3.05)	1.56(1.41-1.73)	3.24(2.94-3.57)	1.65(1.47-1.85)
Difficulties with significant interference in life or academic context:
Difficulties in adapting to new situations (city, housing, distance from family, among others)
No	77.7	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.
Yes	22.3	1.14(1.11-1.17)	0.95(0.92-0.99)	1.12(1.07-1.16)	0.93(0.89-0.97)	1.16(1.11-1.22)	0.90(0.85-0.95)
Difficulty in access to materials and means of study (books, computer, other)
No	81.9	Ref.	Ref.	Ref.	-	Ref.	-
Yes	18.1	0.86(0.83-0.88)	0.91(0.88-0.95)	1.05(1.01-1.10)	-	1.07(1.01-1.13)	-
Financial difficulties
No	58.9	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.
Yes	41.1	0.93(0.91-0.95)	1.20(1.17-1.23)	1.17(1.13-1.21)	1.32(1.27-1.38)	1.12(1.07-1.17)	1.29(1.23-1.36)
Learning Difficulty
No	83.7	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.
Yes	16.3	0.92(0.89-0.95)	0.94(0.91-0.97)	0.96(0.91-1.00)	0.94(0.89-0.99)	0.94(0.89-1.00)	0.92(0.86-0.98)
Lack of discipline/study habit
No	71.2	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.
Yes	28.8	1.65(1.61-1.70)	1.41(1.37-1.45)	1.80(1.73-1.87)	1.53(1.46-1.59)	2.35(2.25-2.45)	1.85(1.76-1.94)
Excessive student workload
No	69.8	Ref.	-	Ref.	Ref.	Ref.	-
Yes	30.2	1.06(1.03-1.08)	-	0.93(0.89-0.96)	0.90(0.87-0.94)	1.01(0.96-1.06)	-
Difficulties in the teacher-student relationship
No	81.0	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.
Yes	19.0	1.33(1.30-1.38)	1.14(1.10-1.18)	1.32(1.27-1.38)	1.14(1.09-1.20)	1.47(1.40-1.54)	1.17(1.10-1.23)

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[1] Corresponding author: Mayla Paula Torres Simplício E-mail: mayla.simplicio@ufv.br