Factors associated with health risk behaviors among Brazilian adolescents: an integrative review

Moura, Luciana Ramos de; Torres, Lilian Machado; Cadete, Matilde Meire Miranda; Cunha, Cristiane de Freitas

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Brasil

Revista da Escola de Enfermagem da USP

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Brasil

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Sumário

Review Article • Rev. esc. enferm. USP 52 • 2018 • https://doi.org/10.1590/S1980-220X2017020403304 copy

Factors associated with health risk behaviors among Brazilian adolescents: an integrative review^* * Extracted from the thesis: “Fatores associados aos comportamentos de risco para a saúde em adolescentes: um recorte do estudo de riscos cardiovasculares em adolescentes – ERICA”, Faculdade de Medicina, Universidade Federal de Minas Gerais, 2017.

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

Identifying knowledge about factors associated with health risk behaviors among Brazilian adolescents.

Method:

An integrative review of the literature conducted in the Cochrane, IBECS, LILACS, MEDLINE and SciELO databases in relation to risk behaviors recommended by the Centers for Disease Control and Prevention.

Results:

Thirty-seven (37) studies were analyzed, with a predominance of risky sexual behavior, tobacco use and violent behavior. Advancing age favored unprotected sex, alcohol and tobacco use. Family and friends influence was related to smoking and alcoholism. Males were more involved in situations of violence and the female gender was associated with physical inactivity. Belonging to a lower economic class was related to unprotected sex, physical inactivity, unhealthy dietary behaviors and violence. Studying in private school was related to unhealthy dietary behavior.

Conclusion:

Risk behaviors were related to social, economic and family factors and they tend to agglomerate.

DESCRIPTORS
Adolescent; Adolescent Health; Adolescent Behavior; Risk-Taking; Pediatric Nursing; Review

Authors	Objectives	Design	Factors associated with HRB among Brazilian adolescents
Bittencourt et al., 2013⁽⁸8. Bittencourt LJ, Nunes MO, Oliveira JJF, Caron J. Risco para transtornos alimentares em escolares de Salvador, Bahia, e a dimensão raça/cor. Rev Nutr. 2013;26(5):497-508. DOI: 10.1590/S1415-52732013000500001 https://doi.org/10.1590/S1415-5273201300... ⁾	To estimate risk factors associated with eating disorders in schoolchildren in the city of Salvador, Bahia.	Quantitative/descriptive/retrospective/cross-sectional	Non-white females are at risk of eating disorders (p=0.0087).
Fortes et al., 2013⁽⁹9. Fortes LS, Morgado FFR, Ferreira MEC. Fatores associados ao comportamento alimentar inadequado em adolescentes escolares. Rev Psiquiatr Clín. 2013;27(3):59-64. DOI: 10.1590/S0101-60832013000200002 https://doi.org/10.1590/S0101-6083201300... ⁾	To associate body dissatisfaction, degree of psychological commitment to exercise, body adiposity, nutritional status, economic level and ethnicity to inappropriate food behavior.	Quantitative/descriptive/retrospective/cross-sectional	The related HRB was associated with body dissatisfaction, exercise commitment and economic level for girls (p <0.05). For boys, body fat, body dissatisfaction and nutritional status were associated with inadequate dietary behavior (p <0.05). Body dissatisfaction among adolescents was the most important predictor for risk related to inadequate dietary patterns.
Fernandes et al., 2008⁽¹⁰10. Fernandes RA, Casonatto J, Christofaro DGD, Ronque ERV, Oliveira AR, Freitas Júnior IF. Riscos para o excesso de peso entre adolescentes de diferentes classes socioeconômicas. Rev Assoc Med Bras. 2008;54(4):334-8. DOI: 10.1590/S0104-42302008000400019 https://doi.org/10.1590/S0104-4230200800... ⁾	To analyze the association between risk factors and overweight among adolescents from different socioeconomic classes.	Quantitative/descriptive/retrospective/cross-sectional	Inadequate food intake among lower classes (OR=4.59) and parents being overweight (OR=5.33) were associated with being overweight. Among higher classes, the mother's schooling (OR=0.57), private school (OR=3.04) and parents being overweight (OR=3.47) were associated with being overweight.
Menezes et al., 2014⁽¹¹11. Menezes AHR, Dalmas JC, Scarinci IC, Maciel SM, Cardelli AAM. Fatores associados ao uso regular de cigarros por adolescentes estudantes de escolas públicas de Londrina, Paraná, Brasil. Cad Saúde Pública. 2014;30(4):774-84. DOI: 10.1590/0102-311X00173412 https://doi.org/10.1590/0102-311X0017341... ⁾	To identify factors associated with regular cigarette smoking by adolescents.	Quantitative/descriptive/retrospective/cross-sectional	The factors age ≥ 15 years (p=0.011) and having friends who smoke (p<0.0001) were associated with smoking.
Bonilha et al., 2013⁽¹²12. Bonilha AG, Souza EST, Sicchieri MP, Achcar JA, Crippa JAS, Baddini-Martinez J. A motivational profile for smoking among adolescents. J Addict Med. 2013;7(6):439-46. DOI: 10.1097/01.ADM.0000434987.76599.c0 https://doi.org/10.1097/01.ADM.000043498... ⁾	To characterize the motivators for smoking among adolescents and to investigate the influence of clinical and social elements.	Quantitative/descriptive/retrospective/cross-sectional	Advanced age, school failure, use of illicit drugs, alcohol abuse, high levels of perceived stress and the death of at least one parent were associated with smoking (p<0.05).
Oliveira et al., 2010⁽¹³13. Oliveira HF, Martins LC, Reato LF, Akerman M. Fatores de risco para uso do tabaco em adolescentes de duas escolas do município de Santo André, São Paulo. Rev Paul Pediatr. 2010;28(2):200-7. DOI: 10.1590/S0103-05822010000200012 https://doi.org/10.1590/S0103-0582201000... ⁾	To evaluate risk factors for tobacco use in students from two high schools in Santo André (SP).	Quantitative/descriptive/retrospective/cross-sectional	In the private school, mothers and friends who smoke were associated with trying smoking (p<0.01). In the public school, alcohol consumption, friends who smoke and contact with cigarette smoke were associated with trying smoking (p<0.01).
Vieira et al., 2008⁽¹⁴14. Vieira PC, Aerts DRGC, Fredo SL, Bittencourt A, Monteiro L. Uso de álcool, tabaco e outras drogas por adolescentes escolares em município do Sul do Brasil. Cad Saúde Pública. 2008;24(11):2487-98. DOI: 10.1590/S0102-311X2008001100004 https://doi.org/10.1590/S0102-311X200800... ⁾	To analyze the behavior of public school students of Gravataí (RS) in relation to the consumption of alcohol, tobacco and other drugs and associated factors.	Quantitative/descriptive/retrospective/cross-sectional	Smoking experimentation was 11.1 times higher among young people who reported having friends who smoke (p<0.000). Using tobacco and alcohol (last 30 days) was associated with feelings of sadness, isolation, difficulty in sleeping and suicidal ideation. The use of other drugs has been associated with reports of loneliness and suicide plans (p<0.000).
Tassitano et al., 2014⁽¹⁵15. Tassitano RM, Dumith SC, Chica DAG, Tenorio MCM. Aggregation of the four main risk factors to non-communicable diseases among adolescents. Rev Bras Epidemiol. 2014;17(2):465-78. DOI: 10.1590/1809-4503201400020014ENG https://doi.org/10.1590/1809-45032014000... ⁾	To assess the aggregation of the four main HRB (smoking, alcohol use, physical inactivity and low consumption of fruit, vegetables and greens) related to CNCD (Chronic Non-Communicable diseases) in Northeastern Brazil.	Quantitative/descriptive/retrospective/cross-sectional	The aggregation of HRB is a trend, particularly of tobacco and alcohol use, more observed among boys. Low physical activity and consumption below what is necessary of fruit, vegetables and greens was observed among the girls (p<0.05).
Petribú et al., 2011⁽¹⁶16. Petribú MMV, Tassitano RM, Nascimento WMF, Santos EM, Cabral PC. Factors associated with overweight and obesity among public high school students of the city of Caruaru, Northeast Brazil. Rev Paul Pediatr. 2011;29(4):536-45. DOI: 10.1590/S0103-05822011000400011 https://doi.org/10.1590/S0103-0582201100... ⁾	To investigate the prevalence and factors associated with overweight and obesity in high school students of the public state network in Caruaru (PE).	Quantitative/descriptive/retrospective/cross-sectional	Perception of stress (p=0.02), regular use of alcohol and physical inactivity were associated with overweight (p<0.001).
Moraes et al., 2009⁽¹⁷17. Moraes ACF, Fernandes CAM, Elias RGM, Nakashima ATA, Reichert FF, Falcão MC. Prevalence of physical inactivity and associated factors among high school students from state's public schools. Rev Assoc Med Bras. 2009;55(5):523-8. DOI: 10.1590/S0021-75572009000400006 https://doi.org/10.1590/S0021-7557200900... ⁾	To estimate the prevalence of physical inactivity among adolescents (14 to 18 years) in Maringá (PR) and its association with demographic, socioeconomic, behavioral and nutritional variables.	Quantitative/descriptive/retrospective/cross-sectional	Physical inactivity was prevalent among 56.9% of adolescents (boys=55.7%, p=0.46 and girls=57.9%). Lower socioeconomic status, being a public school student and being overweight were associated as risk factors.
Hallal et al., 2006⁽¹⁸18. Hallal PC, Bertoldi AD, Gonçalves H, Gomes VC. Prevalência de sedentarismo e fatores associados em adolescentes de 10-12 anos de idade. Cad Saúde Pública. 2006;22(6):1277-87. DOI: 10.1590/S0102-311X2006000600017 https://doi.org/10.1590/S0102-311X200600... ⁾	To evaluate the prevalence of sedentarism and associated factors in 4,452 adolescents aged 10 to 12 years, of a 1993 birth cohort in Pelotas (RS).	Quantitative/descriptive/Retrospective/Cohort	Being sedentary was positively associated with being a young women, with the socioeconomic level, to the fact that the mother was inactive and the amount of time in front of the television (p<0.001). Low economic level was associated to a higher number of times of active movement towards school (p<0.001).
Silva et al., 2014⁽¹⁹19. Silva RJS, Soares NMM, Oliveira ACC. Factors associated with violent behavior among adolescents in Northeastern Brazil. Sc World J. 2014;2014:863918. DOI: 10.1155/2014/863918. DOI 10.1155/2014/863918 https://doi.org/10.1155/2014/863918... ⁾	To identify the prevalence and factors associated with violent behavior among adolescents in the greater Aracaju area.	Quantitative/descriptive/retrospective/cross-sectional	An association was observed between violent behavior and smoking (p<0.01). Violent behavior was associated with the use of alcohol and cigarettes.
Malta et al., 2014⁽²⁰20. Malta DC, Medeiros MMD, Porto DL, Barreto SM, Morais Neto OL. Exposure to alcohol among adolescents and associated factors. Rev Saúde Pública [Internet]. 2014 [cited 2017 May 10];33(4):55-62. Available from:⁾	To analyze the prevalence of alcohol consumption among adolescent students and identify associated individual and contextual factors.	Quantitative/descriptive/retrospective/cross-sectional	When alcohol consumption was higher in the previous month, it was associated with: being 15 years of age or older; female; white skin; being the child of a mother with a higher education level; studying in private school; trying cigarettes; using drugs and cigarettes regularly and having had sexual intercourse (p=0.000).
Malta et al., 2010⁽²¹21. Malta DC, Sardinha LMV, Mendes I, Barreto SM, Giatti L, Castro IRR, et al. Prevalência de fatores de risco e proteção de doenças crônicas não transmissíveis em adolescentes: resultados da Pesquisa Nacional de Saúde do Escolar (PeNSE), Brasil, 2009. Ciênc Saúde Coletiva. 2010;15 Supl.2:3009-19. DOI: 10.1590/S1413-81232010000800002. https://doi.org/10.1590/S1413-8123201000... ⁾	To present the main results of the Student National Health Survey (Pesquisa Nacional de Saúde do Escolar).	Quantitative/descriptive/retrospective/cross-sectional	Occurrences of violence prevailed among boys.
Castro et al., 2011⁽²²22. Castro ML, Cunha SS, Souza DPO. Violence behavior and factors associated among students of Central-West Brazil. Rev Saúde Pública. 2011;45(6):10054-61. DOI: 10.1590/S0034-89102011005000072 https://doi.org/10.1590/S0034-8910201100... ⁾	To estimate the prevalence of violence among adolescents and young adults and identify the associated factors.	Quantitative/descriptive/retrospective/cross-sectional	Violence behaviors were associated with alcohol consumption (PR=2.51, 95% CI = 1.22-5.15), use of psychoactive drugs (PR=2.10, 95% CI = 1.61-2.75), males (PR=1.63, 95% CI = 1.13-2.35) and dissatisfaction in the relationship with parents (PR=1.64, 95% CI = 1.25-2.15). High prevalence of violence among 12-to-19-year-old male individuals, who consume alcohol and drugs, from families whose adolescents experience satisfactory relationships.
Teixeira et al., 2010⁽²³23. Teixeira SAM, Taquette SR. Violence and unsafe sexual practices in adolescents under 15 years of age. Rev Assoc Med Bras [Internet]. 2010 [cited 2017 Feb 17]; 56(4):440-6. Available from: http://www.scielo.br/pdf/ramb/v56n4/en_17.pdf DOI 10.1590/S0104-42302010000400017 http://www.scielo.br/pdf/ramb/v56n4/en_1... ⁾	Identify factors associated with unprotected sexual activity in female adolescents under 15 years of age.	Quantitative/descriptive/retrospective/cross-sectional	Unprotected sex was associated with the first relationship before the age of 13, sexual exploitation for commercial purposes, multiplicity of sexual partners, violence within the family, delay in school life, black race/skin color, unintended pregnancy and STDs (p<0.05).
Moreira et al., 2008⁽²⁴24. Moreira TC, Belmonte EL, Vieira FR, Noto AR, Ferigolo M, Barros HMT. Community violence and alcohol abuse among adolescents: a sex comparison. J Pediatr (Rio J.) [Internet]. 2008 [cited 2017 Feb 26];84(3):244-50. Available from: http://www.scielo.br/pdf/jped/v84n3/en_v84n3a10.pdf http://www.scielo.br/pdf/jped/v84n3/en_v... ⁾	To verify the existence of an association between victimization and alcohol use among boys and girls from Porto Alegre.	Quantitative/descriptive/retrospective/cross-sectional	Teenagers became drunk more than pre-teenagers; 32% of boys, 22% of girls who suffered intense violence reported being drunk at least once.
Assis et al., 2014⁽²⁵25. Assis SG, Gomes R, Pires TO. Adolescência, comportamento sexual e fatores de risco à saúde. Rev Saúde Pública. 2014;49(1):43-51. DOI: 10.1590/S0034-8910.2014048004638 https://doi.org/10.1590/S0034-8910.20140... ⁾	To analyze the relationship between sexual behavior and risk factors for physical or mental health among adolescents.	Quantitative/descriptive/retrospective/cross-sectional	Young people who declare being homo/bisexual in comparison to heterosexuals reported (p<0.05), respectively: getting drunk (18.7 and 10.5%), frequently using marijuana (6.1 and 2.1%), having suicidal thoughts (42.5 and 18.7%) and having suffered sexual violence (11.7 and 1.5%). Those who declared being homo/bisexual used condoms less frequently (74.2%) in relation to those who declared themselves as heterosexuals (48.6%, p<0.001).
Morrison et al., 2014⁽²⁶26. Morrison P, Smith AE, Akers A. Substance use and sexual risk among at-risk adolescents in Juiz de Fora, Minas Gerais State, Brazil. Cad Saúde Pública [Internet]. 2014 [cited 2017 May 10];30(4):794-804. Available from: http://www.scielo.br/pdf/csp/v30n4/0102-311X-csp-30-4-0794.pdf http://www.scielo.br/pdf/csp/v30n4/0102-... ⁾	To examine the difference in the prevalence of drug use and risky sexual behavior among high-risk adolescents in programs offered by organizations in the community of Juiz de Fora (MG).	Quantitative/descriptive/retrospective/crosssectional	Abandonment and homelessness associated with drug and alcohol use were more commonly reported by young males (p<0.05). The girls reported high-risk sexual behavior associated with crime (p<0.05). Young people belonging to NGOs had a lower propensity for HRB (p<0.05).
Oliveira-Campos et al., 2013⁽²⁷27. Oliveira-Campos M, Giatti L, Malta D, Barreto SM. Contextual factors associated with sexual behavior among brazilian adolescents. Ann Epidemiol. 2013;23(10):629-35. DOI: 10.1016/j.annepidem.2013.03.009. https://doi.org/10.1016/j.annepidem.2013... ⁾	To investigate the factors related to family and school contexts associated with sexual behavior	Quantitative/descriptive/retrospective/cross-sectional	21% of sexually active adolescents who did not use protection the last time they had sex. Never having meals with their parents increased the incidence of unprotected sex (OR=1.60).
Costa et al., 2013⁽²⁸28. Costa ACPJ, Lins AG, Araújo MFM, Araújo TM, Gubert FA, Vieira NFC. Vulnerabilidade de adolescentes escolares às DST/HIV, em Imperatriz – Maranhão. Rev Gaúcha Enferm. 2013;34(3):179-86. DOI: 10.1590/S1983-14472013000300023. https://doi.org/10.1590/S1983-1447201300... ⁾	To investigate the vulnerability of school adolescents in relation to STDs and HIV, identifying the main HRB and prevention.	Quantitative/descriptive/retrospective/cross-sectional	The habit of using condoms was associated with its use in the last sexual intercourse experienced by the majority of the youth (86.3%) (p=0.001).
Moura et al., 2013⁽²⁹29. Moura LR, Lamounier JR, Guimarães PR, Duarte JM, Belling MTC, Pinto JA, et al. The gap between knowledge on HIV/AIDS and sexual behavior: a study of teenagers in Vespasiano, Minas Gerais State, Brazil. Cad Saúde Pública. 2013;29(5):1008-18. DOI: 10.1590/S0102-311X2013000500018 https://doi.org/10.1590/S0102-311X201300... ⁾	To investigate the gaps in knowledge about HIV/AIDS and sexual behavior among high school adolescents.	Quantitative/descriptive/retrospective/cross-sectional	Sexual intercourse maintained in the last six months was associated with condom use the first time (p<0.001). Frequent condom use and having multiple partners were not associated with having knowledge about HIV/AIDS.
Silva et al., 2013⁽³⁰30. Silva AAA, Coutinho IC, Souza ASR. Fatores associados à recorrência da gravidez na adolescência em uma maternidade escola: estudo caso-controle. Cad Saúde Pública. 2013;29(3)496-506. DOI: 10.1590/S0102-311X2013000300008 https://doi.org/10.1590/S0102-311X201300... ⁾	To identify factors associated with the recurrence of pregnancy in adolescents.	Quantitative/descriptive/case control	Recurrence of pregnancy in adolescence was associated with the first sexual intercourse before 15 years, being primigravida (first time pregnant) before the age of 16, not gestation, associated factors were first sexual intercourse <15 years, age of first gestation <16 years, family income less than one minimum wage and the fact that they were not involved in the care of the children (p<0.0001). Change of partner was a protective factor (p=0.03).
Viana et al., 2007⁽³¹31. Viana FJM, Faúndes A, Mello MB, Sousa MH. Factors associated with safe sex among public school students in Minas Gerais, Brazil. Cad Saúde Pública. 2007;23(1):43-51. DOI: 10.1590/S0102-311X2007000100006 https://doi.org/10.1590/S0102-311X200700... ⁾	To evaluate factors associated with the practice of safe sex among sexually active adolescents from public schools in Minas Gerais.	Quantitative/descriptive/retrospective/cross-sectional	For young boys, the presence of health workers at the school was positively associated with indicators of safe sex. Having a mother with more than eight years of schooling was positively associated with condom use with a single partner or with occasional partners (p<0.005).
Martins et al., 2006⁽³²32. Martins LBM, Costa-Paiva LH, Osis MJD, Sousa MH, Pinto-Neto AM, Tadini V. Fatores associados ao uso de preservativo masculino e ao conhecimento sobre DST/AIDS em adolescentes de escolas públicas e privadas do Município de São Paulo, Brasil. Cad Saúde Pública. 2006;22(2):315-23. DOI: 10.1590/S0102-311X2006000200009 https://doi.org/10.1590/S0102-311X200600... ⁾	To compare knowledge about STD/AIDS and evaluate factors associated with knowledge and consistent male condom use among public and private schools of São Paulo (SP).	Quantitative/descriptive/retrospective/cross-sectional	Condom use was frequent and adequate in 60% of private schools and 57.1% of public schools (p<0.05). An association with young males and low socioeconomic status was observed. Being a girl, white and single were the factors most associated with knowledge about STDs (p<0.001).
Cureau et al., 2014⁽³³33. Cureau FV, Duarte P, Santos DL, Reichert FF. Clustering of risk factors for noncommunicable diseases in Brazilian adolescents: prevalence and correlates. J Phys Act Health. 2014;11(5):942-9. DOI: 10.1123/jpah.2012-0247 https://doi.org/10.1123/jpah.2012-0247... ⁾	To evaluate the agglomeration of risk factors and their associations with socio-demographic variables.	Quantitative/descriptive/retrospective/cross-sectional	The combination between unhealthy diets and sedentary lifestyle (OR=1.32, 95% CI: 1.16-1.49) prevailed. The aggregation of risk factors was directly associated with age and inversely associated with socioeconomic status.
Silva et al., 2014⁽¹⁹19. Silva RJS, Soares NMM, Oliveira ACC. Factors associated with violent behavior among adolescents in Northeastern Brazil. Sc World J. 2014;2014:863918. DOI: 10.1155/2014/863918. DOI 10.1155/2014/863918 https://doi.org/10.1155/2014/863918... ⁾	To investigate gender differences in the grouping of HRBs associated with CNCD in Brazilian adolescents	Quantitative/descriptive/retrospective/cross-sectional	Non-working adolescents and boys living in urban areas exhibited more HRB (boys: 183 PR=1.37, CI 95%: 1.20; 1.55; girls: PR=1.22; CI 95%:1.10; 1.35). Girls aged 17-19 years old and boys who had mothers with ≥12 years of schooling presented less HRB (PR=0.83, 0.72, 0.95) and (PR=0.79, 0.64, 0.98), respectively.
Dias et al., 2014⁽³⁴34. Dias PJP, Domingos IP, Ferreira MG, Muraro AP, Sichieri R, Gonçalves-Silva RM. Prevalence and factors associated with sedentary behavior in adolescents. Rev Saúde Pública. 2014;48(2):266-74. DOI: 10.1590/S0034-8910.2014048004635 https://doi.org/10.1590/S0034-8910.20140... ⁾	To analyze the prevalence of sedentarism and associated factors in adolescents.	Quantitative/descriptive/cross-sectional/cohort	The variables associated to sedentarism were: age (14 years) (OR=3.51, 95% CI 2.19, 5.60); high socioeconomic level (OR=3.83, 95% CI 2.10, 7.01), higher maternal education level (OR=1.81, 95% CI 1.09, 3.01); living in the country (OR=0.49, 95% CI 0.30, 0.81); the act of trying alcoholic beverages (OR=1.34, 95% CI 1.08, 1.66); and being overweight (OR=1.33, 95% CI 1.06, 1.68).
Abreu et al., 2011⁽³⁵35. Abreu MNS, Souza CF, Caiaffa WT. Tabagismo entre adolescentes e adultos jovens de Belo Horizonte, Minas Gerais, Brasil: influência do entorno familiar e grupo social. Cad Saúde Pública. 2011;27(5):935-43. DOI: 10.1590/S0102-311X2011000500011 https://doi.org/10.1590/S0102-311X201100... ⁾	To estimate the prevalence of smoking among adolescents from Belo Horizonte (MG) and evaluate associated factors.	Quantitative/descriptive/retrospective/cross-sectional	Smoking prevalence was 11.7%, associated with the factors: excessive alcoholic consumption (OR=20.6), age (OR=1.2); having a father who smokes (OR=4.0), or siblings (OR=2.5) or also close friends who are usual smokers (OR=5.2).
Vale et al., 2011⁽³⁶36. Vale A, Kerr L, Bosi M. Comportamentos de risco para transtornos do comportamento alimentar entre adolescentes do sexo feminino de diferentes estratos sociais do Nordeste do Brasil. Ciênc Saúde Coletiva. 2011;16(1):122-33. DOI: 10.1590/S1413-81232011000100016 https://doi.org/10.1590/S1413-8123201100... ⁾	To estimate the prevalence of eating disorders and to identify risk factors among female adolescents in Fortaleza (CE).	Quantitative/descriptive/retrospective/cross-sectional	The fear of gaining weight was reported by 62%, both by private school students and by public school students (p<0.05), however, predisposition for greater risk was accentuated in the youth from private institutions.
Farias et al., 2009⁽³⁷37. Farias Júnior JC, Nahas MV, Barros MVG, Loch MR, Oliveira ES, Bem MFL et al. Comportamentos de risco à saúde em adolescentes no Sul do Brasil: prevalência e fatores associados. Rev Panam Salud Publica. 2009;25(4):344-52. DOI: 10.1590/S1020-49892009000400009. https://doi.org/10.1590/S1020-4989200900... ⁾	To determine the prevalence of HRB and analyze factors associated with exposure in adolescents from the state of Santa Catarina.	Quantitative/descriptive/retrospective/cross-sectional	For every 10 young people, seven (64.7%) were simultaneously exposed to two or more HRB. The identified risk subgroups were: males, aged between 18 and 19 years, living in urban areas, studying at night and with high family income.
Castro et al., 2008⁽³⁸38. Castro IRR, Cardoso LO, Engstrom EM, Levy RB, Monteiro CA. Vigilância de fatores de risco para doenças não transmissíveis entre adolescentes: a experiência da cidade do Rio de Janeiro, Brasil. Cad Saúde Pública. 2008;24(10):2279-88. DOI: 10.1590/S0102-311X2008001000009 https://doi.org/10.1590/S0102-311X200800... ⁾	To present methods and results of the risk factor surveillance system for CNCD among adolescents.	Quantitative/descriptive/retrospective/cross-sectional	Tobacco consumption and a lower rate of physical activity were more present in females.
Peres et al., 2008⁽³⁹39. Peres CA, Rutherford G, Borges G, Galano E, Hudes ES, Hearst N. Family structure and adolescent sexual behavior in a poor area of São Paulo, Brazil. J Adolesc Health. 2008;42(2):177-83. DOI: 10.1016/j.jadohealth.2007.08.007 https://doi.org/10.1016/j.jadohealth.200... ⁾	To examine the influence of family structure on HRB among lowincome adolescents.	Quantitative/descriptive/retrospective/cross-sectional	The rates of several HRB were lower among adolescents living with both parents and greater among those living with neither of them.
Campos et al., 2011⁽⁴⁰40. Campos JADB, Almeida JC, Garcia PPNS, Faria JB. Consumo de álcool entre estudantes do ensino médio do município de Passos-MG. Ciênc Saúde Coletiva. 2011;16(12):4745-54. DOI: 10.1590/S1413-81232011001300023. https://doi.org/10.1590/S1413-8123201100... ⁾	To identify the pattern of alcohol consumption among high school students of Passos (MG) and its association with sociodemographic factors.	Quantitative/descriptive/retrospective/cross-sectional	High risk for young boys who work and have problems with their mothers. They described precocity in contact with alcohol and there was a high prevalence of behaviors that represent a risk for alcoholism.
Vieira et al., 2007⁽⁴¹41. Vieira DL, Ribeiro M, Laranjeira R. Evidence of association between early alcohol use and risk of later problems. Rev Bras Psiquiatr. 2007;29(3):222-27. DOI: 10.1590/S1516-44462007000300006 https://doi.org/10.1590/S1516-4446200700... ⁾	To investigate the relation between age of onset of alcohol use, consumption pattern and related problems.	Quantitative/descriptive/retrospective/cross-sectional	Those who started drinking earlier reported having consumed a higher number of doses per use (p=0.013) and they presented and had more drunken episodes in the last month (p=0.05). Their age when they experimented with alcohol and tobacco use (p=0.017) and other drugs (p=0.047) were associated.
Costa et al., 2007⁽⁴²42. Costa MCO, Alves MVQM, Santos CAST, Carvalho RC, Souza KE, Sousa HL. Experimentação e uso regular de bebidas alcoólicas, cigarros e outras substâncias psicoativas/SPA na adolescência. Ciênc Saúde Coletiva. 2007;12(5):1143-54. DOI: 10.1590/S1413-81232007000500011 https://doi.org/10.1590/S1413-8123200700... ⁾	To analyze the use of alcoholic beverages, cigarettes, other psychoactive substances and risk factors among adolescents of the schools of a municipality with 500 thousand inhabitants in Bahia.	Quantitative/descriptive/retrospective/cross-sectional	The use of alcohol, tobacco and other substances were significantly higher between 17-19 years and in younger boys. The main reasons were related to the fact they were more curious, proximity to parents and friends, participation in festive celebrations and staying at a friend's house.
Wesselovicz et al. 2008⁽⁴³43. Wesselovicz1 AAG, Souza TG, Kaneshima EK, Souza-Kaneshima1 AM. Fatores associados ao consumo de bebidas alcoólicas pelos adolescentes de uma escola pública da cidade de Maringá, estado do Paraná. Acta Sci Health Sci. 2008;30(2):161-66. DOI: 10.4025/actaschhealthsci.v30i2.917. https://doi.org/10.4025/actaschhealthsci... ⁾	To identify the factors associated with the consumption of alcoholic beverages by adolescents of a public school.	Quantitative/descriptive/retrospective/cross-sectional	32.30% of the adolescents admitted that they had become used to drinking alcohol with their family members, and the rest reported that it happened under the influence of friends.

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[1] Corresponding author: Luciana Ramos de Moura, Alameda Ezequiel Dias, 275, 4° andar CEP 30130-110 – Belo Horizonte, MG, Brazil lulysramos29@yahoo.com.br