André Bedendo

Web-based self-help intervention reduces alcohol consumption in both heavy-drinking and dependent alcohol users: A pilot study.

As part of a multicenter project supported by the World Health Organization, we developed a web-based intervention to reduce alcohol use and related problems. We evaluated the predictors of adherence to, and the outcomes of the intervention. Success was defined as a reduction in consumption to low risk levels or to <50% of the baseline levels of number of drinks. From the 32,401 people who accessed the site, 3389 registered and 929 completed the full Alcohol Use Disorders Identification Test (AUDIT), a necessary condition to be considered eligible to take part in the intervention. Based on their AUDIT scores, these participants were classified into: low risk users (LRU; n=319) harmful/hazardous users (HHU; n=298) or suggestive of dependence users (SDU; n=312). 29.1% of the registered users (LRU=42; HHU=90; SDU=82) completed the evaluation form at the end of the six-week period, and 63.5% reported low-risk drinking levels. We observed a significant reduction in alcohol consumption in the HHU (62.5%) and SDU (64.5%) groups in relation to baseline. One month after the intervention, in the follow-up, 94 users filled out the evaluation form, and their rate of success was similar to the one observed in the previous evaluation. Logistic regression analyses indicated that HHU participants presented higher adherence than LRU. Despite a relatively low adherence to the program, its good outcomes and low cost, as well as the high number of people that can be reached by a web-based intervention, suggest it has good cost-effectiveness.

Sports practices related to alcohol and tobacco use among high school students.

OBJECTIVE To examine the relationship between alcohol and tobacco use and sports in a national sample of secondary students. METHODS This cross-sectional study enrolled a representative sample of secondary students from public and private schools from all 27 Brazilian state capitals. Students were assessed in 2010 by a self-report questionnaire including questions on drug use and sport activity in the last month (n=13,872). RESULTS Subjects who played sports exhibited a higher frequency of alcohol use and heavy episodic drinking than their peers who did not play sports. Practices that were associated with higher odds of heavy episodic drinking in the last month included gym, weight training (adjusted odds ratio [aOR]: 2.0, 95% confidence interval [95%CI] 1.6-2.4), and soccer (aOR: 1.3, 95%CI 1.1-1.5). Fighting, martial arts, or capoeira were associated with smoking (aOR: 1.9, 95%CI 1.2-3.2). CONCLUSION These results suggest a relationship between some sports preferences and a higher risk of alcohol or tobacco use among Brazilian secondary students. This relationship should be considered in preventive programs.

Estilos parentais como fator de proteção ao consumo de tabaco entre adolescentes brasileiros

The objective was to evaluate the relationship between tobacco use (previous month and frequent use), parenting styles and parental smoking behavior in a sample of high school students. Participants were recruited from public and private high schools from 27 Brazilian state capitals (N = 17,246). The overall prevalence of tobacco use in life was 25.2%; 15.3% in the previous year; 8.6% in the previous month; and 3.2% for frequent use. Tobacco use by the parents was reported by 28.6% of the students. Regarding parenting styles, 39.2% were classified as negligent, 33.3% authoritative, 15.6% as indulgent and 11.9% authoritarian. Compared to adolescents with authoritative parents, those with negligent or indulgent parents were more prone to report tobacco use during the last month or frequent use. This study showed an association between parenting styles and tobacco use by high school students. Authoritative parents were associated with protection from frequent and previous month tobacco use among adolescents.El objetivo fue analizar la asociacion entre el consumo de tabaco (durante el mes y su frecuencia) con los estilos parentales y el habito de fumar de los padres, en una muestra de estudiantes de secundaria. Los participantes fueron reclutados de escuelas publicas y privadas de 27 capitales estatales de Brasil (n = 17.246). La prevalencia de uso en la vida fue un 25,2%, en el ultimo ano 15,3%, en el ultimo mes 8,6%, y 3,2% de uso frecuente. El consumo de tabaco parental fue reportado por un 28,6% de los estudiantes. 39,2% de los padres fueron clasificados como negligentes, 33,3% autoritativos, 15,6% indulgentes y 11,9% autoritarios. Comparados con los adolescentes con padres autoritativos, aquellos con padres negligentes o indulgentes reportaron mas uso de tabaco durante el ultimo mes o uso frecuente. Se encontro asociacion entre estilos parentales y uso de tabaco por parte de los estudiantes. El estilo parental autoritativo se asocio con la proteccion para el uso del tabaco en el mes y frecuencia entre los adolescentes.

Binge drinking: padrão associado ao risco de problemas do uso de álcool entre universitários

ABSTRACT Objective: to evaluate problems associated with alcohol use among university students who reported binge drinking in comparison to students who consumed alcohol without binging. Method: a cross-sectional study among university students (N=2,408) who accessed the website about alcohol use. Logistic and linear regression models were included in the statistical analyzes. Results: alcohol use in the last three months was reported by 89.2% of university students; 51.6% reported binge drinking. Compared to students who did not binge drink, university students who presented this pattern were more likely to report all evaluated problems, among them: black out (aOR: 5.4); having academic problems (aOR: 3.4); acting impulsively and having regrets (aOR: 2.9); getting involved in fights (aOR: 2.6); drinking and driving (aOR: 2.6) and accepting a ride with someone who had drunk alcohol (aOR: 1.8). Students who binged also had higher scores on the Alcohol Use Disorders Identification Test (b=4.6; p<0.001), more negative consequences (b=1.0; p<0.001) and a reduced perception of the negativity of the consequences (b=-0.5; p<0.01). Conclusion: binge drinking was associated with an increase in the chances of manifesting problems related to alcohol use. The conclusions of this study cannot be generalized for all of the Brazilian population.Objetivo: evaluar problemas asociados al uso de alcohol entre estudiantes universitarios que relataron binge drinking en comparacion a estudiantes que consumieron alcohol sin binge drinking. Metodo: estudio transversal entre estudiantes universitarios (N=2.408) que visitaron una pagina web sobre el uso de alcohol. En los analisis estadisticos, fueron incluidos modelos de regresion logistica y linear. Resultados: el uso de alcohol, en los ultimos tres meses, fue relatado por 89,2% de los estudiantes universitarios, y entre ellos 51,6% relataron uso binge. En comparacion a estudiantes universitarios que no practicaron binge, los estudiantes que presentaron ese estandar tuvieron una mayor oportunidad de relatar todos los problemas evaluados, entre ellos: incapacidad de recordar lo que sucedio (aOR:5,4); problemas academicos (aOR:3,4); actuar por impulso y arrepentirse (aOR:2,9); involucrarse en peleas (aOR:2,6); manejar despues de beber (aOR:2,6) y compartieron viaje con alguien que bebio (aOR:1,8). Estudiantes que consumieron alcohol dentro del estandar binge tambien presentaron una mayor puntuacion en el Alcohol Use Disorders Identification Test (b=4,6; p<0,001), mas consecuencias negativas (b=1,0; p<0,001) y menor percepcion de la negatividad de las consecuencias (b=-0,5; p<0,01). Conclusion: la practica de binge drinking estuvo asociada al aumento de las oportunidades de manifestacion de problemas relacionados al alcohol. Las conclusiones de este estudio no pueden ser adaptadas a toda la realidad brasilena.

Studying an unreal world: incentives on internet-based interventions for alcohol use

Bertholet and colleagues recently reported results from an internet-based brief intervention (IBI) aimed at reducing unhealthy alcohol use among young males [1]. The authors found that individuals who received the intervention (with data about their alcohol use, related consequences, normative feedback and health information) reported a 10% reduction in the number of drinks consumed per week after 6months. Despite this modest effect, which is common in this type of intervention, the authors suggest that IBI may still be effective due to its low cost and the large number of individuals that can potentially be reached. Loss of participants during follow-up is an important issue on IBIs [2], and most of the studies involving the use of IBI for reducing alcohol consumption, including Bertholet’s study, provide monetary or other incentives (vouchers, electronic products, lottery prizes, etc.) to improve the participation and retention rates. Studies have shown that incentives maximize response rate in surveys, including in electronic health surveys [3–6] where even small amounts of money (US

Parenting styles as a tobacco-use protective factor among Brazilian adolescents

2 or US

Neurobiology of Substance Abuse

5) and lottery incentives have been shown to improve enrollment and response rates [7,8]. Conversely, studies not using incentives in IBI aimed at reducing alcohol use frequently have worse attrition rates than those with incentives. For example, Ekman and colleagues had only 24% of the sample at 6-month follow-up [9]. The rates for Bertholet’s study are almost four times higher. Even with possible benefits in terms of participation, the use of incentives on research still remains an ethically controversial subject [10]. Incentives inweb-based studiesmay be attracting people who are only interested in receiving the remuneration; or who rush to finish the questionnaire without giving it the appropriate attention [11,12]. Consequently, the use of incentives could bias the sample or the outcomes. Randomized controlled trials, which give incentives to participants to enroll in research, have claimed that IBI is effective in reducing alcohol use [13–15]. However, the use of incentives to improve retention and response rates in web-based research means that these types of study fail to replicate a real-world situation and bring into question the intervention’s actual effectiveness. Two great advantages of the internet are its capability to disseminate information widely and provide free access to information. The extensive use of IBI as an adjunct to other policy strategies will only be possible once the intervention is provided freely through the internet to anyonewhowants to know more about their alcohol use and the related consequences. Situations in which services pay individuals to complete the intervention are not feasible in a real-world setting. Because few studies did not use incentives, we need to encourage internet-based studies, which sacrifice low attrition rates in exchange for the ability to better evaluate the effectiveness of IBI in a realistic context, avoiding an unreal scenario.

Estilos parentales como factor protector para el consumo de tabaco entre adolescentes brasileños

The objective was to evaluate the relationship between tobacco use (previous month and frequent use), parenting styles and parental smoking behavior in a sample of high school students. Participants were recruited from public and private high schools from 27 Brazilian state capitals (N = 17,246). The overall prevalence of tobacco use in life was 25.2%; 15.3% in the previous year; 8.6% in the previous month; and 3.2% for frequent use. Tobacco use by the parents was reported by 28.6% of the students. Regarding parenting styles, 39.2% were classified as negligent, 33.3% authoritative, 15.6% as indulgent and 11.9% authoritarian. Compared to adolescents with authoritative parents, those with negligent or indulgent parents were more prone to report tobacco use during the last month or frequent use. This study showed an association between parenting styles and tobacco use by high school students. Authoritative parents were associated with protection from frequent and previous month tobacco use among adolescents.El objetivo fue analizar la asociacion entre el consumo de tabaco (durante el mes y su frecuencia) con los estilos parentales y el habito de fumar de los padres, en una muestra de estudiantes de secundaria. Los participantes fueron reclutados de escuelas publicas y privadas de 27 capitales estatales de Brasil (n = 17.246). La prevalencia de uso en la vida fue un 25,2%, en el ultimo ano 15,3%, en el ultimo mes 8,6%, y 3,2% de uso frecuente. El consumo de tabaco parental fue reportado por un 28,6% de los estudiantes. 39,2% de los padres fueron clasificados como negligentes, 33,3% autoritativos, 15,6% indulgentes y 11,9% autoritarios. Comparados con los adolescentes con padres autoritativos, aquellos con padres negligentes o indulgentes reportaron mas uso de tabaco durante el ultimo mes o uso frecuente. Se encontro asociacion entre estilos parentales y uso de tabaco por parte de los estudiantes. El estilo parental autoritativo se asocio con la proteccion para el uso del tabaco en el mes y frecuencia entre los adolescentes.

Heavy episodic drinking and soccer practice among high school students in Brazil: the contextual aspects of this relationship

Drug dependence is understood as a complex disorder associated with biological, emotional, and social factors. Consequently, an individual might develop dependence as a result of the interaction of those factors or even one of them alone, which favors the repetitive use that leads to dependence.

Practica deportiva y el uso de sustancias entre estudiantes de secundaria: diferentes perspectivas de esta relación

The objective was to evaluate the relationship between tobacco use (previous month and frequent use), parenting styles and parental smoking behavior in a sample of high school students. Participants were recruited from public and private high schools from 27 Brazilian state capitals (N = 17,246). The overall prevalence of tobacco use in life was 25.2%; 15.3% in the previous year; 8.6% in the previous month; and 3.2% for frequent use. Tobacco use by the parents was reported by 28.6% of the students. Regarding parenting styles, 39.2% were classified as negligent, 33.3% authoritative, 15.6% as indulgent and 11.9% authoritarian. Compared to adolescents with authoritative parents, those with negligent or indulgent parents were more prone to report tobacco use during the last month or frequent use. This study showed an association between parenting styles and tobacco use by high school students. Authoritative parents were associated with protection from frequent and previous month tobacco use among adolescents.El objetivo fue analizar la asociacion entre el consumo de tabaco (durante el mes y su frecuencia) con los estilos parentales y el habito de fumar de los padres, en una muestra de estudiantes de secundaria. Los participantes fueron reclutados de escuelas publicas y privadas de 27 capitales estatales de Brasil (n = 17.246). La prevalencia de uso en la vida fue un 25,2%, en el ultimo ano 15,3%, en el ultimo mes 8,6%, y 3,2% de uso frecuente. El consumo de tabaco parental fue reportado por un 28,6% de los estudiantes. 39,2% de los padres fueron clasificados como negligentes, 33,3% autoritativos, 15,6% indulgentes y 11,9% autoritarios. Comparados con los adolescentes con padres autoritativos, aquellos con padres negligentes o indulgentes reportaron mas uso de tabaco durante el ultimo mes o uso frecuente. Se encontro asociacion entre estilos parentales y uso de tabaco por parte de los estudiantes. El estilo parental autoritativo se asocio con la proteccion para el uso del tabaco en el mes y frecuencia entre los adolescentes.