Montse Juan

Predictors of violence in young tourists: a comparative study of British, German and Spanish holidaymakers

BACKGROUND International youth holiday resorts feature many of the key risk factors for violence, including large numbers of bars and nightclubs and high levels of substance use. However, little information currently exists on the extent of violence amongst holidaymakers or factors that increase risks of involvement in fights on holiday. METHODS A cross-sectional comparative survey of 3003 British, German and Spanish holidaymakers aged 16-35 years, undertaken in the departure areas of Ibiza and Majorca (Spain) airports. RESULTS Nightlife was the most common reason for destination choice in both locations. Overall, more than half of participants reported drinking to drunkenness at least 2 days per week during their holiday (59.3% Majorca, 58.0% Ibiza; significantly lower in Spanish participants in both locations). Levels of illicit drug use were highest in Ibiza and in British and Spanish holidaymakers. Levels of violence were highest in Majorca, where 6.4% of participants reported involvement in a fight, compared with 2.8% in Ibiza. However, after controlling for confounding factors, holiday destination was not a significant predictor of violence. Predictors of fighting were being male, young, British, frequent drunkenness and use of cannabis or cocaine during the holiday. Use of ecstasy on holiday was associated with not being involved in violence. CONCLUSIONS High levels of substance use contribute to violence being a relatively common feature of young peoples visits to international holiday resorts. To protect the health and well-being of holidaymakers and local populations in popular resorts, violence and substance use prevention must adapt to an increasingly globalized nightlife.

Parental styles and drug use: A review

The family plays a fundamental role in the prevention and treatment of substance use. Parental styles are among the family variables most widely studied. This review covers the studies published in the last 30 years on the relationship between parental styles and their offsprings drug use. Research indicates that the authoritative style is the most protective against substance use, whilst the neglectful style would increase the risk of drug use; research on the authoritarian and permissive styles is as yet inconclusive. We discuss the need to take into account other family variables in addition to parental style, such as parents’ drug use, emotional support and warmth, family structure and the influence of culture.

Drinking behaviours and blood alcohol concentration in four European drinking environments: a cross-sectional study

BackgroundReducing harm in drinking environments is a growing priority for European alcohol policy yet few studies have explored nightlife drinking behaviours. This study examines alcohol consumption and blood alcohol concentration (BAC) in drinking environments in four European cities.MethodsA short questionnaire was implemented among 838 drinkers aged 16-35 in drinking environments in four European cities, in the Netherlands, Slovenia, Spain and the UK. Questions included self-reported alcohol use before interview and expected consumption over the remainder of the night. Breathalyser tests were used to measured breath alcohol concentration (converted to BAC) at interview.ResultsMost participants in the Dutch (56.2%), Spanish (59.6%) and British (61.4%) samples had preloaded (cf Slovenia 34.8%). In those drinking < 3 h at interview, there were no differences in BAC by gender or nationality. In UK participants, BAC increased significantly in those who had been drinking longer, reaching 0.13% (median) in females and 0.17% in males drinking > 5 h. In other nationalities, BAC increases were less pronounced or absent. High BAC (> 0.08%) was associated with being male, aged > 19, British and having consumed spirits. In all cities most participants intended to drink enough alcohol to constitute binge drinking.ConclusionsDifferent models of drinking behaviour are seen in different nightlife settings. Here, the UK sample was typified by continued increases in inebriation compared with steady, more moderate intoxication elsewhere. With the former being associated with higher health risks, European alcohol policy must work to deter this form of nightlife.

Traffic Risk Behaviors at Nightlife: Drinking, Taking Drugs, Driving, and Use of Public Transport by Young People

Road traffic crashes associated with nightlife alcohol and recreational drug use are a major health problem for young people. Objectives: This study explores use of different forms of transport to and from nightlife environments and the relationships between traffic risk behaviors, drunkenness, and drug consumption. Methods: 1363 regular nightlife users from nine European cities in 2006 completed a self-administered and anonymous questionnaire. Sampling utilized a variation of respondent-driven sampling. Results: Private car was the most frequent form of transport used when going out, especially by males and older individuals. Drug use was related to crashes and traffic risk behaviors, including having a lift from someone drunk or driving drunk or driving having taken drugs; drunkenness was related to risk behaviors but not to crashes (possibly because drunk people tend to use the private car less). Males showed higher levels of drunkenness and drug consumption, traffic risk behaviors, and traffic crashes. Age is not related to the traffic risk behaviors, but older individuals had less crashes. Conclusions: There are serious health problems related to transport and recreational nightlife activities. It is necessary to improve later public transport services, complemented by actions that deter the use of private cars. The relationships of both drunkenness and cannabis/cocaine use with traffic risk behaviors should be addressed and programs implemented to change risk perceptions on the effects of illegal drugs on driving.

Alcohol, drogas, sexo y violencia: riesgos y consecuencias para la salud entre los jóvenes turistas británicos en las Islas Baleares

BACKGROUND Substance use, risky sexual behaviour and violence are among the key youth health issues today. Whilst they are the focus of much prevention work in the UK, relatively little information is available to inform prevention in international holiday resorts, where young people can take the greatest risks with their health. METHODS We conducted a cross-sectional survey of 1033 British holidaymakers aged 16-35 in Ibiza and Majorca airports (Spain). Surveys covered frequency of alcohol and drug use at home and abroad, and drunkenness, sexual activity and experience of a range of negative experiences on holiday. RESULTS Illicit drug use was more common in Ibiza. Over half (53.9%) of visitors to Ibiza reported using at least one drug on holiday (compared with 13.9% in Majorca) and over a third reported using more than one drug. However visitors to Majorca reported more frequent drunkenness and more negative outcomes (arguments, fighting, unintentional injury, illness and requiring medical attention). In both locations, frequency of substance use increased on holiday. A quarter of those travelling without a partner reported having had sex during their holiday, and of these a third did not consistently use condoms. Frequent drunkenness was associated with fighting, unintentional injury and sex with a new partner. Illicit drug use, particularly polydrug use, was associated with fighting and unprotected sex. CONCLUSIONS Young holidaymakers face significant health risks on holiday. Understanding which resorts are associated with which types of health risk behaviour is critical in targeting health promotion and harm reduction measures appropriately.

Drunk and disorganised: relationships between bar characteristics and customer intoxication in European drinking environments.

Preventing alcohol-related harm in drinking environments is a growing international priority. Factors relating to the physical, social and staffing environments in bars can contribute to increased alcohol consumption and harm. Understanding the relationships between such factors and intoxication in European drinking environments is critical to developing appropriate interventions. We undertook a quantitative observational study in 60 bars in four European cities, in The Netherlands, Slovenia, Spain and the UK (n = 237 observational visits). Using a structured observational schedule, researchers recorded characteristics of the bar environment and rated customer intoxication levels. All physical bar characteristics showed associations with intoxication before interactions between them were controlled for. Hierarchical modelling found significant independent associations between intoxication and use of plastic glassware, promotion of non-alcoholic drinks (often energy drinks), permissive environments, poor washroom facilities, the presence of a dance floor, customer sexual activity/competitiveness and later observational time. Findings suggest that prevention efforts should focus on raising and enforcing managerial standards in bars. While harm reduction measures such as plastic glassware are often promoted for high risk bars, such measures are inadequate to address public health concerns and insufficient to demonstrate social responsibility.

Relative contributions of holiday location and nationality to changes in recreational drug taking behaviour: a natural experiment in the Balearic Islands.

Aim: To examine the contributions of international holiday resorts and visitors’ nationality to recruitment, relapse into, and escalation in frequency of recreational drug use. Methods: Retrospective design surveying British, German and Spanish (n = 3,003) holidaymakers aged 16–35 visiting Ibiza or Majorca (Spain). Results: Individuals’ drug use in international resorts was related to use at home, holiday destination and nationality. While visiting Ibiza, 7.2% of British tourists tried ecstasy for the first time with similar recruitment amongst Spanish (8.6%) but not Germans (1.8%) or those visiting Majorca (0.8, 1.5 and 1.2%, respectively). Recruitment into cocaine use was associated with being Spanish, male, visiting Ibiza and drunkenness. One in 5 British holidaymakers visiting Ibiza tried at least one new drug. British and Spanish were most likely to relapse into using a drug after at least 12 months’ abstinence; 6.8% of British (1.3% German, 2.9% Spanish) relapsed into using at least one drug. Across nationalities, substance use frequency increased on holiday. Conclusions: International nightlife resorts are major sources of recruitment, relapse and escalation in drug use. Such resorts contribute to the international spread of drug cultures but have been largely ignored as settings for interventions to tackle drugs.

Nightlife young risk behaviours in Mediterranean versus other European cities: are stereotypes true?

BACKGROUND Mediterranean lifestyle has long been hailed as protective against certain risk behaviours and diseases. Mediterranean drinking patterns of moderate alcohol consumption as part of daily life have often been assumed to protect young people from harmful alcohol consumption, in contrast to Northern European drinking patterns. Nightlife environments are strong related to alcohol and drugs use, and other health risk behaviours but few cross-national studies have been undertaken amongst young Europeans frequenting bars and nightclubs. This study aims to understand differences in nightlife risk-taking behaviours between young nightlife users from Mediterranean and non-Mediterranean cultures, including alcohol and illicit drug use, unprotected sex, violence and driving under the influence of alcohol. METHODS A total of 1363 regular nightlife users aged 16-35 years were surveyed in nine European cities by means of a self-reported questionnaire. Sample selection was done through respondent driven sampling techniques. RESULTS after controlling for demographic variables, no differences among the Mediterranean and non-Mediterranean samples were found in current alcohol, tobacco, cannabis, or cocaine use, neither in violent behaviours, but Northern people were more likely to get drunk [adjusted odds ratio (AOR) = 0.53], while Mediterranean were more likely to have unprotected sex (AOR = 2.01) and to drive drunken (AOR = 5.86). CONCLUSION Our data suggest that stereotypes are partially confirmed, and that Mediterranean lifestyle is protective for some risk behaviours (drunkenness, ecstasy and amphetamines current use), but not for all of them. Further research in depth is needed in order to clarify the relations between cultural patterns, social norms and nightlife risk behaviours assumed by the young people.

Factors associated with risky sexual behaviour: a comparison of British, Spanish and German holidaymakers to the Balearics

BACKGROUND Previous studies exploring risk-taking behaviour on holiday are typically limited to single nationalities, confounding comparisons among countries. Here we examine the sexual behaviour of holidaymakers of three nationalities visiting Ibiza and Majorca. METHODS A comparative cross-sectional study design was used focusing on British, Spanish and German holidaymakers in the age range of 16-35 years. Overall, 3003 questionnaires were gathered at airports in Majorca and Ibiza from holidaymakers returning home. RESULTS Of those surveyed, 71.1% were single (travelling without a current sexual partner) (Majorca, 74.3%; Ibiza, 68.0%). Overall, 34.1% of single holidaymakers had sex on holiday. Amongst single participants, factors associated with having sex on holiday were high levels of drunkenness, being Spanish and holidaying for over 2 weeks. Of those single and having sex on holiday, factors associated with multiple sexual partners were being male and age ≤19 years. Unprotected sex was predicted by being German and holidaying in Majorca, holidaying with members of the opposite sex and using four or more drugs on holiday. All sexual behaviours were predicted by a high number of sexual partners in the previous 12 months. Furthermore, single holidaymakers having sex abroad were more likely to prefer night-time venues facilitating casual sex and excessive alcohol consumption. CONCLUSIONS Casual sex encounters in youth holiday resorts may be commonplace and mediated through substance use. Further focused public health efforts, including in bars/nightclubs, are needed to prevent sexual risk-taking which can increase the likelihood of poor sexual health outcomes and associated factors such as regretted sex.

Parental permissiveness, control, and affect and drug use among adolescents

BACKGROUND Parents play an important role in determining the risk of childrens drug use. The aim of this study was to analyse how certain family-related variables (permissiveness toward drug use, and parental control and affect) were linked to the use of alcohol, tobacco and cannabis, based on young peoples self-report of such variables. METHOD The sample was composed of 1,428 school children (51.8% males) aged between 11 and 19 from Mallorca (Spain). RESULTS We found that the young people who perceived their parents as permissive and those who perceived less maternal control and higher levels of both paternal and maternal affect were more likely to use alcohol, tobacco and cannabis. Sex differences were found within this pattern. Variables of maternal affect and control were not influential among males, whereas the general pattern was maintained among females. CONCLUSIONS This study highlights the importance of perceived permissiveness and the need of considering parents and childrens gender when providing control and affect, as fathers will influence male children whereas mothers will influence female children.