The prevalence of inhalant use and associated factors among adolescents in Belo Horizonte, Brazil
Ciência & Saúde Coletiva
Print version ISSN 1413-8123
Ciênc. saúde coletiva vol.19 no.3 Rio de Janeiro Mar. 2014
http://dx.doi.org/10.1590/1413-81232014193.07542013
The prevalence of inhalant use and associated factors among adolescents in Belo Horizonte, Brazil
1Departamento de Odontologia Social e Preventiva, Faculdade de Odontologia, Universidade Federal de Minas Gerais. Av. Antônio Carlos 6627, Pampulha. 31.270-901 Belo Horizonte MG Brasil. nando.sol@gmail.com
2Departamento de Odontopediatria e Ortodontia, Universidade Federal de Minas Gerais
3Harvard School of Public Health
ABSTRACT
The scope of this study was to establish the prevalence of inhalant use among adolescents and its association with marijuana use, alcohol consumption, socioeconomic status and gender. A cross-sectional study was performed with a representative sample of 891 adolescents from public and private schools in the city of Belo Horizonte, Brazil. Data were collected using two self-administered questionnaires: the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) and the Alcohol Use Disorders Identification Test (AUDIT C). The socioeconomic status was evaluated using the Social Vulnerability Index, mother’s education level and type of school (public or private). The data were analyzed using the chi-square test (p < 0.05) and logistic regression analysis. The prevalence of inhalant use was 7.9%. No significant association was found between the use of inhalants and socioeconomic status after the logistic regression analysis. Inhalant use among adolescents was associated with marijuana use (OR: 4.61; 95% CI: 2.27 – 9.36) and with binge drinking (OR: 5.02; 95% CI: 2.57 – 9.81).
Key words: Inhalants; Adolescents; Binge drinking; Illicit drugs; Socioeconomic factors; Epidemiology
Key words: Inalantes; Adolescentes; Beber pesado; Drogas ilícitas; Fatores socioeconômicos; Epidemiologia
RESUMO
O objetivo deste estudo foi avaliar a prevalência do uso de inalantes em adolescentes e sua associação com o uso de maconha, consumo de álcool, condição socioeconômica e gênero. Um estudo transversal foi realizado em uma amostra representativa de 891 adolescentes de escolas públicas e privadas de Belo Horizonte, Brasil. Os dados foram coletados por meio de dois questionários autoaplicáveis: o Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) e o Alcohol Use Disorders Identification Test (AUDIT C). O Índice de Vulnerabilidade Social, o nível de escolaridade da mãe e o tipo de escola (pública ou privada) foram utilizados para determinar o nível socioeconômico. Os dados foram analisados utilizando o teste qui-quadrado (p < 0.05) e a análise de regressão logística. A prevalência do uso de inalantes foi de 7,9%. Não houve associação entre o uso de inalantes e o nível socioeconômico após a análise de regressão logística. O uso de inalantes por adolescentes esteve associado ao uso de maconha (OR: 4.61; 95% CI: 2.27 – 9.36) e ao consumo abusivo de álcool (OR: 5.02; 95% CI: 2.57 – 9.81).
Introduction
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), inhalant drugs are psychotropic substances divided into four groups based on their action mechanism: volatile solvents, aerosols, gases and nitrites1. Ethyl chloride (found in lança perfume – an ether-based drug used in Brazil), benzene derivatives (solvents found in some glues and paints), ether, benzene and chloroform are examples of common psychoactive inhalants.
Many of these substances are widely available, easily obtained and relatively inexpensive, which likely contributes to the high prevalence of use in the overall population2 , 3 and may also account for their popularity among adolescents4 , 5. Moreover, research suggests that first contact with drugs often occurs in adolescence, which is a period of significant physiological, social and psychological change and vulnerability6 – 8.
In 2005, researchers conducted a household survey in Brazil involving approximately 8000 individuals between 12 and 65 years of age in 108 cities with populations of more than 200,000 inhabitants. A total of 6.1% of the sample reported having used inhalants, which constituted the second most frequently consumed illicit drug after marijuana9. In surveys conducted by the Brazilian Information Center on Psychotropic Drugs (CEBRID) in 1987, 1989, 1993 and 1997 with representative samples of adolescents enrolled at elementary and high schools in ten Brazilian state capitals, inhalants had the highest reported use (over 13% of the samples)10. According to data from a survey conducted in 2010 by the US National Institute on Drug Abuse published in a report entitled “Monitoring the Future,” 14.5% of eighth grade students reported having used inhalants at least once, which was a higher usage rate than that reported for marijuana, amphetamines, hallucinogens, cocaine and heroin11 , 12.
Inhalants cause dependence13 and can lead to brain damage, heart problems, liver problems, kidney failure and death, including suicide5 , 13 – 17. These drugs can also contribute to personality, mood and anxiety disorders18 – 20 as well as broader social problems, such as violence and vandalism15. Historically, alcohol, tobacco and marijuana have been considered the “gateway drug” of choice. This progression is followed by inhalants, which can lead to the use of harder substances, such as heroin and crack3. A number of studies also report the use of inhalants in combination with other drugs, especially marijuana, tobacco and alcohol3 , 20. This combined drug use needs to be investigated further to assist in the establishment of more effective public policies. Research also suggests that adolescents who use inhalants receive poorer grades at school and have higher scholastic failure, absenteeism and dropout rates21 , 22.
This study was undertaken to identify groups that are more vulnerable to using psychoactive substances and multiple drugs, as such individuals are more susceptible to the combined use of inhalants and heavier drugs. Moreover, the identification of associated factors can help guide public policies regarding effective strategies aimed at inhibiting the use of inhalants and other drugs3 , 22 – 24. Thus, the aim of the present study was to determine the prevalence of inhalant use among adolescents at public and private schools in the city of Belo Horizonte, Brazil, and investigate associations with marijuana use, alcohol consumption, socioeconomic status and gender.
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