The prevalence of alcohol consumption among the students newly enrolled at a public university.

BACKGROUND: Alcohol is the number one toxic substance consumed by people of all age groups, which makes its use a public health problem. The overall trend shows that university students are those who suffer the most pressure.
OBJECTIVE: To assess the prevalence of alcohol use among students newly enrolled at a public university in Alagoas, Brazil.
MATERIALS AND METHODS: We conducted an analytical sectional study at the Federal University of Alagoas, with 1435 (44% of total) newly enrolled students of all courses in 2006. They answered a questionnaire based on the CAGE. Some points such as sex, age, marital status, course, housing, family characteristics and how drugs fit into in the student life were studied with the resources of EpiInfo version 3.3.2. The survey was approved by the Research Ethics Committee of the Federal University of Alagoas (number 000878/2005-17).
RESULTS: Of the group studied, 95.9% lived with family and 87.6% reported ever drinking alcohol at some time in their life. Of all the respondents, 55.4% of men reported having the habit of drinking with friends or colleagues (Odds = 0.71; CI = 0.58-0.88; P-value = 0.00088). Among all respondents, 17.7% of male students and 9.8% females skipped class after using alcohol (Odds = 0.52; CI = 0.38-0.72; P-value = 0.000023). The transition from adolescence to youth and study time at university is marked by greater vulnerability to alcohol abuse. The family is decisive for the initiation of alcohol use, and the university is a factor that increases the possibility of maintaining the practice. The fact that not all students were present in the classroom at the time of the application questionnaire may have limited the search because this was a sectional study.
CONCLUSION: Alcohol consumption in this university is similar to that in other higher education institutions in the world, which is a cause for concern, since the external lesions are accentuated with the practice of using alcohol, characterizing the risk of violence.

The antiquity of alcohol use in the life of societies around the world allows this substance to have different cultural connotations, such as being used as an essential element in religious rituals and in moments of celebration and relaxation. In Western societies, the autointoxication by alcohol is socially accepted and is currently the most consumed drug worldwide. In Brazil, in 2002, 68.7% of the total population had already made use of alcohol in their life, with stability in the proportion amongst the age ranges.[1-3]

High demand for alcoholic drinks describes its abuse. This pattern of consumption produces increased violence (such as traffic accidents and injuries by firearms and white arms) in society.[2-7] Moreover, individuals with this profile are more likely to develop diseases, which confirms the fact that alcoholism is a matter of public health.[8]

According to international literature, binge drinking (consumption of four or more doses of alcohol for women and five or more for men) is considered a risk for consumer. From this, problems in internal and external dimensions of the subject can be inferred because this practice leads to drunkenness.[910]

The use of alcohol is present in all age groups. However, the greater concern is the consumption by adolescents and youth. One of the reasons why such use is encouraged is the influence, albeit indirect, of their own families, who generally condemn only the use of illicit drugs, like marijuana.[10] Of the whole Brazilian population in the age group 12-17 years, 48.3% claim to consume alcoholic beverages and 5.2% are alcoholic.[11]

This age group entering the university acquires social mobility from specific rules where behaviors are built from the process of social comparison. Thus, the teenager tends to model his actions searching similarities with the reference group, in this case, university students, who overestimate alcohol use.[12-14] Social remodeling intensifies when the individual is presented with little experience in a new place, which occurs on entry to the university.[15]

Objective

To assess the prevalence of alcohol use among the students entering a public university in Alagoas, Brazil.

Materials and Methods

This was a cross-sectional study, analytically performed with young college graduates enrolled in all courses at a public university in Alagoas, Brazil, in 2006.

A closed questionnaire, based on CAGE, was used in classrooms during the months of April and May in 2006. It was administered by college students. An exchange ofcourse happened whit the intent of not matching the ones used on the research. After explanations and clarifications were given, students who agreed to participate in research signed an informed and free consent term, forming a non-probabilistic sample, representing 44% of the universe of students enrolled. The collected data were stored and analyzed using EpiInfo version 3.3.2.

Social variables were studied (gender, age, course, marital status and residential and occupational situations) and related to drug use (frequency of consumption, types of alcoholic beverages consumed, opinions on the issues concerning the use of drugs and the consequences and experiences after the use of drugs). Odds was used as statistical test and CI = 95%.

The research was approved by the Ethics Committee of the Federal University of Alagoas with the number 000878/2005-17.

Results

The sample comprised 1435 students (44% of all those enrolled in university). The group was made up of 51.5% female students, 91.0% singles, 27.3% were working, 55.4% of the Catholic religion and the majority (95.9%) who lived with the family. Slightly more than half of the respondents (54.5%) had age less than or equal to 20 years, the majority being of age 18 years (25%). Of the total number of students, only 12.4% said they had never drunk alcohol.

As for the consumption of alcohol during the year, it was observed that 71.3% had done it. Among the 1435 students, 56.7% of those who said they had drunk to intoxication were men, and data were statistically significant (Odds = 0.43; CI = 0.34-0.53; P-value = 0.000000) [Table 1].

Table 1

Significant variables related to drinking habit by gender (Maceio-AL, Brazil, 2006)

The most cited place of the first dose was their own home (25.5%), followed by the homes of friends and colleagues (23.7%) and bars, concert halls (21.3%) [Table 2]. The most consumed alcohol beverages by students were beer or draft beer (32.2%) and wine (16.7%) [Figure 1].

Table 2

Distribution of first alcohol dose places (Maceio-AL, Brazil, 2006)

Figure 1

Drink varieties which are most consumed (Maceio-AL, Brazil, 2006)

Among all the respondents, by studying the fact of intoxication, it was found that 5.9% of women and 11.5% of men participated in fights after getting drunk (Odds = 0.48, CI = 0.33-0.70; P-value = 0.000071). Of the total sample studied, 17.7% of male students and 9.8% females refrained from class due to alcohol use (Odds = 0.52; CI = 0.38-0.72; P-value = 0.000023) [Table 3]. Of the total sample, 258 (18.6%) reported that they had used other drugs in combination with alcohol, tobacco being highlighted (34.6%) followed by solvent (32.0%) [Figure 2].

Table 3

Significant consequences that are related to the gender and drunkenness act (Maceio-Al, Brazil, 2006)

Figure 2

Association of alcohol with other drugs (Maceio-AL, Brazil, 2006)

Friends or colleagues were the most frequently cited in relation to those who offered alcohol for the first time (37.6%), followed by relatives (21.6%), and 158 of them (11.0%) bought the first dose alone [Table 4]. Man and woman had different choices when they answered the question “With whom do you usually drink?”. (Odds = 0.71; CI = 0.58-0.88; P-value = 0.00088) [Table 1].

Table 4

People who offered the first alcohol dose (Maceio-AL, Brazil, 2006)

The option for the question regarding the use of alcoholic beverages, “unwise under any circumstances”, was chosen by 46.2%, and 50.4% of respondents considered that their drug misuse was due to “psychiatric issues and/or emotional (anxiety, distress, depression, fear, complex) reasons”.

Discussion

The academic audience is predominantly made of teenagers and young students. This group, despite having achieved the goal of approval at the selection exam, can present problems with stress and are prone to make use of drugs in general. Excessive consumption of alcohol is a recurring pattern amongst undergraduate students. This pattern differs from others because this specific population has developed typical patterns of alcohol use and its risks are related to drinking too much, with social norms that approve it.[1315]

The frequency of opportunities for peer interaction receives an increment during the university time. Peers influence the consumption of beverage and show which behaviors are accepted and admired in a particular social context, which leads to acceptance and its reinforcement.

Whereas most teenagers think just about the present moment, with no concern about social expectation,[4] a large portion of them feel free to consume alcoholic beverages intensely. The proportion reaches 65% of the students in elementary and high schools, who have made use of drugs at least once in life, with alcohol being the highlight amongst others.[3]

The literature indicates that the university is not the starting point for the alcohol consumption, but a factor that magnifies it, determinedly maintaining the practice, given the respondents’ age characteristic.

The distance from family can be an important factor in determining the problematic behavior of drinking, providing a possible looseness for the act and its consequences. Yet, it was realized that this factor had no significant influence on alcohol use by the study group, since almost every student reported living with family. Incentives and tolerance from the family members for the act of drinking, especially the members of the family nucleus (parents and siblings), give sufficient support for teenagers to consume alcohol.[15] According to WHO, Brazil was at 63rd position amongst 153 countries in alcohol consumption among people of age 15, in 1999, showing a very moderate use in adolescence.[1]

Friends and colleagues were those who offered the first dose of alcohol to the majority of respondents. Nevertheless, it is observed that the place of the first dose was their own home for the majority, which confirms the complicity of the family members.

Students who abuse alcohol are more likely to develop risky behaviors with negative consequences for them and the whole society, this profile being responsible for the increased number of deaths due to external factors. Epidemiological data show that in a capital city in Brazil, 53.6% of victims and 58.9% of the authors were under the influence of alcohol at the time of the crime. In another capital, amongst those drivers who had been involved in car accidents, 37.7% had consumed alcoholic beverages on the day of the incident, indicating that this population group is the more exposed to the external injuries.[1]

There are laws that seek to limit the opening hours of establishments in which alcoholic beverages are sold and prohibit driving after its consumption.[16] Brazilian Law nº 11.705, known popularly as “Prohibition of alcohol”, aims to punish those drivers who have ingested alcohol.[16] However, it is perceived lack of control necessary to prevent this practice[21] which shows negligence of the government's authorities and, therefore, actions to inhibit the association of alcohol and driving do not happen. A study[17] found that the young Brazilian college males with blood alcohol content (BAC) drive after alcohol use more often than females, and men get involved in fights with friends and police also, more than the females. This finding was confirmed in this university, proving the fact that gender is associated with the recreational use of alcohol and risk behaviors of beginners. The relative frequencies of all the consequences of alcohol use for men are higher than for women, especially the act of driving while they are intoxicated and presenting aggressive behaviors.

Most of those surveyed students believe that alcohol use is not advisable to any situation. This is not coherent with the way and intensity of alcohol use among the students that had consumed alcohol at least once in their lifetimes. In other Brazilian universities, the use was justified as an opportunity to socialize and get drunk, more consistent with the reality presented.[17] The fact that drug use is linked to psychiatric/emotional disorders such as anxiety and distress explains the possible exposure to the stress that students undergo during the graduation.

The advertising strategies are an important milestone influencing alcohol use in this public. The advertisements are associated with the expectation of consumption, initiation of use and intensity of use.[18]

The alcoholic beverages advertisings connect the consumption of alcohol with an easy-going style of life. It is exemplified when national holidays, soccer games, beautiful young people and celebrities are present on this kind of advertisements.[911]

According to this study, beer and wine were the beverages most consumed by the sample of students surveyed, following the same pattern as that found in Brazilian university students. Beer is the most nationally well-publicized alcohol product and has recorded a consumption of 54 L per capita a year in the country, occupying the first position in the consumption and production among the other alcoholic beverages.[16] A study conducted in 2009 at public universities in Alagoas found that this profile of consumption was among college students, with beer being more used by men and wine, by women.[2]

By observing the results, it is perceived that skipping class was the most cited consequence. There are different effects amongst those who abuse alcohol (binge-drinkers) and moderate drinkers, but everyone is exposed to weaknesses in the cognitive functions.[19] In general, on the day after use, there is confusion and decreased level of attention, which negatively influences the actions for the start of an activity, in this case, go to class.[19] Like most of the students in the sample reported never having been drunk, it is possible to see that respondents are more exposed to acute effects of alcohol, justifying the higher rate of abstentions to classes.

The association between alcohol and nicotine can be observed among the students. It is very common for the user to combine both substances because alcohol has a depressive action on the central nervous system (CNS) and nicotine is a stimulant of CNS.[20]

Study limitations

Since this was a cross-sectional study, data collection took place in just a moment, which made it impossible obtaining a larger sample, and the characteristic of the theme precluded obtaining a representative sample.

Conclusion

It was felt that the students at this public university in Alagoas showed the prevalence of alcohol use similar to several universities in Brazil and the world, exposing them to risks of abuse and drug dependency. The family's influence could be observed even if living alone allows the student more freedom to consume more alcoholic beverages.

In addition, men tend to become “heavy drinkers” with friends and colleagues predominantly and apparently do not worry about the consequences of the act. Since we observe a high prevalence of alcohol use at this university and risky behaviors to society with considerable frequency, prevention measures must be created emphasizing the importance of reducing the problems, the consequences of use, and also make laws to avoid drugs.