Individual, interpersonal, organizational, and community contexts: factors associated with alcohol consumption among Brazilian adolescents

BACKGROUND: Adolescence is a development period characterized by biological, psychological, and social changes that may lead to risk behaviors, such as alcohol consumption. Family, school, and community contexts, together with exposure to different communication media, may contribute to adolescents' vulnerability to alcohol use. OBJECTIVE: To identify individual, interpersonal-, organizational-, and community-level factors associated with current alcohol consumption among Brazilian adolescents. METHODS: We conducted a cross-sectional study using data from the 2019 National Survey of School Health (PeNSE). The outcome was current alcohol consumption (use in the past 30 days). Poisson regression with robust variance was employed to estimate prevalence ratios (PR) and their respective 95% confidence intervals (95% CI), including factors from individual, interpersonal, organizational, and community levels. RESULTS: Twenty-eight point one percent of Brazilian adolescents reported alcohol consumption. At the individual level, alcohol use was positively associated with age 16-17 years (PR = 1.54), cigarette smoking (PR = 1.47), use of other tobacco products (PR = 2.04), illicit drug use (PR = 1.21), regular consumption of sugar-sweetened foods (PR = 1.20), feeling sad (PR = 1.29), and thought that life was not worth living (PR = 1.24). At the interpersonal level, alcohol consumption was associated with parental alcohol consumption (PR = 1.66), parental concern about the adolescent (PR = 1.05), intrafamilial physical violence (PR = 1.09), sexual violence (PR = 1.15), and truancy (PR = 1.23). At the community level, higher prevalence was observed in the South (PR = 1.27). CONCLUSIONS: We observed a high prevalence of current alcohol consumption among Brazilian adolescents, associated with factors across multiple contextual levels, highlighting the complexity and multidimensional nature of this behavior.