Prevalence and Risk Factors of Alcohol Abuse among Elementary and Secondary Schoolchildren in Herzegovina-Neretva County, Bosnia and Herzegovina

Article excerpt

Summary - The aim of our study was to investigate the prevalence of alcohol use among the elementary and high school children in various towns of Herzegovina-Neretva County, and to identify the risk factors for this kind of behavior. The survey was based on total sample of 7,025 Caucasian students, aged 13-18, who were living in the county of Herzegovina-Neretva, Bosnia and Herzegovina, and attended 7th and 8th grades of elementary schools and all grades of high schools. We used self-reported questionnaire, modified from ESPAD, which was concerned with illicit drugs, tobacco and alcohol use and socio-demographic traits of participants and their families. The results of this study showed a high prevalence of alcohol use among adolescents. Drugs use, cigarette smoking, peer and family influences, gender, and age of participants were the most important predictors for alcohol abuse. The effective prevention programs for adolescent substance abuse have to be multidimensional, addressing a number of risk and protective factors. Such prevention programs must consider associations between different substances of abuse, and include involvement at the school, community and family level.

Key words: Alcohol; Adolescents, Risk factors; Bosnia and Herzegovina

INTRODUCTION

It has been known for long period of time that drinking of alcoholic beverages have an important effect on morbidity and mortality among people, representing a big public health problem.1 Alcoholism is in closely related with the tradition of drinking alcohol beverages which had been drunk from the ancient days of human history. The ilustrations of preparation and consumption of alcoholic beverages can be seen even on the oldest written monuments. Until the eighteenth or the nineteenth century, drinking and its consequences were rarely seen as a medical problem. At the beginning of the twentieth century, with the advancement of medical knowledge, there was a growing perception of disorders caused by alcoholic beverages.2 Nowadays, alcoholism is considered as a disease and the therapeutically directed medical model of treating alcoholics emphasizes that alcoholism is a socio-medical disorder.3 The data from different national studies show significant differences in drinking habits which depend not just on tradition and social circumstances but also on political attitudes, legal regulations and spending power.4 During the last few decades close attention has been directed towards the adolescent drinking habits. Use of tobacco, alcohol and psychoactive drugs usually begins during adolescence and adolescents are, because of the particularity of maturation period, their relative inexperience, and propensity to risk, the most jeopardized population subgroup.5 Among adolescents, prevailing adverse effects of alcohol abuse are increased risk from car accidents injuries and violence caused by acute intoxication.2 Risk assessments by adolescents are focused on the present and less concerned with the future consequences. The longterm adverse health consequences seem less important for them than the shortterm effects, especially social stigma. Substance abuse among adolescents follows a fairly predictable progression, beginning with the recreational use of gateway substances such as alcohol and cigarettes, followed by marijuana, and eventually by other illicit drugs. With the exclusion of inhalants, the risk of using other illicit drugs tends to be low without the prior use of marijuana.6 Risk factors for substance abuse among adolescents can be examined under four general categories: cognitive and attitude-related; personality and psychopathology, behavioral, social or environmental, and biologic or genetic.7 Social and environmental factors, such as family characteristics, parenting style, low socioeconomic status, poor academic performance, and peer influences can be associated with substance abuse.8,9

This study was designed to investigate prevalence of alcohol use among elementary and high school children in various towns of Herzegovina-Neretva County, and to identify the risk factors for this kind of behavior. …