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      Prevalencia del uso de drogas ilegales en función del consumo de tabaco en una muestra de estudiantes en México Translated title: Prevalence of illicit use in function of tobacco smoking in Mexican students sample

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          Abstract

          OBJETIVO: Evaluar el uso de drogas ilegales y su interacción con el consumo de tabaco en jóvenes estudiantes de un estado de la región central de México, 2005-2007. MATERIAL Y MÉTODOS: Se realizó un estudio de cohorte en el ámbito escolar en el estado de Morelos. La población fue de 4 625 alumnos. Se efectuó el análisis de la medición basal describiendo el consumo de tabaco, alcohol y drogas ilegales; se evaluó la diferencia del consumo de estas últimas mediante modelos de regresión logística y se estratificó por el antecedente de fumar. RESULTADOS: El promedio de edad fue 13.8 (DE 2.03). La proporción de mujeres fue de 51.9%; 11.9% notificó el antecedente de consumo de tabaco (13.5% hombres y 10.4% mujeres). El uso de drogas ilegales fue de 3.3% (3.7% hombres y 2.8% mujeres), su distribución según el consumo de tabaco fue de 2.0% en los no fumadores y 12.4% en los que tenían antecedente de consumo de tabaco. En el grupo de no fumadores, el consumo de drogas ilegales por parte de los padres incrementó 4.5 veces (IC95% 1.9-11.0) la posibilidad de que un adolescente usara drogas ilegales en relación con aquellos cuyos padres no consumen drogas ilegales, relación no significativa en el grupo de fumadores. Para este último grupo, el consumo de alcohol se asoció con el uso de drogas ilegales (OR = 2.6; IC95% 1.2-5.9). CONCLUSIONES: El control y prevención del consumo de tabaco y otras sustancias adictivas debe realizarse de manera integral, ya que vistas en su contexto tales conductas se encuentran relacionadas.

          Translated abstract

          OBJECTIVE: To evaluate the use of the illicit drugs and its interaction with smoking in young students in a state of Central Mexico, 2005-2007. MATERIAL AND METHODS: A population cohort study with 4 625 students was carried out in different public schools in Morelos State. Baseline measurement analysis was carried out describing tobacco, alcohol and illegal drugs consumption. Drug abuse according to tobacco onsumption was assessed through logistic regression models, stratified by smoking habit. RESULTS: Mean age was 13.8 (SD 2.03); 51.9% were female students and 11.9% of total population informed having smoked (13.5% men and 10.4% women). Illicit drug use was 3.3%; 3.7% in men and 2.8% in women and its distribution according tobacco smoking was 2.0% for non smokers and 12.4% for those who had smoked. In non smokers group, parent’s drug use was 4.5 times (CI95% 1.9-11.0) higher compared to those students whose parents do not do drug use. The effect was not significant in smokers group. Alcohol intake was associated to drug abuse in smokers group (OR=2.5; CI95% 1.2-5.9). CONCLUSIONS: The control and prevention of tobacco consumption and other addictive substances should be carried out since in a comprehensive way, because contextual antecedent these behaviors are related.

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          Stages of progression in drug involvement from adolescence to adulthood: further evidence for the gateway theory.

          Sequential stages of involvement in alcohol and/or cigarettes, marijuana, other illicit drugs and medically prescribed psychoactive drugs from adolescence to adulthood are investigated in a longitudinal cohort that has been followed from ages 15 to 35. Alternative models of progression are tested for their goodness of fit. Four stages are identified: that of legal drugs, alcohol or cigarettes; marijuana; illicit drugs other than marijuana; and medically prescribed drugs. Whereas progression to illicit drugs among men is dependent upon prior use of alcohol, among women either cigarettes or alcohol is a sufficient condition for progression to marijuana. Age of onset and frequency of use at a lower stage of drug use are strong predictors of further progression.
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            Why children start smoking cigarettes: predictors of onset.

            We review findings from 27 prospective studies of the onset of cigarette smoking conducted since 1980. Almost 300 measures of predictors of smoking onset were examined, and 74% of them provided multivariate support for predictors of onset derived from theory and previous empirical findings. Expected relationships were strongly supported for (a) socioeconomic status, with students with compromised status being more likely to try smoking; (b) social bonding variables, particularly peer and school bonding, with less support for family bonding; (c) social learning variables, especially peer smoking and approval, prevalence estimates, and offers/availability, with less consistent support for parent smoking and approval; (d) refusal skills self efficacy; (e) knowledge, attitudes and intentions, with the expected stronger predictions from intentions than from attitudes than from knowledge; and (f) broad indicators of self-esteem. The few investigators who analyzed their data separately by age, gender, or ethnicity found many differences by these factors, though there were too few of them to detect any pattern with confidence. Though the 27 studies are far from perfect, we believe that they confirm the importance of many well-accepted predictors and raise some questions about others. In particular, family smoking, bonding and approval each received unexpectedly low support. It is not clear whether this lack of support reflects reality as it has always been, is due to a changing reality, reflects developmental changes, either in the age of subjects or the stage of onset, or is due to poor measurement and too few tests. Future prospective studies need to be theory-driven, use measures of known reliability and validity, report analyses of scale properties, and use statistical methods appropriate to the hypotheses or theories under study. Finally, we encourage more investigations of the potentially different predictors of transitions to experimental or regular cigarette smoking. This will require multi-wave studies and careful measurement of changes in smoking behavior.
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              Stages in adolescent involvement in drug use.

              D Kandel (1975)
              Two longitudinal surveys based on random samples of high school students in New York State indicate four stages in the sequence of involvement with drugs: beer or wine, or both; cigarettes or hard liquor; marihuana; and other illicit drugs. The legal drugs are necessary intermediates between nonuse and marihuana. Whereas 27 percent of high school students who smoke and drink progress to marihuana within a 5- to 6-month follow-up period, only 2 percent of those who have not used any legal substance do so. Marihuana, in turn, is a crucial step on the way to other illicit drugs. While 26 percent of marihuana users progress to LSD, amphetamines, or heroin, only 1 percent of nondrug marihuana users and 4 percent of legal drug users do so. This sequence is found in each of the 4 years in high school and in the year after graduation. The reverse sequence holds for regression in drug use.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                spm
                Salud Pública de México
                Salud pública Méx
                Instituto Nacional de Salud Pública (Cuernavaca )
                0036-3634
                2007
                : 49
                : suppl 2
                : s182-s193
                Affiliations
                [1 ] Instituto Nacional de Salud Pública México
                Article
                S0036-36342007000800008
                10.1590/s0036-36342007000800008
                fce02a69-670b-46f5-8856-ceafba5af18c

                http://creativecommons.org/licenses/by/4.0/

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                SciELO Mexico

                Self URI (journal page): http://www.scielosp.org/scielo.php?script=sci_serial&pid=0036-3634&lng=en
                Categories
                Health Policy & Services

                Public health
                adolescents,tobacco,illicit drugs,cohort,Mexico,adolescentes,tabaco,drogas ilegales,cohorte,México
                Public health
                adolescents, tobacco, illicit drugs, cohort, Mexico, adolescentes, tabaco, drogas ilegales, cohorte, México

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