Probabilidade de ocorrência da inicialização do consumo de cigarro combinado ao consumo prévio de álcool na população brasileira

Abstract

Current evidence in the literature indicates that the initial consumption of alcohol can lead to a later use of cigarettes by cultural, psychological, emotional and social factors. Therefore, the objective of this study was to analyze the probability of initiation of cigarette consumption, once the consumption of alcohol in the Brazilian adult population, according to gender, age, race, region and income, has started.As specific objectives, it sought to verify the proportionality of risks between alcohol and cigarette consumption concomitantly; to identify which individuals initialized cigarette consumption after the initial consumption ofalcoholic beverages; analyze the time taken for its concomitant use and the factors that led to such behavior and to verify the incidence of the combined consumption of the substances mentioned above by gender. As a methodological procedure, used secondary data from a questionnaire obtained by the National Health Survey (PNS) for the year 2013. The sample is made up of 9,717 individuals, aged over 17 years, of both sexes, living in all Brazilian regions, who initialized the consumption of alcoholic beverages and who consume or can later consume cigarettes. The data were analyzed using the following survival analysis tests: Irtest, Schoenfeld, Cox-Snell and Kaplan-Meier, which identified the proportionality of the risks of the event in question and the possible risk factors (gender, race, age group, income level and region). The data obtained demonstrated that the probability of initiation to cigarette consumption due to alcohol consumption is 0.88 times higher for men than for women; white individuals, aged 18 to 28 years and the southern region of the country presented a higher probability of initiating cigarette smoking, given the previous use of alcohol. In addition, the income variable presented a direct relation with the initiation of cigarette consumption. Regarding the mean time of initiation to the concomitant use of the substances, it was found that the older an individual, the less likely the initiation of cigarette consumption, due to the consumption of alcoholic beverages. This outcome raises the possibility of intervention by Brazilian public policies that postpone consumption, through tax increases for the sale of such substances; prohibition of advertising campaigns related to alcohol and cigarettes; prohibition of advertising campaigns related to alcohol and cigarettes; in addition to the process of raising awareness among young people and women (due to the increase in their consumption over the years) through educational programs that highlight the consequences that the consumption of thetwo substances can cause.