Predictive Factors of Alcohol Initiation among Brazilian Adolescents: Assessing the Role of Attitudes, Decision-Making, Communication, and Resistance Skills

This study aims to evaluate if attitudes toward drug use, decision-making, communication, and alcohol resistance skills act as predictors of alcohol use and binge drinking initiation among Brazilian students, considering the sex differences. We used a longitudinal sample of 1,103 seventh-grade students from 15 Brazilian public schools. We explored if attitudes toward drug use, decision-making, communication, and alcohol resistance skills at baseline predicted alcohol outcomes nine months later. We found that lower levels of resistance skills (i.e., ORboys=0.29, 95% CI: 0.12; 0.70) and positive attitudes toward drugs (i.e., ORgirls:=1.41, 95% CI: 1.02; 1.94) are predictors of alcohol use onset and binge drinking, independently of sex. Decision-making predicts binge drinking initiation only for girls (OR=0.73, 95% CI: 0.59; 0.91). Negative attitudes toward drugs are a risk factor for alcohol use initiation only for boys (OR=0.78, 95% CI: 0.64; 0.95). Our findings highlighted the importance of understanding the predictors of adolescents' alcohol outcomes to inform the key components that preventive programs should address in their activities to achieve the expected preventive outcomes.