Daily Tobacco Consumption and Binge Drinking in Roma Adolescents in Three Spanish Areas

3 Re is a de ce ce a e [i in e en]ie social ISSN: 1583-3410 (p in ), ISSN: 1584-5397 (elec onic) Selec ed by co e age in Social Sciences Ci a ion Index, ISI da abases DAILY TOBACCO CONSUMPTION AND BINGE DRINKING IN ROMA ADOLESCENTS IN THREE SPANISH AREAS Ca men MENESES FALCÓN, Eugenia GIL GARCÍA, A an xa RODRÍGUEZ BERRIO Re is a de ce ce a e [i in e en]ie social , 2014, ol. 44, pp. 132-146 The online e sion o his a icle can be ound a : www. cis. o, www.doaj.o g and www.scopus.com Published by: Expe P ojec s Publishing House On behal o : „Alexand u Ioan Cuza” Uni e si y, Depa men o Sociology and Social Wo k and Hol Romania Founda ion REVISTA DE CERCETARE SI INTERVENTIE SOCIALA is indexed by ISI Thomson Reu e s - Social Sciences Ci a ion Index (Sociology and Social Wo k Domains) Wo king oge he www. cis. o expe p ojec s publishin g 132 REVISTA DE CERCETARE SI INTERVENTIE SOCIALA - VOLUME 44/2014 Daily Tobacco Consump ion and Binge D inking in Roma Adolescen s in Th ee Spanish A eas Ca men MENESES FALCÓN1, Eugenia GIL GARCÍA2, A an xa RODRÍGUEZ BERRIO3 Abs ac s The objec i e o he s udy is o explo e obacco and alcohol consump ion amongs Roma adolescen s, indica ing any di e ences acco ding o gende and geog aphical a ea (Andalusia, Mad id and he Basque Coun y). I was made a ans e sal s udy ia a school su ey comp ising 569 Roma adolescen s, egis e ed in Seconda y Educa ion and anging om 12 o 18 yea s o age. The da a was collec ed be ween Janua y and June 2011. The a iables we e: socio-demog aphic, eligious belie s, p ac ice o spo s, obacco and alcohol consump ion, and con- sump ion con ex (pee s, pa ne , and pa en s). The main esul s we e ha 16.2% o Roma adolescen s smoked daily and d unk i e o mo e alcoholic d inks (binge d inking) on he las occasion. Smoking on a daily basis was associa ed o being a boy, a pa en ha smokes, a pa ne ha smokes and iends ha smoke. Being a boy, ge ing d unk and ha ing been o a bo ellón (social d inking in he s ee ) inc ease he likelihood o binge d inking. Spo s and eligious ac o s we e no associa ed o daily smoking o binge d inking. The e o e he Roma adolescen boys a e a g ea e isk han gi ls o smoking daily and binge d inking, he e being gende di e ences in in ensi e obacco and alcohol consump ion, bu no in he gene al use o hese subs ances. A smoking pa en is associa ed o a g ea e isk o Roma boys smoking, and going o a bo ellón o ge ing d unk is associa ed o a g ea e isk o binge d inking. I is necessa y o bea in mind he e hnic a iable in educa i e socio-sani a y in e en ions. Keywo ds: Roma; e hnici y; adolescen s; alcohol; obacco; Spain. 1 Uni e sidad Pon i icia Comillas, Depa men o Sociology and Social Wo k, Mad id, SPAIN. E- mail: [email protected] (co esponding au ho ) 2 Uni e sidad de Se illa, Depa men o Nu sing, Se ille, SPAIN. E-mail: [email protected] 3 Uni e sidad de Deus o, Depa men o Social Wo k and Sociology, Bilbao, SPAIN. E-mail: a od ig@deus o.es Wo king oge he www. cis. o 133 In oduc ion I is hough ha he popula ion pe aining o he Roma e hnic mino i y in Spain is close o 600,000 people (Fundación Sec e a iado Gi ano, 2007), a ound 1.3% o he o al Spanish popula ion, dis ibu ed e y he e ogeneously in he Spanish e i o y. Amongs hem we can iden i y wo di e en collec i es: hose who ha e been se led in Spain o a long ime, o in o he wo ds, hei o igin goes back o he i s mig a o y mo emen s ha da e om he 16 h cen u y, and a e he e o e indigenous Roma (Gamella, 1999), and hose coming om ecen mi- g a o y mo emen s om Eas e n Eu ope. In gene al, i is an e hnic g oup wi h li ing and heal h condi ions ha a e di e en o he majo i y popula ion wi h which i coexis s, wi h unequal access o heal h se ices and sani a y assis ance (Fundación Sec e a iado Gi ano, 2009). The e a e ew in es iga ions conce ning he heal h condi ions o he Roma popula ion in he Eu opean con ex . The da a indica es ha i is a popula ion ha li es in p eca ious li ing condi ions, ha has unheal hy alimen a y habi s and ha unde u ilizes he p ima y assis ance se ices (Hajio & McKee 2000, Cabedo 2000, Zeman e al. 2003, Fe e , 2003). Too equen ly, hei homes lack sewe sys ems and unning wa e and hey a e loca ed in impo e ished a eas. They ha e poo ly balanced die s and exe cise a ely compa ed o he majo i y popula ion. They ha e a g ea e alcohol and obacco consump ion and a lowe use o con- acep ion me hods. A lack in p e en i e ac i i ies ela ed o accessing heal h se ices can also be no ed. This all a o s a g ea e in an mo ali y a e and a dec ease in li e expec ancy which is 10 yea s less han ha o he socie y wi h which hey coexis (Hajio & McKee, 2000). Many au ho s conside his g oup o be cul u ally di e en o he es o he popula ion. This g oup is cha ac e ized as being younge , ha ing a lowe le el o educa ion and high le els o school ailu e and unemploymen , a high e ili y and bi h a e and a g ea e gende gap han ha o he majo i y g oup (Cal o, 1990; San Roman, 1997; Gamella, 2000; Fe e 2003). Despi e he popula ion being eminen ly young, he e a e ew s udies con- ce ning Roma you hs and adolescen s. Nume ous in es iga ions show ha , amongs he gene al popula ion, adolescence is he ime when he consump ion o d ugs, especially alcohol and obacco is commonplace (Díez, 1998; A iza, 2003; Obse - a o io Español de D ogodpendencias, 2009). Howe e , we do no know how he consump ion o psychoac i e subs ances is dis ibu ed amongs Roma adolescen s since he in es iga ions ca ied ou do no conside he cul u al di e en ia ion, and his is despi e he accul u a ion and in e cul u al p ocesses indica ing ha d ug consump ion and he ci cums ances associa ed o i a y acco ding o e hnic g oups (Blum e al. 2000, Bes e al. 2001, Meneses e al, 2009). I has been conside ed ha Roma adolescen s smoke mo e han hei non Roma coun e pa s REALITIES IN A KALEIDOSCOPE 134 REVISTA DE CERCETARE SI INTERVENTIE SOCIALA - VOLUME 44/2014 (Ge e ich e al. 2010) and ha his could be explained by he alues associa ed o obacco consump ion amongs males (Pe ek e al. 2006). On he o he hand, i has been shown ha eligious belie s can be a p o ec i e ac o in d ug consump ion (Engs & Mullen 1999), as a e spo s ac i i ies (We ch e al. 2003, Delisle e al. 2010). Howe e , we do no know i hese ac o s could o e p o ec ion o no o his e hnic g oup, who has a la ge eligious a ilia ion o he e angelical chu ch (Gamella, 1999). Acco ding o he la es School Popula ion Su ey (OED 2009), 38.1% ha e smoked du ing he las yea , 72.9% ha e d unk alcohol; 30.5% ha e smoked hashish and 47% ha e go en d unk in he las yea . Is his da a applicable o Roma you hs and adolescen s? Does e hnic iden i ica ion in luence in in ensi e d ug consump ion? Is i necessa y o bea cul u al di e ences in mind when designing p e en ion p og ammes agains d ug consump ion? These and o he ques ions ha e guided ou objec i es in his in es iga ion. The objec i e o his s udy is o explo e hose ac o s associa ed o daily obacco consump ion and binge d inking amongs Roma adolescen boys and gi ls, which will enable he o mula ion o p e en i e in e en ions adap ed o hei cul u e. Me hods S udy design T ans e sal s udy ia school su ey ca ied ou be ween he Janua y and July 2011 on s uden s o Compulso y Seconda y Educa ion in Andalusia, Mad id and he Basque Coun y. The su ey was au ho ized by he selec ed educa ion cen e s. Pa icipan s and da a collec ion Ini ially he idea was o use simple andom sampling as a model. Based on he Mapa de i iendas de la Comunidad gi ana (Map o Roma Communi y homes) in Spain in 2007 (Fundación Sec e a iado Gi ano 2007), we es ima e ha he e a e abou 48,000 Roma child en egis e ed in ESO (Compulso y Seconda y Edu- ca ion) h oughou Spain, wi h abou 22080 in Andalusia, 4800 in Mad id and 1056 in he Basque Coun y, gi en he popula ion in each Au onomous Commu- ni y. Conside ing a sample size o 500 Roma adolescen s, es ima ing he sample sizes o p=q=0.5 we would ge a sampling e o o 4.4% wi h a 95% con idence in e al. I we we e o ca y ou a sample p opo ional o he size o each commu- ni y, calcula ed p opo ionally, he co esponding quo as in each communi y would be: in Andalusia n=395, in Mad id n=86 and in he Basque Coun y n=19. This size was used as a minimum e e ence o ob aining he sample, al hough he 135 sample ob ained was om 580 Roma adolescen s dis ibu ed in he ollowing way: 319 in Andalusia, 164 in Mad id and 97 in he Basque Coun y, which globally in he h ee communi ies educes he sampling e o o 4%, wi h a 95% con idence in e al. The inal sample comp ised 569 Roma adolescen s, since 11 ques ionnai es we e disca ded o no ul illing he c i e ia es ablished. The ype o sample ca ied ou in he end was in en ional, as i was no possible o ind a census which could be used o pe o m he andom selec ion. We ound hose educa ion cen e s wi h a g ea e concen a ion o Roma adolescen s wi h he help o he Fundación Sec e a iado Gi ano. To collec he g ea es numbe o ques ionnai es we con ac ed he di ec o s and educa ion ad iso s in he cen e s o each geog aphical a ea and hey con i med he high pe cen age o egis e ed s uden s. The ques ionnai e was comple ed by all s uden s in he selec ed classes and la e he eam selec ed hose s uden s who sel -iden i ied hemsel es as Roma o he sample, ha is o say, he s uden s hemsel es placed hemsel es in one o he e hnic g oups o e ed o hem (Asian, Black, Mixed, Whi e, Roma, O he ). The ins umen o collec ing he in o ma ion was a con iden ial ques ionnai e illed ou indi idually which was alida ed in a p e ious in es iga ion. Howe e , some modi ica ions we e made o i and be o e using i wo discussion g oups we e held wi h adolescen s and a p e- es ial was pe o med in an educa ion cen e ha was no included in he sample and which se ed o assess hese modi ica ions. Educa ion cen e s in o med pa en s o he in es iga ion and we e en us ed wi h ga he ing pe mission o ms. The da a was collec ed in he classes by he esea che s hemsel es, helped by he su ey ake s. Filling ou o he ques ionnai e was supposed o ake 40 o 45 minu es, bu many Roma adolescen s showed eading-w i ing p oblems, needing o be helped pe sonally by he esea che s o su ey ake s. S udy a iables The ques ionnai e co e ed di e en isk beha io s, bu in his a icle we will only se ou hose ela ed o obacco and alcohol consump ion. The a iables o he s udy we e collec ed o he p e ious yea , excep in he case o obacco whe e hey we e also asked i hey smoked a ha momen . A eligious ac o was included wi h six a iables o desc ibe hei si ua ion wi h ega ds o eligious belie s (My eligion is e y impo an o me, I conside mysel a belie e , My eligious belie s in luence my ac ions, I obey he commandmen s o my eligion, I p ay e e y day, I enjoy being wi h o he people who a e as eligious as I am) wi h ou possible answe s (S ongly ag ee, ag ee, disag ee, s ongly disag ee), wi h a C onbach’s alpha o 0.906. The dependen a iables we e dicho omized o ana- lysis. In o ma ion was ga he ed ega ding he numbe o alcoholic d inks (glasses, mixed d inks, and alcoholic d inks) consumed on he las occasion and his was di ided in o wo in e als: less han 5 alcoholic d inks and 5 o mo e alcoholic REALITIES IN A KALEIDOSCOPE 136 REVISTA DE CERCETARE SI INTERVENTIE SOCIALA - VOLUME 44/2014 d inks (binge d inking). The equency o obacco consump ion was eco ded (Ne e , A ew imes a yea , Two o h ee imes a week, A weekends, and Daily) and om his a iable a dicho omous a iable was de i ed (smokes daily o doesn’ smoke daily). Da a analysis In o de o es he independence o a iables, a Chi-Squa e es o - es was used in bi a ia e analysis. Logis ic eg ession models we e cons uc ed sepa a ely o each ype o consump ion s udied (daily smoking and binge d inking). P e- alence odds a ios (OR) we e calcula ed wi h hei co esponding 95% con- idence in e als (95%CI). Fo all analysis, a le el o signi icance o 5% was conside ed. These analyses we e conduc ed wi h SPSS s a is ical package e sion 17. Resul s The age ange o he s uden s was om 12 o 18 yea s old, wi h a median and modal a e age o 15 yea s old. Table 1 shows socio-demog aphic da a om he sample o boys and gi ls, which is simila in he h ee au onomous communi ies. I is no ewo hy ha 52.7% ha e epea ed he school yea and 59.6% planned o con inue s udying. Tobacco and alcohol consump ion ound in he sample is displayed in Table 2, showing he di e ences in each Au onomous Communi y whe e da a was collec ed. The e we e no s a is ically signi ican di e ences be ween boys and gi ls in obacco consump ion a he ime o he su ey (p= 0.140), no in alcohol consump ion du ing he pas yea (p=0.679). We ound s a is ically signi ican di e ences be ween boys and gi ls in couples ha smoked (p=0.000), wi h ha o gi ls being g ea e (48%) han ha o boys (19.6%); and in he op ion o a g oup o iends in which all smoke (p=0.004), since i was less common o gi ls o ha e an all-smoking g oup o iends (7.3%) whe eas i was mo e common o boys o ha e an all-smoking g oup o iends (14.1%). 137 Table 1. Roma adolescen s socio-demog aphic da a a) X= A e age, SD= S anda d de ia ion To al (n=569) Andalusia (n=314) n(%) Mad id (n=164) n(%) Basque Coun y (n=91) n(%) Boys Gi ls 294 (51.9) 272 (49.4) 159 (50.6) 155 (49.4) 94 (58.0) 68 (42.0) 41 (45.6) 49 (54.4) Age (X and SD)a 14.84 (1.30) 14.96 (1.39) 14.68 (1.14) 14.79 (1.25) 1s ESO 2nd ESO 3 d ESO 4 h ESO Voca ional Quali ica ion P og ammes 269 (47.7) 167 (29.6) 70 (12.4) 50 (8.9) 8 (1.4) 134 (42.7) 91 (29.0) 52 (16.6) 32 (10.2) 5 (1.6) 98 (59.8) 48(29.3) 5 (3.0) 10 (6.1) 3 (1.8) 37 (43.0) 28 (32.6) 13 (15.1) 8 (9.3) - Financial si ua ion -Ve y com o able inancially -We do no ha e inancial p oblems -Lo s o inancial p oblems 146(27.1) 278(51.7) 114(21.2) 85(28.5) 155(52.0) 58(19.5) 43(27.9) 81(52.6) 30(19.5) 18(20.9) 42(48.8) 26(30.2) Type o dwelling -Fla -House -Shack -Chale -O he 393 (69.2) 128 (22.5) 16 (2.8) 27 (4.8) 4 (0.7) 193 (61.7) 97 (31.0) 5 (1.6) 16 (5.1) 2 (0.6) 119 (72.6) 27 (16.5) 9 (5.5) 9 (5.5) 81 (89.0) 4 (4.4) 2 (2.2) 2 (2.2) 2 (2.2) A e age no. o people li ing wi h him/he (X and DS)a 4.48 (1.82) 4.18 (1.82) 5.03 (2.08) 4.55(1.90) Has epea ed a school yea Wan s o con inue s udying 303 (54.7) 328 (59.6) 164 (53.4) 193 (63.9) 95 (60.5) 72 (45.6) 44 (48.9) 63 (70.0) Religious ac o (X and SD)a 0.256 (1.14) - 0.048(1.15 ) 0.595(1.04) 0.777(0.89 ) Usually li es wi h a he Usually li es wi h mo he 445 (78.6) 504 (88.9) 234 (75.0) 276 (88.5) 138 (84.1) 153 (93.3) 73 (81.1) 75 (82.4) REALITIES IN A KALEIDOSCOPE 138 REVISTA DE CERCETARE SI INTERVENTIE SOCIALA - VOLUME 44/2014 Table 2. Use o d ugs in he las 12 mon hs n(%) a) X= A e age, SD= S anda d de ia ion. The e we e no di e ences in d inking alone se e al imes in he las yea (p=0.064), no in he amily con ex o consump ion (p=0.235), no in ge ing d unk (p=0.470). 16.2% (n=92) smoked daily and his same pe cen age admi ed o binge d inking a he las occasion hey had. In bo h beha io s we ound signi ican di e ences be ween gende s. Fi s ly, in binge d inking a he las occasion (p=0.000), 12.5% (n=26) o gi ls compa ed o 28.3% (n=66) o boys. Secondly, he e was a signi ican co ela ion (p=0.011) ound in daily smoking, wi h 21.7% (n=59) o boys smoking daily in compa ison o 13.2% (n=33) o gi ls. Table 3 shows he esul s ob ained om he bi a ia e analyses o he wo beha io s analyzed (smoking daily and binge d inking), b oken down o boys and gi ls. Table 4 shows he esul s ob ained om he bina y logis ic eg ession analysis o each beha io s udied. Being a boy o ha ing a pa ne , pa en o iends who smoke a e all signi ican isk ac o s o smoking daily. I is wo h no hing ha ha ing iends who smoke can make i ou een imes mo e likely o smoke daily, whils o he a iables make i nea ly h ee imes mo e likely. P ac icing spo and D ugs To al N% Andalusi a N% Mad id N% Basque Coun y N% p Smokes a he ime o he su ey 113 (21.1) 61 (20.2) 31 (21.2) 21(23.9) 0.758 No. ciga e es (X and SD)a 10.04 (8.95) 7.44(7.23) 12.04(10.54 ) 12.71(8.51) 0.022 Daily 92 (17.6) 37 (12.6) 32 (22.4) 23 (26.1) 0.013 Pa en s smoke Pa en ha smokes Fa he Mo he 335 (62.9) 278(48.9) 127(22.3) 194 (64.9) 148(47.1) 95(30.3) 83 (56.8) 77(47.0) 20(12.2) 58 (65.9) 53(58.2) 12(13.2) 0.209 0.148 0.000 Pa ne All iends 108 (32.6) 59 (11.1) 59 (32.1) 20 (6.7) 25 (26.6) 25 (17.2) 24 (45.3) 14 (15.9) 0.066 0.000 Alcohol 315 (65.2) 177 (63.7) 89 (64.0) 49 (74.2) 0.253 Alcohol consump ion con ex Wi h amily Ou side o amily 246(43.2) 200(35.1) 130(41.4) 124(39.5) 73(44.5) 43(26.2) 43(47.3) 33(36.3) 0.566 0.015 D inks alone o en 72 (14.4) 38 (13.5) 21 (15.6) 13 (15.7) 0.807 No. o d inks on las occasion (X and SD) 2.58 (3.87) 2.26(2.64) 2.81(4.67) 3.70(6.27) 0.035 Has d unk a a bo ellón 211(43.9) 131(45.5) 44(36.1) 36(50.7) 0.097 Has go d unk 217(42.5) 122(43.0) 56(40.3) 39(44.8) 0.781 Binge d inking on las occasion 92(20.8) 50(18.5) 27(22.5) 15(28.3) 0.237 139 he eligious ac o we e no signi ican , al hough hey did ep esen a nega i e coe icien . Wi h ega ds o binge d inking, es ablished as consuming i e o mo e d inks, once again being a boy and going o a bo ellón4 o d ink and ge d unk a e signi ican ly ela ed o his ype o alcohol consump ion, no ing pa i- cula ly ha going o a bo ellón en ails i being i e imes mo e likely o binge d ink. Table 3. Daily obacco consump ion and binge d inking by gende BOYS N(%) N=294 (51.9) GIRLS N(%) N=272 (49.4) o al Smokes Daily 59(20.1%) p o al Smokes Daily 33(12.1%) p No. ciga e es (X and SD)a 12.8(9.726) 14.1(9.53) 0.007 6.23(6.05) 8.55(6.54) 0.000 Pa en s smoke Fa he smokes Mo he smokes 165(56.1) 136(46.3) 64(21.8) 45(78.9) 61(22.4) 15 (25.4) 0.001 0.003 0.533 168(61.8%) 26(81.3) 23(69.7) 17(51.5) 0.000 0.041 0.000 Pa ne F iends None Some Nea ly all 36(12.2) 57(19.4) 128(43.5) 87(29.6) 16 (33.3) 1(1.8) 15(26.8) 40(71.4) 0.007 0.000 72(26.5) 75(27.6) 133(48.9) 51(18.8) 20(80) 1(3) 14(42.4) 18(54.5) 0.000 0.000 Religious ac o (X and SD)a 0.253(1.08) 0.317(0.99) 0.546 0.25(1.21) 0.24(1.26) 0.020 P ac ices spo 253(86.1) 49(87.5) 0.736 112(41.2) 16(48.5) 0.430 To al N Binge d inking 66(22.4%) p To al N Binge d inking 26(9.6%) p D inks alcohol Wi h amily Ou side o amily 122(41.4) 109(37.1 35(53.0) 40(60.6) 0.061 0.000 123(45.2) 90(33.1) 18(69.2) 17(65.4) 0.021 0.000 D inks alone o en 44(15) 17(27) 0.002 27(9.9) 6(25) 0.000 Nº o d inks on las occasion (X and SD) 3.32(4.81) 8.86(5.77) 0.000 1.7(2.17) 6.01(1.28) Has d unk a a bo ellón 124(42.2) 49(77.8) 0.000 86(31.6) 20(87) 0.000 Has go d unk 115(39.1) 43(74.1) 0.000 101(37.1) 16(64) 0.005 Religious ac o (X and SD)a 2.88(0.32) 0.18(1.09) 0.734 0.256(1.21) 0.17(1.21) 0.989 P ac ices spo 253(86.1) 61(92.4) 0.604 112(41.2) 9(34.6) 0.270 4 “The bo ellón phenomenon usually s a s as a g oup o adolescen s o young people, who a e iends, buying alcoholic be e ages in a supe ma ke o ou le and hen engaging in he ou doo consump ion o alcohol in public places, such as pa ks, disco pa king lo s, o isola ed a eas. 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