Bullying involvement and substance use among Brazilian adolescent students

A common experience for many adolescents, bullying can have lifelong repercussions.Worldwide estimates indicate that approximately one in three adolescent males, and one in four adolescent females, have been the target of bullying (1).Longitudinal studies also show that bullying victimization during childhood and adolescence is associated with higher rates of mental health problems later in life (2), while adolescent bullies are more likely to engage in serious violent behaviors in adulthood (3).Thus, the widespread prevalence of bullying, coupled with its potential negative impacts on adolescent development, have made the issue a global public health concern (1). ABSTRACTObjective.Although bullying involvement has been associated with adolescent substance use, most of this evidence comes from high-income countries.Little is known about substance use among perpetrator-victims in low-and middle-income countries.This study explores the asso-ciation between types of bullying involvement and adolescent substance use in Brazil. Methods. Data for this cross-sectional study came from the 2015 Pesquisa Nacional de Saúde do Escolar [National Adolescent School-based Health Survey] (PeNSE), a nationwide school-based survey of Brazilian ninth graders.Substance use was analyzed as any substance use (i.e., use of alcohol, cigarettes, or marijuana in the previous 30 days) and substance co-use (i.e., use of all three substances).Logistic regression analyses were conducted, and adjusted odds ratios (aORs) were calculated, adjusting for demographic characteristics and student loneliness.Results.Odds of any substance use for bullying perpetrators-only and for perpetrator-victims, respectively, were significantly higher compared to no bullying involvement (aOR = 2.99, 95% CI = 2.71-3.30and aOR = 2.52, 95% CI = 2.31-2.75).Adjusted odds of substance co-use were also significantly higher among perpetrators-only and perpetrator-victims (aOR = 4.04, 95% CI = 3.05-5.35and aOR = 3.49, 95% CI = 2.71-4.51,respectively).Victimizationonly was associated with a 14% increase in the odds of any substance use (aOR = 1.14, 95% CI = 1.07-1.22).Conclusions.The results underscore the complex relationship between adolescent bullying involvement and substance use.Findings also indicate the type of bullying involvement, as well as demographic and psychological factors, should be taken into consideration when assessing adolescent health-risk behaviors.