Cómo citar: Campo-Arias A, Daza-Fragozo R, Caballero-Dominguez C. Factores asociados a consumo de cocaína en

estudiantes en Santa Marta, Colombia. Ciencia e Innovación en Salud. 2021. e113: 029-038 DOI 10.17081/innosa.113

Factors associated with cocaine smoking in students at Santa Marta,

Colombia

Factores asociados a consumo de cocaína en estudiantes en Santa Marta,

*Dirigir correspondencia a: acampoa@unimagdalena.edu.co

Like other substances, the initiation and maintenance of cocaine smoking is a complex issue

related to several personal and contextual biological and environmental factors (1, 3). Some

factors include a) biological and individual factors such as age, gender, general health condition,

and b) contextual variables such as family environment, exposure to violence, symptoms or

depressive disorders, and consumption of legal substances and other substances illegal like

Therefore, preventive strategies and early identification of cocaine smoking in adolescents in the

school context are highly relevant in public health (12). This study explores a set of variables

previously omitted from previous research concerning cocaine smoking in adolescent students

in the Colombian Caribbean.

The present study's objective was to explore some factors associated with lifetime cocaine

smoking among high-school adolescents at Santa Marta, Colombia.

An observational, analytical, cross-sectional study was carried out.

level of 95%. A sample of 384 participants was acceptable (13). However, the authors preferred

to multiply the initial estimate by four to facilitate the estimation of associations with narrower

confidence intervals. Likewise, the replacement of 25% was included considering the possible

loss of participants, for example, due to the institution's refusal, not having the informed tutor

consent, nor students assent. With the descriptive parameters, the participation of 1,948

students was requested. Only tenth and eleventh-grade students aged between 13 and 17

years were included. Students with a disability to independently complete the questionnaire

were excluded.

The self-perception of academic performance and perception of general health were evaluated

with a single item taken from the Questionnaire of Epidemiological Surveillance of Psychoactive

Substances, VESPA, widely used in Colombia (14). These items have an excellent, good, fair,

and poor ordinal response pattern. For this analysis, the four response options were

dichotomized into excellent-good and fair-poor.

Lifetime school bullying and substance use (alcohol, cigarette, cannabis, and cocaine) were

assessed with items taken from the Youth Risk Behavior Survey Questionnaire for Middle-

school students of the United States Center for Disease Control. These items have a simple

response pattern, yes or no (15). The Youth Risk Behavior Survey Questionnaire has shown

high reproducibility in previous studies (16).

Family functioning was quantified with the family APGAR. The family APGAR has five items

that measure adaptability, cooperation, growth, affectivity, and resolving capacity. Each item

presents five response options: never, seldom, sometimes, almost always, and always. Such

version of the Brief Davidson Trauma Scale (BDTS). This instrument explores the presence of

hyper-alertness, physiological excitement, anger, and mental dullness of post-traumatic stress

disorder. Each item offers four possible responses to which one to four points are assigned.

Consequently, the total scores are in the range between 4 and 16. In the current investigation,

those scores greater than 12 were categorized as high risk of PTSD (19). The large version of

the scale presented acceptable consistency in a previous study with Colombian adults, with

Cronbach's alpha 0.97 (20). In the sample of the present study, Cronbach's alpha was 0.66.

The risk of an MDE was established with the application of the Well-Being Index (WHO-5). This

index quantifies general well-being or the absence of depressive symptoms during the last two

(21). The WHO-5 brings together five items that address mood, tranquility, energy level, quality

another study in adolescents from the Colombian Caribbean (22). In the current sample,

Cronbach’s alpha was 0.82.

October 2018.

(97.3%) denied having ever used it in their life.

For the final adjustment, grade and self-perception of academic performance that showed

probability values of less than 25% were considered. The best-fitting model showed descending

In the present analysis, it was shown that the risk of PTSD was associated with cocaine

smoking. This finding is consistent with studies in other countries. For example, Flores et al.

(25), in Mexican American adolescents, observed that they experienced marked symptoms of

PTSD correlated with the consumption of illegal substances, cannabis, and cocaine, among

others. Similarly, Schiff et al. (26), in Arab and Jewish middle-school adolescents, observed

that scores for post-traumatic stress were associated with cannabis use and ecstasy during the

Céline et al. (27) reported that lifetime cigarette smoking was associated with cocaine smoking

in French adolescents. In the same sense, longitudinal studies showed a similar association.

Keyes et al. (28), in the United States in high-school students, observed that the prevalence of

cigarette smoking in eighth and tenth grades was associated with the prevalence of cocaine

smoking in twelfth grade. Nkansah-Amankra (29) showed that lifetime cigarette smoking in

early adolescence predicted (between 1 and 19 times) cocaine smoking in late adolescence in

middle- and high-school students in the United States. However, do Nascimento et al. (30)

reported independence between tobacco and lifetime cocaine smoking in adolescent students

at Penabumco, Brazil.

The similarities and differences observed in this study's findings with the previous studies may

lie in the study designs, cross-sectional and longitudinal, the disparities in the social and cultural

contexts, the form of measurement of the variables of interest, and the years of carrying out the

studies. It is essential to unify criteria for the measurement and monitoring of substance use in

adolescents and adults. This strategy would allow better comparisons and interpretation of the

findings in the different contexts (31). Convoluted health problems such as cocaine smoking

require permanent reviews of the prevalence and associated variables according to the

determinants of health for each community; the findings of particular contexts can be rarely

generalized to the world population, beyond the world increasingly globalized (2).

effect or possibility of inducing dependency (29). In the present study, specific cultural variables

that qualify substance use in adolescents, such as sexist cultural patterns or familism, were not

quantified. Measurement of these cultural variables has increased in epidemiological studies;

however, the difficulty of objectifying the evaluation of collective attitudes, beliefs, and practices

(2).

The current study contributes to knowledge because presenting the variables associated

exclusively with lifetime cocaine smoking due to the low prevalence in previous studies, and

they had not been analyzed in a disaggregated way of other illegal substances. However, this

It is concluded that lifetime cigarette and cannabis smoking, the risk of PTSD, and the tenth

grade are associated with lifetime cocaine smoking among high-school adolescents at Santa

Marta, Colombia. It is necessary to know how to explore other factors associated with cocaine

smoking in middle school students.

through Resolution 0347 of 2018 (Fonciencias Call for Proposals 2017).

information for the research assistant psychology students: Adriana Rodríguez Martínez, Ana

Celis Márquez, Carlos Fuentes López, Daniela Gonzales Cantillo, Heiner Tordecilla Arroyo,

Nataly Tapia Duarte, Sandra Gómez Mariscal, and Yuleinys Dávila Gómez. Also, we want to

Johana Guerrero Bolaño, and María Paola Jiménez Villamizar.