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Alcohol and tobacco use among Monteverde youth: A preventative approach

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Title:
Alcohol and tobacco use among Monteverde youth: A preventative approach
Translated Title:
El consumo de alcohol y tabaco en los jovenes de la zona Monteverde ( )
Physical Description:
Book
Language:
Text in English
Creator:
Bose, Hannah
Grams, Danielle
Vollstaedt, Joshua
Publication Date:

Subjects

Subjects / Keywords:
Youth--Alcohol use
Jovenes--Consumo de alcohol
Youth--Drug use
Jovenes--Consumo de droga
Community Health 2011
Salud comunitaria 2011
Costa Rica--Puntarenas--Monteverde Zone
Costa Rica--Puntarenas--Zona de Monteverde

Notes

Abstract:
This study investigates adolescent alcohol and tobacco consumption in the Monteverde zone of Costa Rica, addressing who engages in alcohol and tobacco use, what are the motivations to consume or not consume alcohol and tobacco, what protective and risk factors are acting on Monteverde youth, and what activities are desired by Monteverde youth.
Abstract:
Este estudio investiga el alcohol de los adolescentes y el consumo de tabaco en la zona de Monteverde de Costa Rica, dirigiéndose a quien se involucre en el uso del alcohol y el tabaco, cuales son las motivaciones para consumir o no consumir alcohol y tabaco, cuales son los factores de riesgo y protección que están actuando en la juventud de Monteverde, y qué actividades son deseadas por los jóvenes de Monteverde.
General Note:
Student affiliations: University of South Florida, Tampa, FL, and Indiana University-Purdue University Indianapolis, Indianapolis, Indiana

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All applicable rights reserved by the source institution and holding location.
Resource Identifier:
usfldc doi - M38-00059
usfldc handle - m38.59
System ID:
SFS0044294:00001


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Alcohol and Tobacco Use Among Monteverde Youth A Preventative Approach Hannah Bose Danielle Grams Joshua Vollstaedt Globalization and Community Health Field School Monteverde Institute June 19 th to July 24 th 2011

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Adolescent alcohol and tobacco consumption has become a growing concern among citizens in the Monteverde zone of Costa Rica. Per the request of the Monteverde clinic, the Monteverde Institute was asked to research alcohol and tobacco use among Monteverde youth. To best address this concern, we sought to answer four questions: who engages in alcohol and tobacco use, what are the motivations to consume or not consume alcohol and tobacco, what protective and risk factors are acting on Monteverde youth, and what activities are desired by Monteverde youth. These questions were answered through participant observations, informal conversations with community members, one on one interviews, a focus group and surve ys. It was found that 15.3% of youths between 15 25 years old engage in frequent alcohol use and 6.9% of youths engage in frequent tobacco use, with the average ages of first consumption being 14.2 years and 14.9 years respectively. Additionally, there i s not a statistic different between the consumption of males and consume or not consume alcohol and tobacco. Additionally, the commun ity expresses a great concern that there is a lack of safe activities for youth in the Monteverde zone. This lack of activities is perceived to be contributing to adolescent alcohol and tobacco use. The results of 11 interviews and 62 surveys indicate th at a park, sports/recreation center, sports teams and a movie theater are the top desired activities by Monteverde youth. The results of this study can be used for further research on the topic of alcohol and tobacco use in the Monteverde zone as well as serve as a starting point for the implementation of youth centered activities.

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Biography of the Research Team The research team was comprised of three undergraduate students with backgrounds in Biology and Anthropology. Hannah Bose a senior student at Indiana University Purdue University of Indianapolis majoring in Medical and Cultural Anthropology with a minor in Medical Humanities. Hannah is an intermediate level Spanish speaker. Danielle G rams is a junior in the Hon ors College at the University of South Florida double majoring in Cellular and Molecular Biology and Research. She is interested in the field of medicine, specifically infectious diseases and international health Danielle is a basic intermediate Spanish speaker. Joshua Vollstaedt is a senior at the University of South Florida majoring in Biology and he is a beginning Spanish speaker He is also interested in pursuing a career in medicine. Introduction The Monteverde community identified alcohol and toba cco use among adolescents as a s ocial and public health problem and requested that the Monteverde Institute conduct a research investigation of this issue Based upon recommendations made by previous MVI research groups ( Potts et al, Lee et al, de Luna et al) the research team chose to investigate the motivations and environmental influences of youth consumption of alcohol and tobacco. Studies by Blum and Ireland stress the importance of assessing both risk and protective factors when evaluating a nd pred icting adolescent

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substance abuse. In this study, we evaluat e risk and protective factors as described by Arthur et al such as family support, peer influence and school/community engagement (Appendix A) Additionally, during the research process, the community repeatedly cited a lack of positive recreational activities as a cause for youth cons umption of alcohol and tobacco. de Farmaco Dependencia (IAFA) reported in a 2002 study that participation in activities such as religion, art and sports prevent alcohol consumption ( Sanabria Leon) Therefore, the research team also sought to determine what types of recreational activities are desired by the youth of Monteverde The information acquired through this study can be used to develop anti alcohol and tobacco programs that are of relevance to the Monteverde community. Research Goals Based on informal conversations with community members, interviews and meetings with a Monteverde Communi ty Advisor, the following research questions were formed: Who within our population consumes alcohol and/or tobacco? A t what age does alcohol and tobacco consumption begins? What are the r easons for consuming or not consuming alcohol and /or tobacco? What a re the r isk and protective fac tors affecting Monteverde youth in relation to alcohol and tobacco consumption? What al ternative activities do youth living in the Monteverde Zone (MVZ) desire?

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Research Methods To gain the insight into tobacco and alcohol use among youth in M onteverde, it was first necessary to observe and participate in the culture. Participant observation was performed in two bars in S anta Elena. The two bars within Santa Elena, Mata y Ca a and Bar Amigos were visited in the beginning of the study to observe youth interactions. After collecting this data, a review of literature relevant to alcohol and tobacco use among Central American and, when possible, Costa Rican youth was done to pinpoint a topic. The main literature used was Ar thur et. al, 2002 and Kliewer & Murrelle, 2006. This literature explained risk and protective factors that specifically affect youth in Central America. After reviewing the literature and choosing a specific topic, three methods were used to collect qual itative and quantitative data. The methods used were a focus group, surveys and interviews. Focus Group: An informal focus was held to determine why youth were drinking and smoking tobacco and what could help decrease the amount of youth drinking and s moking tobacco. The group consisted of about 15 theater students ages 11 18 years old. The group was mostly from the Friends school and most participants spoke English. Topics discussed in the focus group included drug, alcohol and tobacco use. The di scussion also included law enforcement as it pertains to illegal sale and use of drugs, alcohol and tobacco.

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Survey: A 21 question survey was administered to 62 Monteverde youths ages 12 25. The sample was non random and the greatest population of thos e surveyed was from Colegio de Santa Elena. The survey included questions pertaining to certain risk factors such as parental relationships, peer use of alcohol and participation in activities. Interviews: A series of 11 interviews were administered th roughout the research period. The interview contained all of the questions from the survey and an increased number of qualitative questions. Questions pertaining to religion and student teacher relationships were included in the interview along with more in depth questions about parental relationships and participation in activities. Of the students surveyed and interviewed, 45.7% we re male and 54.29% were female. Results Key Findings Phase I: Phase I consisted of participant observations at two local bars as well as informal conversations with community members including our host families and community advisor. While in the bars, two predominate observations were made: identification was not a sked for upon entry or purchase of alcohol and there were many under aged youth in attendance. During our informal conversations,

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community members consistently attributed adolescent alcohol and tobacco consumption to a lack of positive activities for you th in the Monteverde Zone. Phase II: Based on phase I conversations and observations, we conducted 11 interviews and one focus group to begin determining the keys issues related to adolescent alcohol and tobacco use in the Monteverde Zone. Three predominate issues were raised: first, the l ack of available healthy activities for youth/the lack of continuity in youth organizations ; second, the lack of enforcement of anti drinking and anti smoking laws ; and third, the inattention to youth voice Ph ase III: The issues raised during phase II were further explored through the administration of 62 surveys covering topics such as participant demographics, family interactions, drinking and smoking habits, drinking and smoking habits of friends, school and community involvement and desired community activities for adolescents. Identical questions asked during the interviews were combined with the results of the survey and the questions were divided into two categories: quantitative responses and qualitative responses. Quantitative

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Out of the 73 participants, 45.71% identify as male and 54.29% identify as female. The age range of participants is from 12 25 year with 16.4 years being the average age. Of the participants surveyed or interviewed, 61.6% report having tried alcohol and 15.3% report drinking frequently. Additionally, 28.8% re port having tried smoking and 6 % report smoking frequently. A total of 22 questions, in addition to demographic information, were asked. After controlling for age and gende r it was found that neither factors effect frequency of alcohol use. However, following SPSS statistical analyzes using chi squared tests with dichotomous variables the following correlations are significant (Appendix B): peer use of alcohol with mother : 80% of the participants answering that they have k alcohol also report never having tried alcohol.

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: Of the youth surveyed, all of those answering no to trying alcohol also answered no to trying cigarettes. Additionally, of the youth answering yes to having tried alcohol, 46% had also tried cigarettes. Of the youth surveyed, 88% o f those living in a house with someone who drinks have tried drinking, while only 52% of youth living in a house with non drinkers had tried alcohol. : 8.3% of participants who rep ort a moderate to high level of comfort speaking with their mother about their problems drink frequently as opposed to 34.8% of participants who drink frequently and report being neutral or uncomfortable speaking with their mother about their problems. Qua litative In addition to answering our research questions through quantitative methods, we took a

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or not consume alcohol and tobacco. We also surveyed particip ants about the types of activities they would like to have available for youth in the Monteverde Zone. What are the reasons you consume/do not consume alcohol? The top three reasons to consume alcohol atencio n" (it does not catch my attention). Participants cited nearly two times as many reasons why they do not consume alcohol than reasons why they do consume alcohol. A visual What are the reasons you consume/do not consume tobacco? The top three reasons to consume tobacco pressue) and third). The top three cancer), "los pulmones" (my lungs) and four tied for third). Participants cited nearly four times as many reasons why they do not

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consume tobacco than reasons why they do consume alcohol. A visual representation of onses can be found in Appendix C What activities would you like to have in the area for youth? The top four activities/locations desired by participants were: park (27 responses), sports/recreation center (10 responses), sports teams (10 responses) and m can be found in Appendix C Conclusions / Recommendations their decision to and not consume alcohol. For this reason, we recommend a three point, communi ty base approach to reducing alcohol and tobacco use among Monteverde adolescents. In this model, attention is focused upon three important roles: that of the parent child relationship, the youth as a group, and the parent role, with all three points furt her supported by the community

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Parent Child Our data showed the importance of family influence in decisions regarding drinking and smoking, thus a focus was directed upon s trengthen ing parent child relationships and open aven ues of communication regarding taboo subjects, such as alco hol and tobacco consumption. This goal might be achieved via i nteractive parent child workshops offered through the Santa Elena Clinic, MVZ high schools and/or MVI ; family oriented community activ ities ; s upport from a community psychologist/social worker ; and p arental involvement in the daily life and activities of child Some of the top free time activities reported among our respondents were going for walks, listening to music, helping out aroun d the house, and playing soccer, all of which can be done with parents, thus strengthening these relationships.

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Parent Based on feedback from adult community members regarding the feelings of helplessness and difficulty in regard to the parental role in pr evention of and recovery from alcohol/tobacco use by their children, we propose a strong focus on support of the parents. I nform ing and empower ing parents to address sensitive issues, such as tobacco and alcohol use, with t heir children via p arental support groups and professional c ounseling services provided by the local psychologist/social worker, would further enhance pr evention and treatment of alcohol and tobacco use. Youth As pointed out by some of our adult community respondents and also demo nstrated by our youth participants, some young people do not receive the necessary support from family members, and are further lead to use and abuse alcohol and tobacco, thus s upport groups for at risk youth are necessary to fill this void. Peer and comm unity support and healthy alternative activities for Monteverde youth would further support the prevention of and recovery from alcohol and tobacco use. The following activities were mentioned in our surveys and interviews: Sports teams/groups Art, music and theater Religious Educational talks (subjects such as alcohol, tobacco, drugs and sexual health)

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Future Research We recommend conducting further research on adolescent alcohol and tobacco use to better elucidate the impact of risk and protective factor s on adolescent consumption. This information can be used to develop anti alcohol and tobacco programs that are of relevance to the Monteverde community. We also recommend surveying a larger sample of tobacco users so that stronger conclusions and correl ations can be made. Additionally, we strongly recommend conducting future research on youth recreational activities. This topic was consistently mentioned during our interviews and surveys and is an important topic to the Monteverde community. Our findi ngs, as well as the findings from Schmidt el al can serve as a foundation for future research on the implementation of recreational activities for Monteverde youth. Limitations The limitations of our study are mostly related to the limited time availa ble for data collection and analysis. They include: Limited time Small population size (in sufficient data about smokers ) Non representative sample size (s urveyed only one high school in the area) Self reporting bias (d ata depended on honesty of participan ts )

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Acknowledgements We would like to acknowledge all the people of Monteverde who took part in our project. We would also like to acknowledge Daniel Vargas and Jenny Pena for advising us on the project, translating and for helping recruit interviewees and youth to survey, Cristina Navarro our community advisor, Kate Brel sford for helping with statistical analysis and input, Heide Castaneda and Ashley Gallentine for instructing us on specific areas of anthropology, Robert Cowherd for assistance with the project. Finally, we would like to acknowledge Nancy Romero Daza and David Himmelgreen for their instruction and for their part in allowing the project to take place.

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References Arthur, Michael, David Hawkins, John A. Pollard, Richard F. Catalano, and A.J. Baglioni. s for Substance Use, Delinquency, and Other Adolescent Evaluation Review 2007: 575 601. Blum, Robert, and Marjorie Ireland. "Reducing Risk, Increasing Protective Factors: Findings from the Caribbean Youth Health Survey." Journal of Adolescent Health 2004: 493 500. Journal of Adolescent Health 40 2007: 448 455. Lee, Joanne, Sandra Oh, Diana Olivia, Myriam Scally, and Susan Walker. "Perceptions of Montevede Youth (14 18 years of age) Towards Pro and Anti Tobacco Advertising in Costa Rica." 2004. Leon, Sanabria. "Motivaciones hacia el Consumo de Alcohol en Jovenes Datos y Extrapolaciones sobre el Caso Costarricense." Rev. Reflexiones 2009: 1021 1209. de Luna, Melanie, Renzo Rosales, and Jennifer Avery. "Mental Health and Alcoholism." 2001. Potts, Steph anie, Rebecca Stepan, and Kelly Yarzab. "Use of and Attitudes Regarding Tobacco among Youth in the Monteverde Zone, Costa Rica." 2003. Schmidt, Lauren, Allison Hayes, Sarah Adkins, and Nihal Hassan. "Recreation Options for Youth in the Monteverde Region." 2002.

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Appendix A: Background findings This model helped us understand and determine which risk and protective factors may be affecting the Monteverde Community

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A ppendix B: Quantitative Results Chi Square Results: Age Comfortable talking to mother about problems 2 (1, N = 64) = 0.395, p = 0.376 Comfortable talking to father about problems 2 (1, N = 60) = 0.067, p = 0.524 Frequency of alcohol use 2 (1, N = 40) = 1.695, p = .35. Gender Number of friends that drink 2 (1, N = 70) = 0.576, p =0.307 Number of friends that smoke 2 (1, N = 70) = 0.02, p = 0.575 Comfortable talking to father about problems 2 (1, N = 68) = 0.070, p = 0.456 Comfortable talking to mother about problems 2 (1, N = 64) = 0.049, p = 0.512 Household Members Drink Alcohol Ever tried alcohol 2 (1, N = 68) = 6.094, p = 0.012 Frequency of alcohol use 2 (1, N = 67) = 0.012, p = 0.596 Ever tried tobacco 2 (1, N = 40) = 4.22, p = 0.074 Peer Use of Alcohol Ever tried alcohol 2 (1, N = 71) = 18.285, p = 0.000 Frequency of drinking 2 (1, N = 70) = 0.711, p = 0.140 Ever smoked 2 (1, N = 42) = 10.734 p = 0.001

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Ever Tried Alcohol Ever tried tobacco 2 (1, N = 70) = 16.667, p = 0.000 Frequency of Alcohol Use Comfortable talking to father about problems 2 (1, N = 41) = 7.979, p = 0.007 Comfortable talking to mother about problems 2 (1, N = 38) = 2.788, p = 0.096 This Chart shows chi square results based on dichotomous variables. These numbers show whether or not there is a relationship between the 2 variables. If the p value is less than 0.05 then a relationship exists.

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vs. peer use of alcohol : Graph shows percentage of participants that have tried alcohol and whether or not they have some or more friends who have tried alcohol or few or no friends that have tried alcohol. 0% 10% 20% 30% 40% 50% 60% 70% 80% Have Tried Have Not Tried Some Friends Have Tried Alcohol Few or No Friends Have Tried Alcohol

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of tobacco : This graph shows the number of people who have tried smoking, which have some or more friends who have tried smoking and the number of participants who have tried smoking who have few or no friends that have tried smoking.

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: Graph shows number of participants that have tried alcohol or not tried alcohol and whether or not those trying or not trying alcohol have tried tobacco.

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: Graph shows number of participants that have tried alcohol or not tried alcohol and whether or not those trying or not trying alcohol have tried tobacco. Have you ever tried alcohol?

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t speaking with mother : Graph shows how number of people who drink sometimes or more or rarely or less and whether or not they are comfortable speaking with their mother.

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Appendix C: Qualitative Results The reasons youth drink or do not drink are listed above. The larger the word the more frequently the response was given. Red words are reasons why youth drink and green words are reasons why youth do not drink.

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The reasons youth smoke or do not smoke are listed above. The larger the word the more frequently the response was given. Red words are reasons why youth smoke and green words are reasons why youth do not smoke. Y o no fumo

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The activities youth would like to see in the area are given above. The larger the word the more frequently the response was given. What activities would you like to have in the area for youth?

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Appendix D: Research Instruments Fe cha de nacimiento: ____/_______/________ ( dd/mm/aaaa) Sexo:___________ Escuela a la cual asisti:_______________. Si no asisti, el ltimo nivel completado:______________________ Cunto tiempo hace que asisti a la escuela?:__________________ FAMILIA 1) Con quien vive? 2) Con quien en su familia se siente ms cmodo/a hablando? 3) Qu tan cmodo/a se siente cuando habla con sus padre/madre sobre sus problemas? [MADRE] o Muy cmodo/a o Un poco cmodo/a o N eutro o Un poco incmodo/a o Muy incmodo/a [PADRE] o Muy cmodo/a o Un poco cmodo/a o Neutro o Un poco incmodo/a o Muy incmodo/a 4) En general, su padre/madre sabe donde est y qu est haciendo? o Siempre o La mayor parte del tiempo o Algunas veces o Usualmente no o Nunca 5) Quin est en casa cuando usted regresa del colegio o trabajo? 6) Con quin en su familia pasa la mayor parte de su tiempo? Normalmente, qu hace con su familia? 7) Con quin fuera de su familia pasa la mayor parte de su tiempo? Normalmente, que hace con sus amigos?

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Interviewer:_______________ Date:____________ Code:_____________ 8) Describa un da tpico de semana para usted: 9) D escriba un fin de semana tpico para usted: RELIGI"N 10) Usted cree en Dis/ poder superior? 11) Usted practica religin? 1) Si s, con qu frecuencia? 12) Su religin es un aspecto integral en su vida y las decisiones que toma? RELACIONES ESTUDIANTE MAESTRO/A 13) Cuntas horas estudia fuera del colegio? 14) Cmo estn sus notas/promedios? 15) Si le est costando, usted recibe ayuda extra de sus maestros? 16) Hay un adulto en la escuela con quien puede hablar sobre sus problemas personales? 1) Qu tan cmodo/a se siente hab lando con esta persona? o Muy cmodo/a o Un poco cmodo/a o Neutro o Un poco incmodo/a o Muy incmodo/a 17) Qu tan cmodo/a se siente hablando con sus amigos/as sobre sus problemas personales? o Muy cmodo/a o Un poco cmodo/a o Neutro o Un poco cmodo/a o Muy cmodo/a

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Interviewer:_______________ Date:____________ Code:_____________ DESPUS DE ESCUELA 18) En su colegio se ofrecen actividades despus de clases? 1) i) cules actividades? ii) cules actividades est involucrado? iii) Si no, por qu no? 2) Qu tipo de actividades le gustara que se ofrezcan en su escuela? USO DE ALCOHOL/TABACO 19) Q uin en su casa fume cigarrillos? 20) Q uin en su casa bebe alcohol? 21) Cuntos de sus amigos beben alcohol? o Todos/as o La mayora o Algunos/as o Casi ninguno/a o Ninguno/a 22) Cuntos de sus amigos fuman cigarrillos? o Todos/as o La mayora o Algunos/as o Casi ninguno/a o Ninguno/a

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Interviewer:_______________ Date:____________ Code:_____________ 23) Alguna vez ha fumado cigarrillos? Si No n/a a) Si s, i. cuntos aos tena cuando los prob por primera vez? _________ ii. Quin influy en esta decisin? ____________________________________ b) Si no, por qu no? 24) Alguna vez ha tomado alcohol? Si No n/a a) Si s, i. cuntos aos tena cuando los prob por primera vez? _________ ii. Quin influy en esta decisin? ____________________________________ b) Si no, por qu no? 25) Con que frecuencia bebe alcohol? o Con mucha frecuencia o Con algo frecuencia o A veces o Con poco frecuencia o Nunca o Prefiero no responder ESPECIFIQUE POR FAVOR: o Todos los das o 4 6 veces por semana o 1 3 veces por semana o 1 3 veces por mes o Ocasiones especial 26) Con que frecuencia fuma cigarrillos? o Con mucha frecuencia o Con algo frecuencia o A veces o Con poco frecuencia o Nunca o Prefiero no responder ESPECIFIQUE POR FAVOR: o Ms de un paquete por da o Un paquete por da o Medio paquete por da o Un paquete por semana o Un paquete por mes o Ocasiones especiales

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27) Por qu cree que la gente joven toma alcohol? 28) Por qu cree que fuma la gente joven? 29) Has sentido presin de sus amigos a beber? 30) Has sentido presin de sus amigos a fumar? 31) Por favor comparte las tres razones principales por las cuales usted toma / no toma? 1) 2) 3) 32) Por favor comparta las tres razones principales por las cuales usted fuma/ no fuma? 1) 2) 3) 33) Qu le gusta hacer cuando no est trabajando o en el colegio? 34) Cuales actividades le gustara que hubiera en la zona para los y las jvenes?

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Survey: Fecha de nacimiento :__ / __ _/_____ Gnero:____ Escuela:______________ SI NO ASISTI" el ultimo nivel completado:_____ Cuntos tiempo hace desde que dej de asistir a la escuela? ___ Est empleado: S N No responde SI S cuntas horas trabaja por semana? ( Marque uno) Tiempo completo (35+ hrs/wk) Tiempo parcial (< 35 hrs/wk) Por hora Por temporada 1. Qu hace usted cuando no est en el colegio o estudiando o trabajando? (deportes arte, msica, trabajar en la casa, pasar tiempo con amigos, ir al bar, caminar, etc.) 2. Con quin en su familia pasa la mayor parte de su tiempo? Normalmente, qu hace con su familia? 3. Con quin fuera de su familia pasa la mayor parte de su tiempo? Norm almente, que hace con esta persona ? 4. Qu tan cmodo/a hablando se siente cuando habla con su padre/madre sobre sus problemas? [MADRE] o Muy cmodo/a o Un poco cmodo/a o Neutro o Un poco incmodo/a o Muy incmodo/a [PADRE] o Muy cmodo/a o Un poco cmodo/a o N eutro o Un poco incmodo/a o Muy incmodo/a

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5. Hay personas en su casa que beben alcohol? S No No responde 6. Hay personas en su casa que fuman tabaco? Si No No responde 7. Cuntos de sus amigos beben alcohol? Todos La mayria Algunos Casi nadie Nadie 8. Cuntos de sus amigos fuman tabaco? Todos La mayria Algunos Casi nadie Nadie 9. Alguna vez ha probado alcohol? S N No responde Si no, vaya a la pregunta 11 Si s, cuantos aos tenia cuando empez a primera vez:_______, quien influy en su decision de probar alcohol?___________________________________________________________ 10. Con que frecuencia bebe alcohol? Con mucha frecuencia Con algo de frecuencia Alguna vez Pocas veces No responde

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Especifique p or favor: Todos los das 4 6 veces por semana 1 3 veces por semana 1 3 veces por mes Ocasiones especial 11. Alguna vez ha probado cigarillos? S N No responde Si no, vaya a la pregunta 13 Si s, cuantos aos tenia cuando fum la primera vez:_______, quien influyo en su decision de probar cigarillos :___________________________________________ 12. Con que frecuencia fuma cigaril los? Con mucha frecuencia Con algo de frecuencia Alguna vez Pocas veces No responde Especifique p or favor: Ms de un paquete por da Un paquete por da Medio paquete por da Un paquete por mes Ocasiones especial 13. Donde pueden conseguir alcohol los jovenes? 14. Donde pueden conseguir cigarillos los jovenes? 15. Donde pueden los jovenes de est zona beber alcohol?

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16. Donde pueden los jovenes de est zona fumar cigarillos? 17 Diga cules son las razones por las cual (bebe/ no bebe) alcohol. ________________________________ ________________________________ _______________ ________________________________ ________________________________ _______________ ________________________________ ________________________________ _______________ ________________________________ ________________________________ _______________ ________________________________ ________________________________ _______________ ________________________________ ________________________________ _______________ 18 Usted ha sentido presin de parte de sus amigos para beber alcohol? S N No responde 19. Diga cules son las razones por las cual (fuma/no fuma) cigarillos. ________________________________ ________________________________ _______________ ________________________________ ________________________________ _______________ ________________________________ ________________________________ _______________ ________________________________ ________________________________ _______________ ________________________________ ________________________________ _______________ ________________________________ ________________________________ _______________ 20. Usted ha sentido presin de parte de sus amigos para fumar cigarrillos ? S N No responde 21. Cules actividades l e gustara que hubiera en la zona para jovenes? ________________________________ ________________________________ _______________ ________________________________ ________________________________ _______________ ________________________________ ________________________________ _______________ ________________________________ ________________________________ _______________ ________________________________ ________________________________ _______________ ________________________________ ________________________________ _______________ 22. Tiene alguna informacin o comentarios adicionales? ________________________________ ________________________________ _______________ ________________________________ ________________________________ _______________ ________________________________ ________________________________ _______________ ________________________________ ________________________________ _______________ ________________________________ ________________________________ _______________ ________________________________ ________________________________ _______________