Bullying and Psychoactive Substance Use Among Adolescents: Evidence from a Nationally Representative Survey in Brazil.

Background: Bullying and the use of psychoactive substances are both prevalent among adolescents and appear to be interconnected. However, the literature has yet to reach a consensus regarding the association between being a victim of bullying and the use of psychoactive substances. In this cross-sectional study, the authors investigated the relationship between psychoactive substance use and involvement in bullying among Brazilian adolescents.

Methods: Data were analyzed from the 2019 National School Health Survey ("Pesquisa Nacional de Saúde do Escolar, PeNSE 2019"), which included responses from 123,261 students aged 13 to 17 years. The survey assessed experiences of bullying (both as victim and perpetrator), as well as lifetime and recent (past 30 days) use of various psychoactive substances. Multivariate logistic regression models were employed to examine associations, with odds ratios (ORs) calculated to estimate the likelihood of substance use across different bullying involvement profiles.

Results: Adolescents involved in bullying-whether as victims or perpetrators-had higher odds of using tobacco cigarettes, hookahs, e-cigarettes, clove cigarettes, straw cigarettes, alcohol, illicit drugs, marijuana, and crack. Those not involved in bullying had the lowest likelihood of substance use, followed by those who were only victims. The highest odds were observed among individuals who perpetrated bullying exclusively, followed by those involved as both perpetrators and victims.

Conclusions: In Brazil, being a victim of bullying is associated with increased use of various psychoactive substances. These findings align with studies conducted in other Latin American countries, yet diverge in part from patterns observed in high-income countries-highlighting the influence of geographic and sociocultural contexts on these risk associations.