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Uvod: Konzumacija alkohola, droga i duhana među mladima najčešći su oblici rizičnih ponašanja. Poznavanje obrazaca navedenih ponašanja u određenoj sredini dalo bi smjernice za izradu specifičnih preventivnih programa. Cilj: Utvrditi prevalenciju, okolnosti i rizične čimbenike konzumacije alkohola droga i duhana među učenicima završnih razreda srednjih škola u Splitsko-dalmatinskoj županiji (SDŽ), razlike među školama (strukovne vs. gimnazije i privatne škole) te razlike u ovisnosti o mjestu pohađanja škole (Split i okolica, dalmatinsko zaleđe, otoci), kao i promjene u konzumaciji alkohola za vrijeme lockdowna tijekom pandemije COVID-19. Ovim istraživanjem želimo utvrditi i učestalost i promjene učestalosti hospitalizacija zbog akutnih alkoholnih intoksikacija (AAI) među djecom u dobi od 0 do 18 godina u razdoblju od 2008. do 2015. te ih usporediti s rezultatima iz razdoblja od 2016. do 2021. godine, kao i okolnosti koje su dovele do intoksikacije. Metode: Anonimni anketni upitnik putem mrežne (online) poveznice proslijeđen je učenicima završnih razreda srednjih škola u SDŽ-u (N = 1030). Učenici su upitnik mogli popuniti od lipnja do srpnja te od listopada do kraja prosinca 2020. godine. Pretražena je i medicinska dokumentacija djece starosti od 0 do 18 godina liječene na Klinici za dječje bolesti KBC-a Split od 1. siječnja 2008. do 31. prosinca 2021. godine zbog AAI-a (N = 272 od 2008. do 2015. i N = 71 od 2016. do 2021.) Rezultati: Prevalencija je pušenja među učenicima u SDŽ-u 37,28 %, konzumacije droga 24,27 % te pijenja alkohola 84,66 %. Učenici koji pohađaju strukovne škole češće puše od učenika u gimnazijama i privatnim školama (P < 0,001), dok među učenicima navedenih škola nema razlike u konzumaciji alkohola (P = 0,751) i droga (P = 0,192). Dječaci češće konzumiraju droge nego djevojčice (P = 0,013), dok nema razlike u konzumaciji alkohola (P = 0,328) i duhana (P = 0,85) među spolovima. Pušenje je najčešće među učenicima iz dalmatinskoga zaleđa (P = 0,037), konzumacija alkohola najčešća je na otocima (P = 0,007), a droga u Splitu i okolici (P = 0,029). Alkohol se najčešće pije u noćnim klubovima i café barovima (54,36 %), s prijateljima (92,89 %). Učenici ga obično piju kako bi se bolje osjećali (34,86 %). Pritom se najčešće piju žestoka pića u kombinaciji s bezalkoholnim pićem (39,33 %). Najveći broj učenika bez problema samostalno nabavlja alkoholna pića (85,33 %), njih 69,03 % barem se jednom opilo. Visina džeparca, samostalno zarađivanje, učestalost izlazaka, depresivnost, muški spol, razvedenost roditelja i viši stupanj obrazovanja majke povezani su s većim rizikom za upuštanje u rizična ponašanja, dok je za religioznost, veću učestalost prakticiranja vjere, bavljenje sportom i bolji školski uspjeh pokazano suprotno. Tijekom lockdowna zbog pandemije COVID-19 došlo je do značajnoga pada konzumacije alkohola među učenicima završnih razreda srednjih škola u SDŽ-u (P < 0,001), posebno u društvu s prijateljima (P < 0,001), dok je porasla učestalost pijenja s članovima obitelji (P < 0,001), samostalnoga pijenja (P < 0,001) te pijenja u različitim socijalnim kontekstima (P = 0,002). Tijekom lockdowna najčešće se pilo iz dosade (39,05 %). Učestalost pijenja tijekom lockdowna bila je manja među 53,98 % učenika, dok je 15,63 % učenika povećalo učestalost konzumacije (P < 0,001). Među učenicima gimnazija i privatnih škola zabilježen je značajniji pad pijenja u odnosu na učenike strukovnih škola (P = 0,002), kao i među učenicima na otocima (P = 0,050). Mladići su tijekom lockdowna češće pili od djevojaka (P < 0,001). Značajno smanjenje AAI-a među djecom u dobi od 0 do 18 godina zabilježen je i u 2020. (razdoblje pandemije) u odnosu na 2019. godinu, koja je prethodila pandemiji (P = 0,025). U razdoblju od 2008. do 2015. godine 488 djece bilo je liječeno na Klinici za dječje bolesti KBC-a Split zbog akutnih intoksikacija, od čega njih 272 (55,74 %) zbog AAI-a, dok ih je u razdoblju od 2016. do 2021. bilo 218, među kojima je 71 dijete (32,57 %) liječeno zbog AAI-a. U obama ispitivanim razdobljima AAI je bio češći među dječacima (63,60 % od 2008. do 2015. te 70,42 % od 2016. do 2021.), najčešće među skupinom u dobi od 14 do 18 godina (P < 0,001), tijekom vikenda i blagdana (P < 0,001) te izvan kuće (P < 0,001). Prosječna je dob bila 15,95 ± 1,51 godinu u razdoblju 2008. – 2015., odnosno 16,17 ± 1,3 godine u razdoblju 2016. – 2021.; koncentracija alkohola 2,003 ± 0,585 ‰ u razdoblju 2008. – 2015., odnosno 2,15 ± 0,539 ‰ u razdoblju 2016. – 2021.; prisustvo ozljeda u 11,03 % slučajeva u razdoblju 2008. – 2015., odnosno 23,94 % u razdoblju 2016. – 2021.; u razdoblju 2008. – 2015. na droge je bilo pozitivno 6,25 %, a u razdoblju 2016. – 2021. 8,45 % djece. Udio hospitalizacija djece u dobi od 0 do 18 godina zbog AAI-a među svim hospitalizacijama u razdoblju od 2008. (1,33 %) do 2021. godine (0,23 %) značajno se smanjio, pri čemu se u svakoj sljedećoj godini očekuje pad za 21,26 %. Zaključak: Iako je učestalost AAI-a među djecom u SDŽ-u u padu, rezultati istraživanja pokazuju visoku prevalenciju konzumacije alkohola, droga i duhana među mladima u ovisnosti o vrsti škole i mjestu pohađanja škole. Stoga rezultati ovoga istraživanja mogu dati smjernice za izradu specifičnijih preventivnih programa među djecom i mladima. Smanjenje konzumacije alkohola među mladima za vrijeme lockdowna posljedica je smanjenoga druženja s prijateljima i ograničene dostupnosti alkohola u tome razdoblju te je pokazatelj da se smanjenjem dostupnosti opojnih tvari, kao i boljom organizacijom i ponudom aktivnosti namijenjenih mladima, može smanjiti incidencija upuštanja u rizična ponašanja., Background: Alcohol, drugs and tobacco consumption is the most common type of risky behaviors among adolescents. Determinating the speciffic patterns of these behaviors in a particular environment would provide guidelines for creating speciffic prevention programs. Aim: To determine the prevalence, circumstances and risky factors for alcohol, drugs and tobacco consumption among high school students in Split-Dalmatia County (SDC), differences between schools (vocational vs. gymnasiums and private schools) and differences depending on the place of school attendance (Split and surroundings, rural parts, islands), as well as changes in alcohol consumption during the COVID-19 pandemic lockdown. We also wanted to determine the frequency and changes in hospitalizations due to acute alcohol intoxications (AAI) among children aged 0-18 in the period from 2008 to 2015 and compare them with the results from 2016 to 2021, as well as changes in circumstances that led to intoxication. Methods: An anonymous questionnaire survey was distributed online to final grade high school students of all schools in SDC (N = 1030). Students were able to complete the questionnaire survey in a period from June to July and from October to the end of December 2020. The data of children aged 0 to 18 years who were hospitalized for AAI at Department of Pediatrics, University Hospital of Split in a period from January 1, 2008 to December 31, 2021 (N = 272 from 2008 to 2015 and N = 71 from 2016 to 2021) were collected retrospectively from hospital medical records. Results: The prevalence of smoking among students in SDC is 37.28 %, drugs consumption 24.27 %, and drinking 84.66 %. Students attending vocational schools smoke more often than students in gymnasiums and private schools (P < 0.001), while there is no difference in alcohol (P = 0.751) and drugs consumption (P = 0.192) between students depending on the school type. Boys consume drugs more often (P = 0.013) than girls, while there is no difference in alcohol (P = 0.328) and tobacco (P = 0.85) consumption depending on the gender. Smoking is most common among students from the rural parts of SDC (P = 0.037), alcohol consumption on islands (P = 0.007), and drugs in Split and the surrounding area (P = 0.029). Students most frequently drink in nightclubs and coffee bars (54.36 %), with friends (92.89 %), “to feel better” (34.86 %), where they often drink mixed drinks (39.33 %). Students most often buy alcoholic beverages without any problem (85.33 %) and 69.03 % had been drunk in lifetime. While the greater amount of pocket money, employment, frequency of going out, depression, male gender, higher level of maternal education and having divorced parents increase the risk of participating in risky behaviors, religiosity, higher frequency of religion practicing, sports participation, and higher school performance reduce it. During the COVID-19 pandemic lockdown, there was a significant decrease in alcohol consumption among high school students in SDC (P < 0.001), especially with friends (P < 0.001), while the frequency of drinking with family members (P < 0.001), drinking alone (P < 0.001) and in different social context (P = 0.002) increased. Students were most often drinking out of boredom (39.05 %) during the lockdown. There was a decrease in frequency of drinking during the lockdown among 53.98 % of students, while 15.63 % of them increased it (P < 0.001). The decrease in alcohol consumption was more signifficant among students in gymnasiums and private schools than among students from vocational schools (P = 0.002), as well as among students on islands (P = 0.050). Boys were drinking more often than girls (P < 0.001) during the lockdown period. A significant decrease in AAI among children aged 0-18 years was also recorded in 2020 (pandemic period) compared to 2019 (pre-pandemic period) (P = 0.025). In the period from 2008 to 2015, 488 children were hospitalized at Department of Pediatrics, University Hospital of Split for acute intoxications, 272 (55.74 %) of them due to AAI, while in the period from 2016 to 2021 there were 218 intoxicated children, 71 (32.57 %) of them hospitalized due to AAI. In both examined periods, AAIs were more frequent among boys (63.60 % from 2008 – 2015, and 70.42 % from 2016 – 2021), most often among children aged 14 to 18 years (P < 0.001), during weekends and holidays (P < 0.001), and in outside places (P < 0.001). The average age was 15.95 ± 1.51 (in a period 2008 – 2015) and 16.17 ± 1.30 (in a period 2016 – 2021); blood alcohol concentration 2.003 ± 0.585 ‰ (in a period 2008 – 2015) and 2.15 ± 0.539 ‰ (in a period 2016 – 2021); the presence of injuries was detected among 11.03 % (in a period 2008 – 2015) and 23.94 % (in a period 2016 – 2021) children; and 6.25 % (in a period 2008 – 2015) and 8.45 % (in a period 2016 – 2021) children were positive for drugs in urine samples. The proportion of hospitalizations of children aged 0-18 due to AAI among all hospitalizations has signifficantly decreased from 2008 (1.33 %) to 2021 (0.23 %), with an expected decrease of 21.26 % in every next year. Conclusion: Although the incidence of AAIs among children in SDC is declining, the results of this study show a high prevalence of alcohol, drug and tobacco consumption among adolescents, depending on the type and place of school attendance. Therefore the results of this study can provide guidelines for more specific prevention programms among children and adolescents. The decrease in alcohol consumption among adolescents during the lockdown is a consequence of reduced socializing with friends and limited availability of alcohol during this period, and an indication that reducing the availability of psychoactive substances and maybe with better organization and offer of activities where young people can socialize, the incidence of risky behaviors among them can be reduced.

Cilj rada bio je dokazati povećanje učestalosti pijenja alkohola u srednjim školama u odnosu na završne razrede osnovne škole, prema vrsti škole obraditi učenike s visokim brojem bodova na AUDIT (Alcohol Use Disorders Identification Test) upitniku, te izvršiti validaciju AUDIT upitnika na hrvatskom jeziku. Rad je proveden kao presječno istraživanje na prigodnom uzorku. Istraživanje je provedeno tijekom 2012./2013. kod 180 ispitanika, 90 iz završnog razreda osnovne škole, a 90 iz završnog razreda srednjih škola (gimnazija, zdravstvena i pomorska škola). Kod ispitanika je provedena anonimna anketa AUDIT upitnik i dodatna standardizirana anonimna anketa. Prikupljeni podaci uneseni su u program Microsoft Excel za operacijski sustav Windows. Statističku obradu podataka proveli smo primjenom programa StatSoft, Inc. (2004). STATISTICA (data analysis software system), version 7. Statistička razina značajnosti bila je p < 0,05. Obradom podataka iz AUDIT upitnika utvrdilo se da muški ispitanici piju više i da je učestalost i intenzitet pijenja više zastupljen u srednjoj pomorskoj, nego u ostalim školama. Prema standardiziranom upitniku učestalost pijenja povećava se za oba spola. Učenici piju više od učenica u osnovnoj školi, dok ta razlika u završnom razredu srednjih škola gotovo nestaje. U porastu je pojava vikend-alkoholizma. Utvrđena je sve veća raširenost "binge drinking" ili ekscesivnog pijenja kod svih ispitanika. Broj učenika koji zadovoljavaju kriterije za dijagnozu alkoholizma, manji je u odnosu na svjetsku literaturu., The aim of the work is to prove the increase in alcohol drinking frequency in secondary schools compared to the final grades in elementary schools. Pupils have been analyzed according to high AUDIT (Alcohol Use Disorders Identification Test) questionnaire points. The AUDIT questionnaire validation was in the Croatian language. The work has been performed as a cross-sectional research on convenient examples. During the years 2012/2013, the research was performed on 180 examinees, 90 from final grades in elementary schools and 90 from secondary schools (high school, medical and maritime schools). An anonymous AUDIT questionnaire was made along with an additional standardized anonymous survey. The gathered data were entered in Microsoft Excel of Windows system. Statistics data processing was performed by applying the StatSoft, Inc. (2004) STATISTICA (data analysis software system) programme, version 7. The statistical significance level was p < 0.05. Data processing from the AUDIT questionnaire established that the male examinees drank more and that drinking frequency and intensity was represented more in the maritime secondary school than in other schools. According to the standardized questionnaire, drinking frequency increased in both genders. Male pupils drank more than the female ones in elementary school, while that difference almost disappeared in the final years of secondary school. Weekend alcoholism is on the rise. An all the more increasing "binge drinking" or excessive drinking with all examinees has appeared. The number of pupils that satisfy the alcohol diagnosis criteria is smaller in relation to world literature.