Background: The research involved 170 adolescents from Brazil and Ecuador, ages 12 to 19, comprising 87 Brazilians and 83 Ecuadorians, with a gender distribution of 95 females and 75 males. Purpose: Examine the correlation between impulsivity, emotional symptoms, and the use of alcohol and drugs among teenagers in these countries. Methods: Implemented Addiction Severity Index (ASI-version 6), Barratt Impulsiveness Scale for Young People (BIS-11 and BIS-Brief), a Sociodemographic Questionnaire, and Strength and Difficulties Questionnaire (SDQ). Results: Findings indicated a significant link between higher impulsivity levels and increased alcohol consumption across both nations. Specifically, adolescents with greater impulsivity were 1.18 times more likely to consume alcohol (OR = 1.18, 95% CI [1.017-1.374]), and the likelihood of alcohol use escalated with age, with older teenagers 1.80 times more prone to drinking (OR = 1.80, 95% CI [1.285-2.541]). Discussion: Brazilian adolescents exhibited more emotional symptoms than their Ecuadorian counterparts. No gender differences were found in alcohol use, though females showed more emotional symptoms and males had more positive peer interactions. Translation to Health Education Practice: The research highlights the need for culturally sensitive health education interventions targeting these issues to promote healthier behaviors among adolescents.