Preventing Daily Substance Use among High School Students Using a Cognitive-Behavioral Competence Enhancement Approach

Gilbert J. Botvin^{1, 2,} , Kenneth W. Griffin^{1, 2} and Christopher Williams²

¹Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, NY, USA

²National Health Promotion Associates, White Plains, NY, USA

Cite this paper:
Gilbert J. Botvin, Kenneth W. Griffin and Christopher Williams. Preventing Daily Substance Use among High School Students Using a Cognitive-Behavioral Competence Enhancement Approach. World Journal of Preventive Medicine. 2015; 3(3):48-53. doi: 10.12691/jpm-3-3-1

Abstract

The present study tested the effectiveness of a substance abuse prevention program for deterring tobacco, alcohol, and marijuana use among high school students. The prevention program teaches social resistance skills and general personal and social competence skills. Rates of substance use behavior were examined among students (N = 452) from 12 public high schools that were randomly assigned to either receive the prevention program (5 schools, n = 196) or serve as a treatment-as-usual control group (7 schools, n = 256). The impact of the prevention program was tested using composite indicators of daily substance use based on items measuring the frequency of smoking, drinking, drunkenness, marijuana use, and marijuana intoxication. Data were analyzed using generalized estimating equations to adjust for school-level clustering. Comparison of the posttest adjusted means (controlling for school clustering, gender, race/ethnicity, and family structure) revealed that the intervention produced significant prevention effects on daily substance use, both in terms of a daily polysubstance use index and the proportion of daily substance users across experimental condition. Findings indicated that there were 52% fewer daily substance users in the intervention condition compared to controls. Conclusions drawn from this study are that: (1) daily substance use can be prevented in high school students using a competence enhancement approach that addresses key risk and protective factors; (2) prevention approaches that are effective for middle school students can also be effective for high school students, if adapted to be developmentally appropriate; and (3) universal prevention approaches delivered by classroom teachers with minimal specialized training offer the potential for widespread dissemination and a cost-effective approach to an important public health problem.

Keywords:
drug abuse prevention high school competence enhancement

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References:

[1]	Barnea, Z., Rahav, G., & Teichman, M. The reliability and consistency of self‐reports on substance use in a longitudinal study. British Journal of Addiction, 82(8), 891-898, 1987.
[2]	Botvin, G.J., & Griffin, K.W. Preventing tobacco, alcohol, and drug abuse through Life Skills Training. In: Scheier, L. M. (Ed.), Handbook of adolescent drug use prevention: Research, intervention strategies, and practice (pp. 177-196). Washington DC: American Psychological Association, 2015.
[3]	Botvin, G.J., Griffin, K.W., Diaz, T., Ifill-Williams, M. Drug abuse prevention among minority adolescents: One-year follow-up of a school-based preventive intervention. Prevention Science, 2, 1-13, 2001.
[4]	Cox, R.G., Zhang, L., Johnson, W.D., Bender, D.R. Academic performance and substance use: Findings from a state survey of public high school students. Journal of School Health, 77, 109-115, 2007.
[5]	Danielsson, A.K., Wennberg, P., Tengstrom, A., Romelsjo, A. Adolescent alcohol use trajectories: Predictors and subsequent problems. Addictive Behaviors, 35, 848-852, 2010.
[6]	Giovino, G.A. The tobacco epidemic in the United States. American Journal of Preventive Medicine, 33, S318-S326, 2007.
[7]	Griffin, K.W., & Botvin, G.J. Preventing substance abuse among children and adolescents. In: Ries, R.K., Fiellen, D.A., Miller, S.C., & Saitz, R. (Eds.), The ASAM principles of addiction medicine, Fifth Edition (pp. 1572-1579). Philadelphia: Wolters Kluwer, 2014.
[8]	Griffin, K.W., Botvin, G.J., Nichols, T.R., Doyle, M.M. Effectiveness of a universal drug abuse prevention approach for youth at high risk for substance use initiation. Preventive Medicine, 36, 1-7, 2003.
[9]	Hallfors, D., Vevea, J.L., Iritani, B., Cho, H., Khatapoush, S., Saxe, L. Truancy, grade point average, and sexual activity: A meta‐analysis of risk indicators for youth substance use. Journal of School Health, 72, 205-211, 2002.
[10]	Hingson, R.W., Zha, W., Weitzman, E.R. Magnitude of and trends in alcohol-related mortality and morbidity among U.S. college students ages 18-24, 1998–2005. Journal of Studies on Alcohol & Drugs, S16, 12-20, 2009.
[11]	IBM Corp. IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp, 2012.
[12]	Johnston, L.D., O’Malley, P.M., Miech, R.A., Bachman, J.G., Schulenberg, J.E. Monitoring the Future national survey results on drug use: 1975-2014: Overview, key findings on adolescent drug use. Ann Arbor: Institute for Social Research, University of Michigan, 2015.
[13]	Miller, J.W., Naimi, T.S., Brewer, R.D., Jones, S.E. Binge drinking and associated health risk behaviors among high school students. Pediatrics, 119, 76-85, 2007.
[14]	Needle, R., Su, S., & Lavee, Y. A comparison of the empirical utility of three composite measures of adolescent overall drug involvement. Addictive Behaviors, 14(4), 429-441, 1989.
[15]	Newcomb, M.D., & Locke, T. Health, social, and psychological consequences of drug use and abuse. In: Sloboda, Z. (Ed.) Epidemiology of drug abuse (pp. 45-59). New York: Springer, 2005.
[16]	Scheier, L.M. (Ed.), Handbook of adolescent drug use prevention: Research, intervention strategies, and practice. Washington DC: American Psychological Association, 2015.
[17]	Spoth, R., Trudeau, L., Guyll, M., Shin, C., Redmond, C. Universal intervention effects on substance use among young adults mediated by delayed adolescent substance initiation. Journal of Consulting & Clinical Psychology, 77(4), 620-632, 2009.
[18]	Squeglia, L.M., Jacobus, J., Tapert, S.F. The influence of substance use on adolescent brain development. Clinical EEG & Neuroscience, 40, 31-38, 2009.
[19]	Tibbits, M.K. Drug abuse prevention programs for adolescence. In Gullotta, T.P. & Bloom, M. (Eds.), Encyclopedia of primary prevention and health promotion, Second Edition (pp. 1104-1113). New York: Kluwer Academic/Plenum Publishers, 2015.
[20]	Townsend, L., Flisher, A.J., King, G. A systematic review of the relationship between high school dropout and substance use. Clinical Child & Family Psychology Review, 10, 295-317, 2007.
[21]	U.S. Department of Health and Human Services. The health consequences of smoking—50 years of progress: A report of the Surgeon General. Atlanta, GA: Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 17, 2014.
[22]	Wood, M.D., Read, J.P., Mitchell, R.E., Brand, N.H. Do parents still matter? Parent and peer influences on alcohol involvement among recent high school graduates. Psychology of Addictive Behaviors, 18, 19-30, 2004.
[23]	Zarrett, N., & Eccles, J. The passage to adulthood: Challenges of late adolescence. New Directions for Youth Development, 2006 (111), 13-28, 2006.
[24]	Zeigler, D.W., Wang, C.C., Yoast, R.A., Dickinson, B.D., McCaffree, M.A., Robinowitz, C.B., Sterling, M.L. The neurocognitive effects of alcohol on adolescents and college students. Preventive Medicine, 40, 23-32, 2005.