School-based drug prevention programs: a review of what works

Australian and New Zealand Journal of Criminology, August, 2008 by David W. Soole, Lorraine Mazerolle, Sacha Rombouts

Our review of the evaluation literature suggests that these programs are unlikely to reduce self-reported illicit drug use (Hansen, Johnson, Flay, Graham, & Sobel, 1988). Knowledge-based programs (that include passive information dissemination) that augment these affective education programs similarly tend not to be effective in reducing illicit drug use (Forman et al., 1990).

Resistance Skills Training

Resistance skills training typically involve a strong knowledge dissemination component and emphasise the development of refusal and resistance skills, but do not emphasise the development of social influence, normative education, and generic skills. Six studies in our review involved evaluations of resistance skills training programs, which scored a mean of 2 (Mdn = 1, Mo = 0) on our methodological rigour scale. The methodologically more rigorous studies found significant reductions, mainly in initiation of drug use. The less rigorous studies found mixed results with half reporting significant reductions in drug use.

Overall, our review suggests that girls benefit from these types of programs more than boys, and that there may be an immediate preventive effect on reducing marijuana initiation rates among baseline nonusers (Graham, Johnson, Hansen, Flay, & Gee, 1990; Hurry et al., 2000; Kim, McLeod, & Shantzis, 1993; Shope, Copeland, Kamp, & Lang, 1998; Shope, Copeland, Marcoux, & Kamp, 1996; Stevens, Freeman, Mott, & Youells, 1996).

Generic Skills Training

Generic skills training programs typically include a knowledge dissemination component as well as a focus on teaching generic life skills such as decision-making, problem-solving, communication, assertiveness and coping skills. Eight studies in our review involved evaluations of generic skills training programs, which scored a mean of 3.25 (Mdn = 4, Mo = 4) on our methodological rigour scale. The methodologically more rigorous studies found mixed results, with two studies reporting significant reductions in hard drug use and one study finding significant reductions in marijuana use. The less rigorous studies found no significant effects.

Overall, our review of included evaluation studies suggest that generic skills training programs tend to have more impact on reducing or preventing harder drug use than marijuana use, and their effectiveness may be restricted to low-risk youths (Aseltine, Dupre, & Lamlein, 2000; Dent, Sussman, & Stacy, 2001; Hansen & Dusenbury, 2004; Snow, Tebes, & Ayers, 1997; Sussman, Dent, Stacy, & Craig, 1998; Sussman, Sun, McCuller, & Dent, 2003). A self-instruction component tends not to lead to main or interaction effects on either marijuana or hard drug use. By contrast, inclusion of a mentoring component slightly increased the effectiveness of generic skills training programs.

Social Influence

Social influence programs are designed to 'increase awareness of social influence to smoke, drink, or use drugs; develop skills for resisting substance use influences; increase knowledge of immediate negative consequences; [and] establish non-substance-use norms' (Botvin & Griffin, 2003, p. 46). That is, youths are educated about the influence of the media, peers, and adults on subsequent drug use and a variety of refusal skills are taught to aid the young person's ability to abstain from use. Misconceptions regarding drug use among youth are corrected and replaced with more accurate information. Eleven studies in our review involved evaluations of social influence programs, which scored a mean of 3.06 (Mdn = 4, Mo = 5) on our methodological rigour scale. The methodologically more rigorous studies produced mixed results with half of the studies reporting significant reductions in marijuana use and initiation of marijuana use. The less rigorous studies found similar results with half of the studies reporting significant reductions in marijuana use.