Why do young people smoke cigarettes or use alcohol or drugs? What skills do they need to avoid starting these habits? A new study by researchers from Weill Cornell Medical College shows that competence skills can reduce adolescent substance use over the long term, even when friends smoke or use alcohol.
Previous research has shown that friends' substance use is one of the most powerful influences that lead adolescents to use themselves. Recent studies have focused on the role of competence skills, which include good self-management and positive psychological characteristics. These skills could protect young people from social risk factors for using substances.
The study, published in the April issue of the journal Addictive Behaviors, specifically looked at the skills of high refusal assertiveness (positive responses to questions like "Do you say ‘no' when someone asks you to smoke") and sound decision-making skills (positive responses to questions like "When I have a problem I think about which of the alternatives are best").
Results were taken from surveys of close to 1,500 predominantly Hispanic children from 22 inner-city middle and junior high schools in New York City over three years. The surveys included questions related to smoking cigarettes and marijuana, drinking alcohol, friends' substance use, family smoking patterns, and competence skills, including refusal assertiveness and decision-making skills. The surveys were collected from the control group only (those not receiving a prevention program) during a prior prevention project.
The study found that students with high-refusal-assertiveness skills were less likely to use multiple substances (cigarettes, alcohol and marijuana), even when their friends used substances or their siblings smoked. Similarly, students with high-refusal-assertiveness skills, as well as those with good decision-making skills, were also less likely than students without these skills to intend to smoke in the future, even if they had friends who smoked. The study controlled for ethnicity, gender, age, academic grades and family structure. The anonymity of all participating students was protected.
Since the study followed students over a three-year period, it was able to demonstrate that competence skills had a long-term effect in reducing the impact of friends' substance use. Previous research also showed that some competence skills decreased risk factors for some forms of substance use, however, these prior studies did not examine outcomes over an extended time period or concentrate on multiple substance use or future intentions. The Weill Cornell research is also unique in its focus on understudied inner-city adolescents.