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Promoting Reduced and Discontinued Substance Use among Adolescent Substance Users: Effectiveness of a Universal Prevention Program

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Abstract

Efforts to address youth substance use have focused on prevention among non-users and treatment among severe users with less attention given to youth occupying the middle ground who have used substances but not yet progressed to serious abuse or addiction. Using a sample from 35 middle schools of 1,364 youth who reported using substances, this study examined the effectiveness of a universal youth substance use prevention program, the SAMHSA Model Program keepin’ it REAL, in promoting reduced or recently discontinued alcohol, cigarette, and marijuana use. Discrete-time event history methods modeled the rates of reduced and recently discontinued use across four waves of data. Each substance (alcohol, cigarettes, and marijuana) was modeled separately. Beginning at the second wave, participants who reported use at wave 1 were considered at risk of reducing or discontinuing use. Since the data sampled students in schools, multi-level models accounted for the nesting of data at the school level. Results indicated that prevention program participation influenced the rates of reduced and recently discontinued use only for alcohol, controlling for baseline use severity, age, grades, socioeconomic status, ethnicity and gender. Among youth who reported use of alcohol in wave 1 (N=1,028), the rate of reducing use for program participants was 72% higher than the rate for control students. The rate of discontinuing use was 66% higher than the rate for control students. Among youth who reported use of one or more of the three substances in wave 1 (N=1,364), the rate of discontinuing all use was 61% higher for program participants than for control students. Limitations and implications of these findings and plans for further research are discussed.

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Notes

  1. A time-invariant measure of age (in years at wave 1) was tested in the multi-variate models. The direction and statistical significance of the effects were identical to those found using the time-varying measure.

  2. Although we refer to the coefficients as influencing the rate, discrete-time models actually estimate the effects of the predictors on the odds of the transition. When the number of events is small relative to the number of person-periods of risk, the odds (=Number for whom event occurred/number for whom event did not occur) converge to the rates (=Number for whom event occurred/Number of person periods of exposure to risk of event).

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Acknowledgments

This research was supported by the National Institutes of Health/National Institute on Drug Abuse grant funding the Drug Resistance Strategies—Next Generation project (R01 DA14825) and the Southwest Interdisciplinary Research Consortium (SIRC) (R24 DA13937-01) at Arizona State University.

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Authors and Affiliations

  1. Department of Sociology, Arizona State University, Tempe, AZ, 85287-3701, USA

    Stephen Kulis & Scott Yabiku

  2. Southwest Interdisciplinary Research Center, Arizona State University, Phoenix, AZ, USA

    Tanya Nieri

  3. School of Social Work, Arizona State University, Phoenix, AZ, USA

    Layne K. Stromwall & Flavio Francisco Marsiglia

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  1. Stephen Kulis
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  2. Tanya Nieri
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Correspondence to Stephen Kulis.

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Kulis, S., Nieri, T., Yabiku, S. et al. Promoting Reduced and Discontinued Substance Use among Adolescent Substance Users: Effectiveness of a Universal Prevention Program. Prev Sci 8, 35–49 (2007). https://doi.org/10.1007/s11121-006-0052-3

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