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Did These Model Programs Demonstrate Alcohol, Tobacco, and Drug Use Prevention? Research data are quite clear about the role played by alcohol, tobacco, and drug knowledge, attitudes, and use as precursors to sustained and problematic use. In fact, one of the most consistent findings in this literature is that permissive attitudes toward experimentation with substances and use is related to actual use (e.g., Johnston, O’Malley, & Bachman, 1986; Kandel, 1978; Smith & Fogg, 1978). Similarly, the perception of relatively low harm from experimentation or use of substances is related to the propensity to use (e.g., Johnston et al., 1986; Brounstein et al., 1989). Lastly, early experimentation or use of alcohol or drugs is a first step to more serious abuse (Huizinga et al., 1989), and early alcohol and drug use is a better predictor of later use than either interpersonal or intrapersonal measures (e.g., Kandel, Simcha-Fagen, & Davies, 1986).

Earlier discussion has illustrated that certain prevention strategies produce positive outcomes for youth and family. Some are specific to alcohol, tobacco, and drug use, while others target risk and protective factors related to use. For example, these programs helped individuals gain skills and knowledge, fostered relationships between youth and family or community members, and enhanced community awareness of substance abuse problems. These achievements translate into reductions of risk factors and increases in protective factors. While these successes are necessary to demonstrate, the fundamental question posed to these programs has not yet been answered, and that is: “Did these model programs demonstrate alcohol, tobacco, and drug use prevention?”

Regardless of the approach used or the population served, each program was successful in increasing the latency of first alcohol, tobacco, and drug use, or reducing alcohol, tobacco, and drug use, or in decreasing the risk factors known to be related to later alcohol, tobacco, and drug use. Five programs achieved success in reducing substance use:

  • Youth in RSAP showed decreases in substance use: for alcohol, 81.8% of nonusers remained nonusers, while 72.2% of the users became nonusers; for marijuana, 83.3% of the nonusers remained nonusers, while 58.8% of the users became nonusers; and 78.4% of tobacco nonusers remained nonusers, while 26.9% of the users became nonusers. Comparison groups did not show these same declines.

  • The SL program increased knowledge about alcohol, tobacco, and illicit drugs and decreased favorable attitudes toward marijuana. Concomitant with those findings, the SL program participants also showed significant decreases in marijuana and tobacco use and a marginally significant decrease in alcohol use over time.

  • Prevalence of alcohol use declined by an average 11% over 4 years in CDP schools, compared with an increase of 2% in matched comparison schools. Prevalence of marijuana use by CDP students declined by 2%, compared with a 2% increase by comparison school students. Prevalence of cigarette use by CDP students declined by 8%, compared with a 3% decline by comparison school students.

  • GAPS participants showed increases in assertiveness and cultural pride. In conjunction with those improvements, GAPS data also revealed that levels of participant alcohol, tobacco, and marijuana use decreased significantly over time.

  • CLC found that participant youth experienced short-term and sustained delays in the onset of alcohol and drug use as well as decreased levels of substance use, especially as family bonding, communication, and community agency level of activity increased. In addition, parents of participants demonstrated short- and long-term reductions in their use of alcohol, relative to control parents.
DTBY, FAN, and AA worked with youth among whom the incidence of alcohol, tobacco, and drug use was very low. DTBY worked with parents and preschoolers. These youth were too young for involvement with substances, but the program produced dramatic positive effects on parenting skills, family management, bonding, and communication skills, resulting in decreased problem behavior. DTBY was successful because it effected positive changes on one key risk factor for early onset of and sustained severe substance use—dysfunctional family environment (Kumpfer, 1987). FAN youth also were too young to demonstrate change in substance use rates, but they demonstrated prosocial changes in their attitudes and in their perceived ability to refuse drugs and alcohol, clear indicators of inoculation. Similarly, youth in the AA program were observed at an age during which the incidence of alcohol, tobacco, and drug use was low. However, the program did lead to significant positive changes in alcohol, tobacco, and drug knowledge; alcohol, tobacco, and drug attitudes; and school bonding and values related negatively to later substance use. FAN and AA reduced risk factors known to be related to future onset and regular use of substances (CSAP, 1993a). To the extent that the processes set in motion by these programs can be maintained, these youth, their families, and society as a whole will have been well served and better insulated against the ravages of alcohol, tobacco, and drug use.


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Last Updated: March 4, 2002