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A large, randomized study involving more than 3,600 New York City schoolchildren (most of them black or Hispanic) has found that an intervention program that teaches drug refusal skills, antidrug norms, and social and self-management skills can reduce tobacco, alcohol, and drug use among such youth for as long as two years.

The lead investigator of the study, Gilbert J. Botvin, Ph.D., Professor of Public Health and Psychiatry and Director of the Institute for Prevention Research and the Division of Prevention and Health Behavior in the Department of Public Health at Weill Cornell Medical College, says that previously the intervention program, known as the Life Skills Training (LST) program, has been shown to be effective with predominantly white, middle-class youth. In the new study, LST also appears to be effective with inner-city minorities. "Indeed, this is the largest and most rigorous prevention study conducted with inner-city minority youth," Dr. Botvin and his colleagues write in an article presenting the study in the March issue of Prevention Science.

The researchers tested several thousand seventh graders from 29 New York City public schools, randomly assigning each school to receive either LST or the program that was normally in place at New York City schools. The youths were 61 percent black, 22 percent Hispanic, six percent Asian, six percent white, and five percent of mixed backgrounds. The youngsters receiving the intervention (2,144 in number) experienced 15 special sessions (for which their teachers had had special training) in the seventh grade and 10 "booster" sessions in the eighth grade.

"The prevention program teaches students cognitive-behavioral skills for building self-esteem, resisting advertising pressure, managing anxiety, communicating effectively, developing personal relationships, and asserting one’s rights," Dr. Botvin and his colleagues write. "These skills are taught using a combination of teaching techniques—including group discussion, demonstration, modeling, behavioral rehearsal, feedback and reinforcement, and behavioral 'homework' assignments for out-of-class practice."

The students in the trial (1,477 were in the control group) were tested with confidential coded questionnaires before and after the intervention and after the one-year follow-up. The results showed that "Students in the experimental group who received the LST prevention program had significantly lower levels of drug involvement over the 2 years of the study than had students in the control group." Compared to the control group, a student in the experimental group was 32 percent less likely to have used alcohol, 24 percent less likely to have used tobacco, and 21 percent less likely to have used marijuana.

The researchers discuss many questions raised by the study, such as whether a prevention program can be effective with multiple populations and whether the program should be targeted to special populations like new immigrants. Dr. Botvin notes that some recent discussion has cast doubt on the effectiveness of DARE, a widely used prevention program in schools. But, "In summary," the researchers write, "the results of this study provide additional evidence of the effectiveness of a school-based drug abuse prevention approach that teaches drug refusal skills, normative expectations, personal self-management skills, and general social skills."

Dr. Botvin's co-authors in the article are Kenneth W. Griffin, Tracy Diaz, and Michelle Ifill-Williams, all of Weill Cornell Medical College.

The study was part of a five-year investigation supported by funds from the National Institute on Drug Abuse, part of the National Institutes of Health.