Adolescent Neurological Development and its Implications for Adolescent Substance Use Prevention

Barbara Lopez; Seth J. Schwartz; Guillermo Prado; Ana E. Campo; Hilda Pantin

J Prim Prev. 2008;29(1):5-35.

Preventive Interventions for Adolescent Substance Use

In recognition of the deleterious consequences of substance use in adolescence, research has emphasized substance use prevention as an effective way of reducing substance use and the negative consequences associated with use (Skara and Sussman 2003). In recent years, there has been an increase in both the number and types of prevention programs designed and implemented--both in terms of the methods of implementation (e.g., family based, child-centered) chosen and in terms of the specific mediators of substance use targeted (e.g., increasing knowledge about consequences of substance use, decreasing intentions and attitudes to use drugs, improving family functioning) targeted. Whereas the first generation of adolescent substance use prevention interventions tended to focus on increasing knowledge and understanding of adverse consequences of substance use (e.g. Bruvold 1990; Duryea and Okwumabua 1988), more recent programs have begun to focus on multiple aspects of decision making associated with substance use (e.g., attitudes, beliefs, intentions; Botvin and Tortu 1988) and/or multiple social-ecological contexts (e.g., family, school, peer, community; e.g., Hogue et al. 2002; Pantin et al. 2003; Perry et al. 1996, 2002) that impact adolescent substance use.

As the field of substance use prevention has evolved, both the method of implementation and the range of goals selected have become more varied and diverse (see Lochman and van den Steenhoven 2002, for a review). Given the recent growth in the number and scope of prevention programs aimed at preventing adolescent substance use, researchers have begun to compile a set of program characteristics that have been found to produce the greatest reductions in adolescent substance use. Such knowledge is important because it helps to further the understanding of "what works" in substance use prevention. According to a recent review by Nation et al. (2003), effective interventions generally include several of the following characteristics: specific components designed to engage and retain study participants, parent training, youth skills training and normative education, changes in laws and policies, peer resistance skills, and media campaigns. The above-mentioned characteristics have been incorporated into interventions based on a number of methods of implementation (e.g., child-centered, family based, family based + child-centered, and multi-component interventions; see Table 1 for a review).

Child-centered interventions are delivered to youth, have generally focused on the intrapersonal context (e.g., attitudes, beliefs, intentions), and aim to prevent substance use by building youth competencies (resistance skills, self management, social skills, increase knowledge about substance use; Botvin and Griffin 2004). Specifically, these programs attempt to reduce motivation to use substances by increasing awareness of social influences that promote substance use, change normative expectations concerning substance use, teaching resistance skills for substance use, and developing decision making competencies (Botvin et al. 1995; Botvin and Griffin 2004).

In contrast, family-based interventions are usually delivered to parents and focus on improving family functioning (e.g., parent-child communication, parent involvement, parental monitoring). Family-based interventions may also include either child-only sessions or joint parent-child sessions or both. These child-only and parent-child sessions also focus on family functioning. Within family-based interventions, the family is viewed as the main source of the adolescent's protection from substance use. Family functioning reduces adolescent risk for substance use by increasing the likelihood that adolescents will choose to abstain from substance use and by preventing or reducing access to situations that increase the likelihood that substance use will take place. For example, open communication between parent and adolescent reduces risk for substance use by encouraging adolescents to internalize their parents' values and norms (Baldwin and Baranowski 1990; Whitaker and Miller 2000) and enhance their psychosocial competence as displayed by good self-control and resistance to substance use situations (Wills et al. 2003). Parental monitoring decreases risk for substance use by preventing or reducing adolescents' access to risk situations (e.g., unsupervised time with peers) where substance use is possible (Sieving et al. 2000; Simons-Mortan and Chen 2005).

A third type of intervention is one that combines aspects of both child-centered and family-based interventions (family-based + child-centered interventions). For example, Spoth et al. (2002, 2005) combined Life Skills Training (LST), a child-centered intervention, and Strengthening Families Program (SFP), a family-based + child-centered intervention. Another example is the Raising Healthy Children intervention, which included Preparing for the Drug Free Years (a family based intervention; Catalano et al. 1999) along with other child-centered components (e.g., after-school tutoring, classroom curriculum, summer camps, and social skills booster retreats: Brown et al. 2005). These combined interventions are more comprehensive than either one alone in that they address interpersonal and family risk and protective processes.

Multicomponent interventions are a fourth type of preventive intervention. These interventions address multiple contexts (e.g., intrapersonal, community, school, and family) through the addition of components such as child centered interventions, media campaigns, task forces, case management, academic tutoring, community activities, and parent education (e.g., Say Yes First: Zavela et al. 2004 and Project Northland: Perry et al. 1996). One should note that the parent education generally delivered in multicomponent interventions tends to differ from family based interventions in that parent education tends to be administered through non-interactive formats, such as written materials or brief information sessions, and sessions with parents are not conducted. One example of this type of intervention is Project Northland, which includes parent/child homework activities, written materials with information on alcohol use for parents, task forces to affect illegal sales of alcohol to minors, two classroom curricula (e.g., peer resistance skills, alternatives to substance use), peer activity programs to create alcohol free activities, and a theater production (see Perry et al. 1996, for descriptions of each component). These components address several risk and protective factors for adolescent alcohol use (e.g., functional meaning of alcohol use for adolescents, adolescent self-efficacy to resist alcohol use, peer influences, norms regarding alcohol use, and access to alcohol in the community).

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J Prim Prev. 2008;29(1):5-35. © 2008 Springer
Springer Science Business Media

Cite this: Adolescent Neurological Development and its Implications for Adolescent Substance Use Prevention - Medscape - Jan 01, 2008.

Abstract & Introduction
Preventive Interventions for Adolescent Substance Use
Efficacy of Preventive Interventions for the Prevention of Substance Use
Neurological Development and Behavior in Adolescence
Using Findings from Studies on Adolescent Neurological Development to Design Interventions for Adolescents
Conclusion
References

Results for Interventions to Prevent Substance Use Initiation
Study	Analysis sample	Design	Intervention type	Primary prevention results
Aveyard et al. (2001)	N = 8,352 11th grade youth	Transtheoretical model vs no intervention	C	At 1 and 2 years FU, no significant intervention effects for smoking initiation
Botvin et al. (1999)	N = 2,209 8th grade girls	Life Skills Training (LST) vs drug information curriculum control	C	LST group reported less smoking initiation than control group
Brody et al. (2006)	N = 206 African American youth	Strong African American Families (SAAF) vs no intervention control	C	At 21 month FU, SAAF group reported less alcohol initiation and slower rate of increase in alcohol use than control group
Brown et al. (2002)	N = 2,643 10th grade youth	Smoking prevention vs usual care	C	Boys from smoking prevention group reported less smoking initiation than boys from usual care group
Brown et al. (2005)	N = 959 10th grade youth	Raising Healthy Children (RHC) vs control	F + C	Between 6 and 10th grade, no significant intervention effects on growth trajectories of alcohol and marijuana initiation
Byrne and Mazanov (2005)	N = 1,694 7-10th grade youth	Health-oriented vs fitness-oriented vs social skills/stress management-oriented interventions vs no intervention control	C	All three intervention groups reported less smoking reported initiation than control group. Social skills group less smoking initiation than health and fitness groups
Chou et al. (2006)	N = 2,454 8th grade Chinese youth	Chinese version of Project SMART vs no intervention control	C	No significant intervention effects on smoking initiation
Crone et al. (2003)	N = 2,562 middle school Dutch youth	Intervention vs no intervention control	C	Intervention group reported less smoking initiation than control group, at post-intervention. At 1 year FU, no significant intervention effects on smoking initiation
Curry et al. (2003)	N = 3,567 11-14 y/o	Multicomponent intervention vs usual care	M	At 20-month FU, no significant intervention effects on smoking initiation
de Vries et al. (2006)	N = 10,751 youth from Finland, Denmark, UK, Netherlands, Spain, and Portugal. Grade not reported	European Smoking Prevention Framework (ESFA) vs usual care	C	ESFA group reported less smoking initiation than usual care for Portugal only
Ellickson et al. (2003)	N = 4,276 7th and 8th grade youth	Project Alert vs no intervention control	C	Project Alert group reported less smoking and marijuana initiation than control group. No significant intervention effect on alcohol initiation
Fidler et al. (2001)	N = 2,492 11-16 y/o English youth	Psychoeducational material vs control	C	At 12-month FU, psychoeducational group reported less smoking initiation than control group
Furr-Holden et al. (2004)	N = 678 8th grader youth	Classroom centered (CC) vs family-school (FSP) vs no intervention control	C	At 7-year FU, CC group reported less initiation of partnership smoking and illicit drugs (crack, cocaine, heroine) than control group. FSP group reported less smoking initiation than control group. No significant intervention effects on alcohol initiation
Furr-Holden et al. (2004)	N = 678 8th grader youth		F
Hanewinkel and Abhauer (2004)	N = 1,625 youth from Germany, Luxembourg, Austria, and Denmark	LST vs no intervention control	C	At 15-month FU, no significant intervention effects on lifetime prevalence of smoking
Kentala et al. (1999)	N = 2,586 15 y/o Finish youth	Smoking discussion with dentist vs control	C	At 24-month FU, no significant intervention effects on smoking initiation
Lillehoj et al. (2004)	N = 456 8th grade youth	LST only or LST + Strengthening Families Program (SFP) 10-14 vs no intervention control	C	LST only and LST + SFP 10-14 groups reported delayed substance use initiation for girls only
Lillehoj et al. (2004)	N = 456 8th grade youth		F + C
Loveland-Cherry et al. (1999)	N = 428 7th grade youth and their families	In-home parent-centered intervention vs no intervention control	F	At 2-year FU, in-home group reported less alcohol use than control group for non-users at baseline only
Lynam et al. (1999)	N = 1,002 19-21 y/o	Project DARE (Drug Abuse Resistance Education) vs standard drug-education curriculum	C	At 10-year FU, no significant intervention effects on lifetime use of cigarette, alcohol, and drug
McBride et al. (2004)	N = 15 y/o Australian youth	School Health and Alcohol Harm Reduction Project (SHAHRP study) vs regular drug education classes	C	At 1-year FU, intervention group reported less alcohol initiation than control group
Palinkas (1996)	N = 296 14-19 y/o girls. 46% African American	Positive Adolescent Life Skills (PALS) + Facts of Life vs Facts of Life alone control	C	At 3-month FU, PALS + Facts of life group reported more marijuana and alcohol initiation Life alone control and less cigarette and other drug initiation than the Facts of Life alone control group
Peleg et al. (2001)	N = 760 12th grade Israeli youth	Intervention vs control	C	At 1- and 2-year FU, intervention group reported less alcohol initiation than control group
Perry et al. (1996)	N = 1,176 9th grade youth	Project Northland vs no intervention control	M	Project Northland group reported less alcohol, smoking, and marijuana initiation than control group
Peterson et al. (2000)	N = 8,388 12th grade youth	Hutchinson Smoking Prevention Project (HSPP) vs no intervention control	C	At 2-year FU (12th grade) and 4-year FU (2 years after 12th grade), no intervention effects were found on smoking initiation
Schulze et al. (2006)	N = 1,852 9th grade	Smoke-Free Class Competition vs control	C	At 18-month FU, no intervention effects on smoking initiation
Simons-Morton et al. (2005b)	N = 1,320 8th grade youth	Going Places Program vs no intervention control	M	No significant intervention effect on alcohol or smoking initiation
Simons-Morton et al. (2005a)	N = 1,484 9th grade youth	Going Places Program vs no intervention control	M	No significant intervention effect on alcohol or Smoking initiation
Slater et al. (2006)	N = 4,216 8th and 9th grade youth	All Stars + Be Under Your Own Influence (BUYOI) Media Campaign vs All Stars only vs BUYOI only vs no intervention control	M	All Stars + BUYOI group reported less marijuana, cigarette, and alcohol imitation than other three groups
Slater et al. (2006)	N = 4,216 8th and 9th grade youth		C
Spoth et al. (1999a)	N = 329 7th grade youth	Prevention Drug Free Years (PDFY) vs Iowa Strengthening Families Program (ISFP) vs no intervention control	F + C	At 1-year FU (7th grader), no significant intervention effects on substance use initiation. At 2-year FU (8th grade), PDFY & ISFP group reported less substance use initiation than control group non users at 1-year FU
Spoth et al. (1999b)	N = 317 7th grader youth	ISFP vs no intervention control	F + C	At 1-year FU (7th grade) and 2-year FU (8th grade), ISFP group reported less alcohol initiation than control group
Spoth et al. (1999b)	N = 294 8th grade youth	ISFP vs no intervention control	F + C
Spoth et al. (2002)	N = 1,372 8th graders youth	LST only vs LST + SFP 10-14 vs no intervention control	C	No significant intervention effects on smoking initiation. LST + SFP 10-14 group reported the least alcohol initiation. LST only and LST + SFP 10-14 groups reported marijuana initiation than control group
Spoth et al. (2002)	N = 1,372 8th graders youth	LST only vs LST + SFP 10-14 vs no intervention control	F + C
Spoth et al. (2004)	N = 304 12th grade youth	ISFP vs PDFY vs control	F + C	At 4 year FU, ISFP had a lower rate of increase in initiation of alcohol and cigarette use than control. No intervention effects were found for PDFY compared to control
Spoth et al. (2004)	N = 304 12th grade youth	ISFP vs PDFY vs control	F
Spoth et al. (2005)	N = 1,650 9th grade youth	LST only vs LST + SFP 10-14	C	2.5 years post-baseline, LST + SFP 10-14 had a slower increase of initiation rate for substance use than LST only and control. No significant differences were found between LST only and control
Spoth et al. (2005)	N = 1,650 9th grade youth	LST only vs LST + SFP 10-14	F + C
Spoth et al. (2006)	N = 464 12th grade youth	ISFP vs PDFY vs no intervention control	F + C	At 4 year FU, ISFP group had a slower increase of initiation of alcohol and drug use than control. No intervention effect was found for PDFY and alcohol use initiation. PDFY had a higher increase of drug use initiation than control
Spoth et al. (2006)	N = 464 12th grade youth	ISFP vs PDFY vs no intervention control	F
Stevens et al. (1996)	N = 1,200 4th, 5th, and 6th grade youth	Drug prevention curriculum vs drug prevention curriculum + parent & adult community activities vs no intervention control	C	No significant intervention effect on marijuana initiation
Stevens et al. (1996)	N = 1,200 4th, 5th, and 6th grade youth		M	No significant intervention effect on marijuana initiation
Stevens et al. (2002)	N = 2,183 8th and 9th grade youth	Alcohol and tobacco prevention vs primary care safety intervention	C	At 36-month FU, no significant intervention effects on smoking initiation
Storr et al. (2002)	N = 549 7th grade youth. Over 80% African American	Classroom centered (CC) vs family-school partnership (FSP) vs no intervention control	C	At 6-year FU, CC and FSP groups reported less smoking initiation than control group
Storr et al. (2002)	N = 549 7th grade youth. Over 80% African American		F
Trudeau et al. (2003)	N = 847 8th grade youth	LST vs no intervention control	C	At 1-year FU, LST group reported less rate substance initiation than control group
Unger et al. (2004)	N = 1,430 7th grade nonsmoking youth	Project Fun Learning About Vitality Origins & Respect FLAVOR vs standard smoking prevention	C	Project Flavor group reported less smoking initiation than in standard smoking prevention group, for Hispanic boys only
Werch et al. (2000)	N = 515 8th grade Low SES youth	STARS (Start Taking Alcohol Risks Seriously) for Families Program vs no intervention control	M	At 3-month FU, STARS group reported less alcohol initiation than control group, in the magnet school only
Zavela et al. (2004)	N = 256 11th grade youth	Say Yes First (SYF) vs no treatment control	M	At 4-year FU, SYF group reported lower lifetime marijuana use than control. No significant intervention effects on lifetime alcohol use

Note: y/o = years old; FU = follow-up; C = child-centered; F = family-based; M = multicomponent; F + C = family-based and child-centered

Results for Interventions to Prevent Substance Use Initiation
Study	Analysis sample	Design	Intervention type	Primary prevention results
Aveyard et al. (2001)	N = 8,352 11th grade youth	Transtheoretical model vs no intervention	C	At 1 and 2 years FU, no significant intervention effects for smoking initiation
Botvin et al. (1999)	N = 2,209 8th grade girls	Life Skills Training (LST) vs drug information curriculum control	C	LST group reported less smoking initiation than control group
Brody et al. (2006)	N = 206 African American youth	Strong African American Families (SAAF) vs no intervention control	C	At 21 month FU, SAAF group reported less alcohol initiation and slower rate of increase in alcohol use than control group
Brown et al. (2002)	N = 2,643 10th grade youth	Smoking prevention vs usual care	C	Boys from smoking prevention group reported less smoking initiation than boys from usual care group
Brown et al. (2005)	N = 959 10th grade youth	Raising Healthy Children (RHC) vs control	F + C	Between 6 and 10th grade, no significant intervention effects on growth trajectories of alcohol and marijuana initiation
Byrne and Mazanov (2005)	N = 1,694 7-10th grade youth	Health-oriented vs fitness-oriented vs social skills/stress management-oriented interventions vs no intervention control	C	All three intervention groups reported less smoking reported initiation than control group. Social skills group less smoking initiation than health and fitness groups
Chou et al. (2006)	N = 2,454 8th grade Chinese youth	Chinese version of Project SMART vs no intervention control	C	No significant intervention effects on smoking initiation
Crone et al. (2003)	N = 2,562 middle school Dutch youth	Intervention vs no intervention control	C	Intervention group reported less smoking initiation than control group, at post-intervention. At 1 year FU, no significant intervention effects on smoking initiation
Curry et al. (2003)	N = 3,567 11-14 y/o	Multicomponent intervention vs usual care	M	At 20-month FU, no significant intervention effects on smoking initiation
de Vries et al. (2006)	N = 10,751 youth from Finland, Denmark, UK, Netherlands, Spain, and Portugal. Grade not reported	European Smoking Prevention Framework (ESFA) vs usual care	C	ESFA group reported less smoking initiation than usual care for Portugal only
Ellickson et al. (2003)	N = 4,276 7th and 8th grade youth	Project Alert vs no intervention control	C	Project Alert group reported less smoking and marijuana initiation than control group. No significant intervention effect on alcohol initiation
Fidler et al. (2001)	N = 2,492 11-16 y/o English youth	Psychoeducational material vs control	C	At 12-month FU, psychoeducational group reported less smoking initiation than control group
Furr-Holden et al. (2004)	N = 678 8th grader youth	Classroom centered (CC) vs family-school (FSP) vs no intervention control	C	At 7-year FU, CC group reported less initiation of partnership smoking and illicit drugs (crack, cocaine, heroine) than control group. FSP group reported less smoking initiation than control group. No significant intervention effects on alcohol initiation
Furr-Holden et al. (2004)	N = 678 8th grader youth		F
Hanewinkel and Abhauer (2004)	N = 1,625 youth from Germany, Luxembourg, Austria, and Denmark	LST vs no intervention control	C	At 15-month FU, no significant intervention effects on lifetime prevalence of smoking
Kentala et al. (1999)	N = 2,586 15 y/o Finish youth	Smoking discussion with dentist vs control	C	At 24-month FU, no significant intervention effects on smoking initiation
Lillehoj et al. (2004)	N = 456 8th grade youth	LST only or LST + Strengthening Families Program (SFP) 10-14 vs no intervention control	C	LST only and LST + SFP 10-14 groups reported delayed substance use initiation for girls only
Lillehoj et al. (2004)	N = 456 8th grade youth		F + C
Loveland-Cherry et al. (1999)	N = 428 7th grade youth and their families	In-home parent-centered intervention vs no intervention control	F	At 2-year FU, in-home group reported less alcohol use than control group for non-users at baseline only
Lynam et al. (1999)	N = 1,002 19-21 y/o	Project DARE (Drug Abuse Resistance Education) vs standard drug-education curriculum	C	At 10-year FU, no significant intervention effects on lifetime use of cigarette, alcohol, and drug
McBride et al. (2004)	N = 15 y/o Australian youth	School Health and Alcohol Harm Reduction Project (SHAHRP study) vs regular drug education classes	C	At 1-year FU, intervention group reported less alcohol initiation than control group
Palinkas (1996)	N = 296 14-19 y/o girls. 46% African American	Positive Adolescent Life Skills (PALS) + Facts of Life vs Facts of Life alone control	C	At 3-month FU, PALS + Facts of life group reported more marijuana and alcohol initiation Life alone control and less cigarette and other drug initiation than the Facts of Life alone control group
Peleg et al. (2001)	N = 760 12th grade Israeli youth	Intervention vs control	C	At 1- and 2-year FU, intervention group reported less alcohol initiation than control group
Perry et al. (1996)	N = 1,176 9th grade youth	Project Northland vs no intervention control	M	Project Northland group reported less alcohol, smoking, and marijuana initiation than control group
Peterson et al. (2000)	N = 8,388 12th grade youth	Hutchinson Smoking Prevention Project (HSPP) vs no intervention control	C	At 2-year FU (12th grade) and 4-year FU (2 years after 12th grade), no intervention effects were found on smoking initiation
Schulze et al. (2006)	N = 1,852 9th grade	Smoke-Free Class Competition vs control	C	At 18-month FU, no intervention effects on smoking initiation
Simons-Morton et al. (2005b)	N = 1,320 8th grade youth	Going Places Program vs no intervention control	M	No significant intervention effect on alcohol or smoking initiation
Simons-Morton et al. (2005a)	N = 1,484 9th grade youth	Going Places Program vs no intervention control	M	No significant intervention effect on alcohol or Smoking initiation
Slater et al. (2006)	N = 4,216 8th and 9th grade youth	All Stars + Be Under Your Own Influence (BUYOI) Media Campaign vs All Stars only vs BUYOI only vs no intervention control	M	All Stars + BUYOI group reported less marijuana, cigarette, and alcohol imitation than other three groups
Slater et al. (2006)	N = 4,216 8th and 9th grade youth		C
Spoth et al. (1999a)	N = 329 7th grade youth	Prevention Drug Free Years (PDFY) vs Iowa Strengthening Families Program (ISFP) vs no intervention control	F + C	At 1-year FU (7th grader), no significant intervention effects on substance use initiation. At 2-year FU (8th grade), PDFY & ISFP group reported less substance use initiation than control group non users at 1-year FU
Spoth et al. (1999b)	N = 317 7th grader youth	ISFP vs no intervention control	F + C	At 1-year FU (7th grade) and 2-year FU (8th grade), ISFP group reported less alcohol initiation than control group
Spoth et al. (1999b)	N = 294 8th grade youth	ISFP vs no intervention control	F + C
Spoth et al. (2002)	N = 1,372 8th graders youth	LST only vs LST + SFP 10-14 vs no intervention control	C	No significant intervention effects on smoking initiation. LST + SFP 10-14 group reported the least alcohol initiation. LST only and LST + SFP 10-14 groups reported marijuana initiation than control group
Spoth et al. (2002)	N = 1,372 8th graders youth	LST only vs LST + SFP 10-14 vs no intervention control	F + C
Spoth et al. (2004)	N = 304 12th grade youth	ISFP vs PDFY vs control	F + C	At 4 year FU, ISFP had a lower rate of increase in initiation of alcohol and cigarette use than control. No intervention effects were found for PDFY compared to control
Spoth et al. (2004)	N = 304 12th grade youth	ISFP vs PDFY vs control	F
Spoth et al. (2005)	N = 1,650 9th grade youth	LST only vs LST + SFP 10-14	C	2.5 years post-baseline, LST + SFP 10-14 had a slower increase of initiation rate for substance use than LST only and control. No significant differences were found between LST only and control
Spoth et al. (2005)	N = 1,650 9th grade youth	LST only vs LST + SFP 10-14	F + C
Spoth et al. (2006)	N = 464 12th grade youth	ISFP vs PDFY vs no intervention control	F + C	At 4 year FU, ISFP group had a slower increase of initiation of alcohol and drug use than control. No intervention effect was found for PDFY and alcohol use initiation. PDFY had a higher increase of drug use initiation than control
Spoth et al. (2006)	N = 464 12th grade youth	ISFP vs PDFY vs no intervention control	F
Stevens et al. (1996)	N = 1,200 4th, 5th, and 6th grade youth	Drug prevention curriculum vs drug prevention curriculum + parent & adult community activities vs no intervention control	C	No significant intervention effect on marijuana initiation
Stevens et al. (1996)	N = 1,200 4th, 5th, and 6th grade youth		M	No significant intervention effect on marijuana initiation
Stevens et al. (2002)	N = 2,183 8th and 9th grade youth	Alcohol and tobacco prevention vs primary care safety intervention	C	At 36-month FU, no significant intervention effects on smoking initiation
Storr et al. (2002)	N = 549 7th grade youth. Over 80% African American	Classroom centered (CC) vs family-school partnership (FSP) vs no intervention control	C	At 6-year FU, CC and FSP groups reported less smoking initiation than control group
Storr et al. (2002)	N = 549 7th grade youth. Over 80% African American		F
Trudeau et al. (2003)	N = 847 8th grade youth	LST vs no intervention control	C	At 1-year FU, LST group reported less rate substance initiation than control group
Unger et al. (2004)	N = 1,430 7th grade nonsmoking youth	Project Fun Learning About Vitality Origins & Respect FLAVOR vs standard smoking prevention	C	Project Flavor group reported less smoking initiation than in standard smoking prevention group, for Hispanic boys only
Werch et al. (2000)	N = 515 8th grade Low SES youth	STARS (Start Taking Alcohol Risks Seriously) for Families Program vs no intervention control	M	At 3-month FU, STARS group reported less alcohol initiation than control group, in the magnet school only
Zavela et al. (2004)	N = 256 11th grade youth	Say Yes First (SYF) vs no treatment control	M	At 4-year FU, SYF group reported lower lifetime marijuana use than control. No significant intervention effects on lifetime alcohol use

Note: y/o = years old; FU = follow-up; C = child-centered; F = family-based; M = multicomponent; F + C = family-based and child-centered

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Adolescent Neurological Development and its Implications for Adolescent Substance Use Prevention

Preventive Interventions for Adolescent Substance Use

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