Peer pressure may thwart substance use programs

By Joene Hendry

NEW YORK (Reuters Health) - Substance use prevention programs that use peer leaders appear to be effective in limiting tobacco, alcohol and drug use among teens, except when the peer leaders are substance users themselves, study findings suggest.

"Peer influence can be positive and negative, (but) the same message is not appropriate in both positive and negative peer influence situations," Dr. Thomas W. Valente, University of Southern California, Los Angeles, told Reuters Health.

Valente and colleagues evaluated how two substance use prevention programs, versus standard classroom prevention education, influenced the use of tobacco, alcohol, marijuana, and cocaine among 541 students, 16 years old, on average, who were enrolled in alternative high schools in southern California.

One program, Project Towards No Drug Abuse (TND), focused on motivation, skills, and decision-making training that are known to reduce self-reported use of tobacco, alcohol, and hard drugs in high-risk youth, the researchers report in the medical journal Addiction.

The other program, Network Towards No Drug Abuse (TND Network), utilized similar training but emphasized group activities led by peer leaders chosen by the students.

The compilation of a year's worth of monthly student surveys, answered prior to, during, and after the interventions, showed that the quit rate was 12.6 percent in the standard classroom prevention group and 14.3 percent in both the TND and TND Network groups, Valente said.

However, the researchers found that substance use among the TND Network participants decreased mainly among students who nominated peers with low levels of substance use.

"Some adolescents will be attracted to substance-using peers because of their cultural status, they are seen as hip and as rebelling against authority at a time when many teenagers value this trait," Valente notes. "I don't think we can ignore this phenomenon, so we have to find ways to work with it."

"We might have to acknowledge the centrality of substance use in some kid's lives and develop curricula that help them see the negative consequences of their use," Valente suggests.

SOURCE: Addiction, October 2007