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A large, randomized study of more than 3,000 New York City schoolchildren (mostly African-American and Hispanic) has shown for the first time that a school-based prevention program that teaches early adolescents drug refusal skills and other essential behaviors can significantly decrease binge drinking for as long as two years after the initial intervention. The program is the LifeSkills Training (LST) program developed by Weill Cornell Medical College.

"This is the largest and most rigorous prevention study conducted with inner-city youngsters, and one of the first to examine binge drinking in these youth," said the study's lead investigator, Gilbert J. Botvin, Ph.D., an internationally known expert on drug abuse prevention, who is Professor of Public Health and Psychiatry at Weill Medical College of Cornell University and Director of Weill Cornell's Institute for Prevention Research. Dr. Botvin is also Chief of the Division of Prevention and Health Behavior in Weill Cornell's Department of Public Health and Attending Psychologist at NewYork-Presbyterian Hospital's Weill Cornell Medical Center.

In the new study—published in the journal Psychology of Addictive Behaviors—the LST program is shown to be highly effective in preventing binge drinking among inner-city youth. Binge drinking is defined as an episode of heavy drinking in which young people consume five or more alcoholic beverages in a row. LST previously has proven to be effective in curbing alcohol, tobacco, and other drug use among both predominantly middle-class youth and inner-city youth, but research has not examined the effects of the program on binge drinking until now.

With the increase in peer pressure as well as pressures from movies, music, and the media, students need the protection afforded by an array of essential skills such as those taught by the LST program. These skills have been proven to help young people resist the use of tobacco, alcohol, and illicit drugs. They include how to:

• Build self-esteem
• Think critically and make independent decisions
• Resist advertising and media pressures to drink alcoholic beverages or use tobacco
• Manage common adolescent anxieties related to social situations or academic performance
• Communicate effectively with parents, friends, and authority figures
• Develop personal relationships and assert one's rights

These skills are taught using a combination of teaching techniques—including group discussion, demonstration, modeling, behavioral rehearsal (in-class practice), feedback and reinforcement, and behavioral "homework" assignments for out-of-class practice.

The study involved several thousand seventh graders from 29 New York City public schools, randomly assigning each school to receive either LST or the prevention program that was normally used in New York City schools. The youths were 57 percent African-American, 24 percent Hispanic, eight percent Asian, three percent white, two percent Native American, and six percent of mixed backgrounds.

The youngsters in the LST intervention group (1,713 in number) participated in 15 special sessions delivered by their seventh-grade teachers who had special training in LST techniques. Ten "booster" sessions were given the following year by their eighth-grade teachers. The students in the trial (1,328 were in the control group) were tested with confidential coded questionnaires before and after the intervention, as well as at the one-year and two-year follow-up points.

"Students in the experimental group who received the LST prevention program had significantly lower rates of binge drinking over the three years of the study than the students in the control group," reported Dr. Botvin. "In fact, students in the experimental group were more than 50 percent less likely to engage in binge drinking at the follow-up assessments," he adds.

Dr. Botvin notes that most research on binge drinking has been conducted with older youth, particularly college undergraduates. The current findings fill a gap by "increasing our understanding of how to effectively prevent binge drinking during early adolescence, before it increases in frequency and becomes associated with various alcohol-related problems."

Dr. Botvin's co-authors of the article are Dr. 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.

LifeSkills Training

The most comprehensively researched prevention education program available to schools and communities, LifeSkills Training has been proven to cut alcohol, tobacco and drug use by up to 87 percent. Developed in 1979 by Dr. Botvin, LST is recommended by every key federal agency, including the Centers for Disease Control and Prevention, the Center for Substance Abuse Prevention, the U.S. Department of Education, the U.S. Department of Justice, and the White House Office of National Drug Control Policy. The program is being implemented by schools worldwide and is currently in use in Japan, Korea, Mexico, Sweden, New Zealand, Hong Kong, and Argentina.