REFERENCE: Elder, J. P., Stern, R. A., Anderson, M., Hovell, M. F., Molgaard, C. A., Seidman, R. L. (1987). Contingency-based strategies for preventing alcohol, drug, and tobacco use: Missing or unwanted components of adolescent health promotion? Education and Treatment of Children, 10, 33-47.
Because substance abuse (i.e., alcohol, drug, and tobacco) constitutes a major health risk for adolescents in the western world, efforts aimed at preventing substance use and abuse have proliferated in the past ten years. Initial efforts were based on "health belief" approaches to curriculum development, emphasizing knowledge and attitude modification with the hope of behavioral change. Subsequent prevention programs included strategies for remediating skill deficits, primarily with respect to behaviors that would encourage resisting peer pressure to use alcohol, tobacco, or drugs. These strategies have been somewhat successful in preventing cigarette smoking, but have met with mixed results in drug and alcohol use prevention, and are currently untested in the prevention of smokeless tobacco use. What is missing in nearly all these strategies is direct manipulation of positive or negative consequences for the use or nonuse of substances. This paper reviews a variety of recent studies on prevention of drug and alcohol use and analyzes components of various preventive programs.