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Teens Can Learn Skill to “Say No”

Parents and counselors are knowledgeable about the role of peer pressure for influencing adolescent behavior. Nevertheless, a new study shows that competence skills can reduce adolescent substance use over the long term, even when friends smoke or use alcohol.

Previous research has shown that friends’ substance use is one of the most powerful influences that lead adolescents to use themselves. Recent studies have focused on the role of competence skills, which include good self-management and positive psychological characteristics. These skills could protect young people from social risk factors for using substances.

The study, by researchers from Weill Cornell Medical College , specifically looked at the skills of high refusal assertiveness (positive responses to questions like “Do you say ‘no’ when someone asks you to smoke”) and sound decision-making skills (positive responses to questions like “When I have a problem I think about which of the alternatives are best”).

The study is published in the April issue of the journal Addictive Behaviors.

Results were taken from surveys of close to 1,500 predominantly Hispanic children from 22 inner-city middle and junior high schools in New York City over three years. The surveys included questions related to smoking cigarettes and marijuana, drinking alcohol, friends’ substance use, family smoking patterns, and competence skills, including refusal assertiveness and decision-making skills. The surveys were collected from the control group only (those not receiving a prevention program) during a prior prevention project.

The study found that students with high-refusal-assertiveness skills were less likely to use multiple substances (cigarettes, alcohol and marijuana), even when their friends used substances or their siblings smoked. Similarly, students with high-refusal-assertiveness skills, as well as those with good decision-making skills, were also less likely than students without these skills to intend to smoke in the future, even if they had friends who smoked.

Since the study followed students over a three-year period, it was able to demonstrate that competence skills had a long-term effect in reducing the impact of friends’ substance use. Previous research also showed that some competence skills decreased risk factors for some forms of substance use, however, these prior studies did not examine outcomes over an extended time period or concentrate on multiple substance use or future intentions. The Weill Cornell research is also unique in its focus on understudied inner-city adolescents.

“The take-home message from these findings is that competence skills matter in our understanding of substance use,” says Dr. Jennifer A. Epstein, lead author and assistant professor of public health in the Division of Prevention and Health Behavior at Weill Cornell.

“They can combat powerful social influences from friends and siblings to use multiple substances, including cigarettes. Moreover, this research provides important support for drug-abuse prevention programs that include the teaching of competence skills, including refusal skills and decision-making skills.”

“This research highlights the complexity involved in understanding the causes of adolescent substance use,” says Dr. Gilbert J. Botvin, the senior author, professor of psychology in public health and psychology in psychiatry, and chief of the Public Health Department’s Division of Prevention and Health Behavior.

“Such understanding is vitally important to effective prevention programs. Students need to be encouraged to develop competence skills to resist drugs, since social and other risk factors can never be entirely eliminated.”

Source: NewYork-Presbyterian Hospital/

Teens Can Learn Skill to “Say No”

Rick Nauert PhD

Rick Nauert, PhDDr. Rick Nauert has over 25 years experience in clinical, administrative and academic healthcare. He is currently an associate professor for Rocky Mountain University of Health Professionals doctoral program in health promotion and wellness. Dr. Nauert began his career as a clinical physical therapist and served as a regional manager for a publicly traded multidisciplinary rehabilitation agency for 12 years. He has masters degrees in health-fitness management and healthcare administration and a doctoral degree from The University of Texas at Austin focused on health care informatics, health administration, health education and health policy. His research efforts included the area of telehealth with a specialty in disease management.

APA Reference
Nauert PhD, R. (2018). Teens Can Learn Skill to “Say No”. Psych Central. Retrieved on March 21, 2019, from
Scientifically Reviewed
Last updated: 8 Aug 2018
Last reviewed: By a member of our scientific advisory board on 8 Aug 2018
Published on Psych All rights reserved.