Bridging Disciplinary Boundaries (January 11 - 14, 2007)

This study tested for relationships between use of different drug resistance strategies and patterns of substance use among adolescents from the Mexican city of Monterrey. We focus on the REAL drug resistance strategies taught in the keepin'it REAL model prevention program—refusing (saying No), explaining (declining with an explanation), avoiding (people or situations where drugs are offered), and leaving (offer situations). The keepin' it REAL program has been shown previously to be efficacious in reducing substance use among adolescents in the southwestern U.S. The current study examined these drug resistance strategies in a sample of Mexican youth and how use of the strategies influenced patterns of substance use. The sample included 327 students (mean age=16) at two Monterrey secondary schools (preparatorias). Students self-reported the number of times they used each strategy, how often they were offered specific substances, the frequency of recent and lifetime alcohol, cigarette, and marijuana use, and episodes of drunkenness. Regression analyses controlling for gender, age, SES and GPA showed that students who used the Avoid resistance strategy reported significantly less use of alcohol and cigarettes, and that the Refuse strategy was also associated with less cigarette use. Only the Leave strategy was associated with fewer episodes of drunkenness. None of the strategies were significantly related to the frequency of marijuana use. Although these connections between use of strategies and reduced alcohol and cigarette use usually were confined to those who had received direct offers of the particular substance, sub-group analyses showed that the Avoid strategy was also associated with less use of alcohol even among those who never received offers. Moderator (interaction) analyses examined the impact of the use of particular strategies for those receiving many versus few offers, and for males versus females. Results showed that the Refuse strategy reduced alcohol and cigarette use more strongly for students who were offered that substance most frequently, but there were no significant gender differences in how the REAL strategies predicted substance use. The results suggest that although Mexican and U.S. youth use a similar set of drug resistance strategies, the impact of resistance strategies on substance use varies by substance and by exposure to drug offers. Findings are interpreted in light of cultural influences on substance use norms and behaviors.