Drug Resistance Strategies and Substance Use Among Youth In Guanajuato, Mexico

Research Question: Recent studies have shown that substance use rates among Mexican youth are increasing, indicating a need for prevention efforts. Although it is clear that substance use among youth is increasing, little is known about substance use behaviors and the strategies that Mexican adolescents may employ to successfully resist offers to use. Among US youth, four strategies have been found to be used most often by youth (refuse, explain, avoid, leave [REAL]), and are the basis of a model drug-prevention intervention, keepin' it REAL. However, exposure to substance offers and responses to them are influenced by cultural norms and gender socialization in Mexico. It cannot, therefore, be assumed that the REAL resistance strategies are used by Mexican youth in the same way or with the same level of effectiveness. The present study examines how the utilization of drug resistance strategies impacts the rates of substance use in low income Mexican youth from the state of Guanajuato, and how these results vary by gender.

Methods: Data used in this study come from a cross sectional survey of 702 students (64% female) attending alternative schools in the Mexican state of Guanajuato. Participants were selected using a multi-stage cluster sampling procedure in eight sites located within a radius of 100 km of the state's largest city. Consented students completed a self-administered questionnaire in spring semester of 2007. Questions included the number of times they had used REAL (refuse, explain, avoid, leave) strategies and any other strategies in the past 12 months to resist using substances, how often they received substance offers, their substance use, and demographic variables (age, family structure, parent education, SES, grades). Multivariate OLS regression analysis was employed to predict, separately, the extent of alcohol, cigarette, and marijuana use using factor scores that combined lifetime and recent use frequency and amount. Predictors included the number of REAL drug resistance strategies used, and number of other strategies, frequency of offers of the specific substance, and demographic characteristics. Mean centered gender interactions were tested to determine if the use of drug resistance strategies predicted actual substance use in ways that differed for males and females.

Results: As the number of REAL strategies utilized increased, the frequency of alcohol and cigarette use decreased; for marijuana, only non-REAL strategies predicted less use. All these relationship were stronger for males than females.

Implications: For youth living in Guanajuato, use of a wider repertoire of REAL strategies to resist drug offers was associated with less use of the licit substances most commonly used, suggesting the importance of teaching multiple resistance strategies in prevention interventions. That these relationships pertain especially to males suggests the influence of gender socialization in Mexico. Understanding that Mexican youth resist using drugs and alcohol more when they employ multiple–resistance strategies can help inform future research and provide the foundations for developing or adapting effective, culturally tailored, primary prevention programs for use in Mexico.