Although many substance abuse prevention programs seek to enhance the ability of adolescents to refuse offers of alcohol and other drugs, few report assessments of refusal skill ability or its relationship to substance use. This report describes a procedure to assess the ability of adolescents to refuse the offer of a beer, and presents the findings of those assessments as well as their relationships to alcohol misuse prevention knowledge, susceptibility to peer pressure, internal health locus of control, self-esteem, and alcohol use and misuse. A one-third random sample (n = 1012) of 10th graders participating in a longitudinal evaluation of an alcohol misuse prevention curriculum was assessed individually. Students rated their own refusals, which were also rated by trained female and male raters. The results indicated that adolescents refuse the offer of a beer only somewhat convincingly. Those adolescents with better refusal skills had higher levels of alcohol misuse prevention knowledge, especially regarding resisting pressures to use alcohol and the application of knowledge to typical alcohol-related situations. They also reported less susceptibility to peer pressure, greater internal health locus of control and self-esteem, and less alcohol use and misuse. The results provide support for teaching refusal skills in substance abuse prevention programs and for assessing refusal skills in the evaluation of such programs.
2. Festinger L.: A Theory of Cognitive Dissonance. Stanford, CA , Stanford University Press, 1957 .
3.
McGuire W.: Inducing resistance to persuasion, in Berkowitz L (ed.): Advances in Experimental Social Psychology , Vol. I. New York, NY, Academic Press, 1964.
4.
Evans R.: Smoking in children: Developing a social psychological strategy of deterrence . Prev Med5:122-127, 1976.
5.
Botvin G., Eng A.: A comprehensive school-based smoking prevention program. J Sch Health50:209-213, 1980.
6.
Dielman T., Lorenger A., Leech S., Lyons A., Klos D., Horvath W.: Fifteen-month follow-up results of an elementary school-based smoking prevention project. Hygie4:28-35, 1985.
7.
Evans R., Rozelle R., Mittelmark M., Hansen W., Bane A., Havis J.: Deterring the onset of smoking in children: Knowledge of immediate physiological effects and coping with peer pressure, media pressure, and parent modeling . J Appl Soc Psychol8:126-135, 1978.
8.
McAlister A. , Perry C., Maccoby N.: Adolescent smoking: Onset and prevention . Pediatrics63:650-658, 1979.
9.
Murray D., Johnson C., Luepker R., Pechacek T., Jacobs D., Hurd P.: Social factors in the prevention of smoking in seventh grade students: A follow-up experience of one year. Paper presented at the annual meeting of the American Psychological Association, New York, 1979.
10.
Murray D., Johnson C., Luepker R., Pechacek T., Jacobs D.: Issues in smoking prevention research. Paper presented at the annual meeting of the American Psychological Association, Montreal , 1980.
11.
Perry C., Killen J., Telch M., Slinkard L., Danaher B.: Modifying smoking behavior of teenagers: A school-based intervention . Am J Public Health70:722-725, 1980.
12.
Perry C., Maccoby N., McAlister A.: Adolescent smoking prevention: A third year follow-up. World Smoking Health 5:40-54, 1980.
13.
Botvin G., Baker E., Botvin E., Filazzola A., Millman R.: Prevention of alcohol misuse through the development of personal and social competence: A pilot study. J Stud Alcohol45:550-552, 1984.
14.
Botvin G., Baker E., Renick N., Filazzola A., Botvin E.: A cognitive-behavior approach to substance abuse prevention. Addict Behav9:137-147, 1984.
15.
DeJong W.: A short-term evaluation of project DARE (Drug Abuse Resistance Education): Preliminary indicators of effectiveness. J Drug Educ17:279-294, 1987.
16.
Hansen W., Malotte C., Fielding J.: Evaluation of a tobacco and alcohol abuse prevention curriculum for adolescents . Health Educ Q15:93-114, 1988.
17.
McAlister A. , Perry C., Killen J., Slinkard L., Maccoby N.: Pilot study of smoking, alcohol and drug abuse prevention. Am J Public Health70:719-721, 1980.
18.
Duryea E.: Utilizing tenets of inoculation theory to develop and evaluate a preventive alcohol education intervention. J School Health53:250-256, 1983.
19.
Duryea E., Mohr P., Newman I., Martin G., Egwaoje E.: Six-month follow-up results of a preventive alcohol education intervention . J Drug Educ14:97-104, 1984.
20.
Hansen W., Johnson C., Flay B., Graham J., Sobel J.: Affective and social influences approaches to the prevention of multiple substance abuse among seventh grade students: Results from Project SMART. Prev Med17:135-154, 1988.
21.
Dielman T., Shope J., Butchart A., Campanelli P.: Prevention of adolescent alcohol misuse: An elementary school program . J Pediatr Psychol11:259-281, 1986.
22.
Dielman T., Shope J., Leech S., Butchart A.: Differential effectiveness of an elementary school-based alcohol misuse prevention program. J School Health59:255-263, 1989.
23.
Shope J., Dielman T., Butchart A., Campanelli P., Kloska D.: An elementary school-based alcohol misuse prevention program: A follow-up evaluation. J Stud Alcohol53:106-121, 1992.
24.
Ellickson P. , Bell R.: Drug prevention in junior high: A multi-site longitudinal test. Science247:1299-1305, 1990.
25.
Tobler N.: Meta-analysis of 143 adolescent drug prevention programs: Quantitative outcome results of program participants compared to a control or comparison group . J Drug Issues16:537-567, 1986.
26.
Botvin G.: Substance abuse prevention research: Recent developments and future directions . J School Health56:369-374, 1986.
27.
Rundall T., Bruvold W.: A meta-analysis of school-based smoking and alcohol use prevention programs . Health Educ Q15:317-334, 1988.
28.
Kim S., McLeod J., Shantzis C.: An outcome evaluation of refusal skills program as a drug abuse prevention strategy. J Drug Educ19:363-371, 1989.
29.
Telch M., Miller L., Killen J., Cooke S., Maccoby N.: Social influences approach to smoking prevention: The effects of videotape delivery with and without same-age peer leader participation. Addict Behav15:21-28, 1990.
30.
Botvin G., Baker E., Filazzola A., Botvin E.: A cognitive-behavioral approach to substance abuse prevention: One-year follow-up . Addict Behav15:47-63, 1990.
31.
Warzak W., Page T.: Teaching refusal skills to sexually active adolescents. J Behav Ther Exp Psychiatry21:133-139, 1990.
32.
Schinke S., Gilchrist L.: Primary prevention of tobacco smoking. J School Health53:416-419, 1983.
33.
Hops H., Weissman W., Biglan A., Thompson R., Faller C., Severson H.: A taped situation test of cigarette refusal skill among adolescents . Behav Assessment8:145-154, 1986.
34.
Katz R., Robisch C., Telch M.: Brief report: Acquisition of smoking refusal skills in junior high school students. Addict Behav14:201-204, 1989.
35.
Rohrbach L. , Graham J., Hansen W., Flay B., Johnson C.: Evaluation of resistance skills training using multitrait-multimethod role play skill assessments . Health Educ Res2:401-407, 1987.
36.
Jones R., McDonald D., Fiore M., Arrington T., Randall J.: A primary preventive approach to children's drug refusal behavior: The impact of rehearsal-plus. J Pediatr Psychol15:211-223, 1990.
37.
Dielman T., Butchart A., Shope J., Campanelli P., Caspar R.: A covariance structure model test of antecedents of adolescent alcohol misuse and a prevention effort. J Drug Educ19:337-361, 1989.
38.
Dielman T., Campanelli P., Shope J., Butchart A.: Susceptibility to peer pressure, selfesteem and health locus of control as correlates of adolescent substance abuse. Health Educ Q14:207-221, 1987.
39.
Campanelli P. , Dielman T., Shope J.: Validity of adolescents' self-reports of alcohol use and misuse using a bogus pipeline procedures. Adolescence22:7-22, 1987.
40.
Akers R., Massey J., Clarke W., Lauer R.: Are self-reports of adolescent deviance valid? Biochemical measures, randomized response, and the bogus pipeline in smoking behavior. Soc Forces62:234-251, 1983.
41.
O'Malley P.: Cigarette smoking among high school seniors.Did the rate decline?Prev Med13:421-426, 1984.
42.
O'Malley P., Bachman J., Johnston L.: Reliability and consistency in self-reports of drug use. Int J Addict18:805-824, 1983.
43.
Hansen W., Malotte C., Fielding J.: The bogus pipeline revisited: The use of the threat of detection as a means of increasing self-reports of tobacco use. J Appl Psychol70:789-792, 1985.
