A School Resilience Program Did Not Reduce Teen Substance Use Including Marijuana
A three-year school-based resilience intervention across 32 Australian schools showed no effect on reducing tobacco, alcohol, marijuana, or other substance use among students.
Quick Facts
What This Study Found
This large cluster-randomized controlled trial tested whether building student resilience through school-based programs could reduce substance use among adolescents.
Twenty intervention schools implemented resilience-building programs targeting individual protective factors (like problem-solving skills) and environmental factors (like caring relationships) for students in grades 7 through 10 over three years.
At follow-up, when students were 15-16 years old, there were no significant differences between intervention and control students on any substance use measure. Marijuana use rates were virtually identical (OR 1.12, p=0.57). The same null results applied to tobacco, alcohol, and other illicit substances.
The intervention also failed to increase individual or environmental protective factors, suggesting the program did not successfully build resilience at all, rather than building resilience that simply failed to reduce substance use.
Key Numbers
32 schools (20 intervention, 12 control). 2,105 students at follow-up. Marijuana use OR: 1.12 (95% CI 0.74-1.68, p=0.57). No significant effects on any primary or secondary outcome.
How They Did This
Cluster-randomized controlled trial across 32 Australian secondary schools (20 intervention, 12 control). A cohort of grade 7 students was followed to grade 10 (ages 15-16). Intervention schools selected and implemented available resilience programs with implementation support. Online surveys measured substance use and protective factors at baseline and follow-up. 2,105 students provided follow-up data (69% of baseline).
Why This Research Matters
This is one of the largest and most rigorous tests of whether school-based resilience programs prevent substance use. The null result across every outcome measured is significant because many school systems invest in similar resilience-building programs with the expectation of substance use prevention.
The Bigger Picture
This study contributes to a growing body of evidence questioning whether generic resilience or social-emotional learning programs translate into measurable reductions in adolescent substance use. More targeted or intensive approaches may be needed to influence behavior.
What This Study Doesn't Tell Us
The pragmatic design allowed schools to choose their own resilience programs, which may have resulted in inconsistent implementation quality. The 31% attrition rate could introduce bias. Australian results may not generalize to other educational or cultural contexts.
Questions This Raises
- ?Would more intensive or standardized resilience programs produce different results?
- ?Are there specific components of resilience that matter for substance use prevention even if generic programs fail?
- ?Should schools redirect prevention resources toward approaches with stronger evidence?
Trust & Context
- Key Stat:
- No significant effect on marijuana use (OR 1.12, p=0.57) or any other substance
- Evidence Grade:
- Large cluster-randomized controlled trial with longitudinal follow-up, representing strong evidence despite the pragmatic design limitations.
- Study Age:
- Published in 2017, with data collected 2012-2014.
- Original Title:
- Effectiveness of a pragmatic school-based universal resilience intervention in reducing tobacco, alcohol and illicit substance use in a population of adolescents: cluster-randomised controlled trial.
- Published In:
- BMJ open, 7(8), e016060 (2017)
- Authors:
- Hodder, Rebecca Kate, Freund, Megan, Bowman, Jenny, Wolfenden, Luke, Campbell, Elizabeth, Dray, Julia, Lecathelinais, Christophe, Oldmeadow, Christopher, Attia, John, Wiggers, John
- Database ID:
- RTHC-01404
Evidence Hierarchy
Participants are randomly assigned to treatment or placebo groups to test cause and effect.
What do these levels mean? →Frequently Asked Questions
Do school resilience programs prevent drug use?
This large trial found no evidence that they do. Across 32 schools and over 2,000 students, the resilience intervention produced no significant reduction in marijuana, tobacco, alcohol, or other drug use after three years.
Why didn't the program work?
The intervention also failed to increase the protective factors it was targeting (like problem-solving skills and caring relationships), suggesting the programs did not successfully build resilience in the first place, which would explain why substance use was unaffected.
Read More on RethinkTHC
Cite This Study
https://rethinkthc.com/research/RTHC-01404APA
Hodder, Rebecca Kate; Freund, Megan; Bowman, Jenny; Wolfenden, Luke; Campbell, Elizabeth; Dray, Julia; Lecathelinais, Christophe; Oldmeadow, Christopher; Attia, John; Wiggers, John. (2017). Effectiveness of a pragmatic school-based universal resilience intervention in reducing tobacco, alcohol and illicit substance use in a population of adolescents: cluster-randomised controlled trial.. BMJ open, 7(8), e016060. https://doi.org/10.1136/bmjopen-2017-016060
MLA
Hodder, Rebecca Kate, et al. "Effectiveness of a pragmatic school-based universal resilience intervention in reducing tobacco, alcohol and illicit substance use in a population of adolescents: cluster-randomised controlled trial.." BMJ open, 2017. https://doi.org/10.1136/bmjopen-2017-016060
RethinkTHC
RethinkTHC Research Database. "Effectiveness of a pragmatic school-based universal resilien..." RTHC-01404. Retrieved from https://rethinkthc.com/research/hodder-2017-effectiveness-of-a-pragmatic
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.