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.
Read this if you are interested in whether school-based programs actually prevent teen marijuana and substance use.
No significant effect on marijuana use (OR 1.12, p=0.57) or any other substance
What the researchers 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.
Why it 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 numbers in context
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 the study worked
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).
What this study cannot 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.
How to read the evidence
Large cluster-randomized controlled trial with longitudinal follow-up, representing strong evidence despite the pragmatic design limitations.
When this study was published
Published in 2017, with data collected 2012-2014.
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.
Questions still open
- 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?
Common questions
Do school resilience programs prevent drug use?
Why didn't the program work?
Read the original research
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
Citation
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
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