Cited by 118Substance Abuse Treatment and OutcomesMindfulness and Compassion InterventionsSmoking Behavior and Cessation

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Evaluation of Yoga for Preventing Adolescent Substance Use Risk Factors in a Middle School Setting: A Preliminary Group-Randomized Controlled Trial

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Butzer, Bethany, LoRusso, Amanda, Shin, Sunny H., Khalsa, Sat Bir S.·2017·Journal of Youth and Adolescence

DOI 10.1007/s10964-016-0513-3PMC PMC5133199

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Abstract

Adolescence is a key developmental period for preventing substance use initiation, however prevention programs solely providing educational information about the dangers of substance use rarely change adolescent substance use behaviors. Recent research suggests that mind-body practices such as yoga may have beneficial effects on several substance use risk factors, and that these practices may serve as promising interventions for preventing adolescent substance use. The primary aim of the present study was to test the efficacy of yoga for reducing substance use risk factors during early adolescence. Seventh-grade students in a public school were randomly assigned by classroom to receive either a 32-session yoga intervention (n = 117) in place of their regular physical education classes or to continue with physical-education-as-usual (n = 94). Participants (63.2 % female; 53.6 % White) completed pre- and post-intervention questionnaires assessing emotional self-regulation, perceived stress, mood impairment, impulsivity, substance use willingness, and actual substance use. Participants also completed questionnaires at 6-months and 1-year post-intervention. Results revealed that participants in the control condition were significantly more willing to try smoking cigarettes immediately post-intervention than participants in the yoga condition. Immediate pre- to post-intervention differences did not emerge for the remaining outcomes. However, long-term follow-up analyses revealed a pattern of delayed effects in which females in the yoga condition, and males in the control condition, demonstrated improvements in emotional self-control. The findings suggest that school-based yoga may have beneficial effects with regard to preventing males' and females' willingness to smoke cigarettes, as well as improving emotional self-control in females. However additional research is required, particularly with regard to the potential long-term effects of mind-body interventions in school settings. The present study contributes to the literature on adolescence by examining school-based yoga as a novel prevention program for substance use risk factors.

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May, A. C., & Tapert, S. F. (2025) · Current topics in behavioral neurosciences · doi:10.1007/7854_2025_580 · Cited by 5
Exploring the Impact of a Trauma-informed Yoga and Mindfulness Curriculum for Multiple Populations: A Pilot Study
Richard, F. D., Rousseau, D., Umapathy, K., Pandya, H., Rousis, G. J., & Peeples, P. (2023) · EXPLORE · doi:10.1016/j.explore.2023.05.007 · Cited by 4
Evidence-based Review of Yoga Interventions for Adolescent Health and Well-being in US Schools
Dai, C., Guo, Y. J., Sharma, M., Chen, C.-C., & Rodriguez, J. M. (2025) · International Journal of Yoga · doi:10.4103/ijoy.ijoy_54_25 · Cited by 3
“[29] Felver et al .”
Influential
Effects of yoga on impulsivity in patients with and without mental disorders: a systematic review
Machado, Y. D. C., Oliveira, M., Lima, J. L. F., Bhargav, H., Varambally, S. S., de Miranda, D. M., & Romano‐Silva, M. A. (2024) · BMC Psychiatry · doi:10.1186/s12888-024-05608-3 · Cited by 3
Physical Education Participation and Student Anxiety, Depression, and/or Stress: A Scoping Review
Lanier, K. V., Killian, C. M., Wilson, K. E., & Ellis, R. (2022) · Kinesiology Review · doi:10.1123/kr.2022-0002 · Cited by 4
MINDFUL YOGA: Strategies for Mindfulness and Yoga in Physical Education
Vicente, S. J., & Stuhr, P. T. (2022) · Strategies · doi:10.1080/08924562.2021.2000540 · Cited by 3
Educational Interventions Through Physical Activity for Addiction Prevention in Adolescent Students—A Systematic Review
Carrellán, J. Á. M., Robles, M. T. A., Fuentes‐Guerra, F. J. G., & Macías, M. R. (2025) · Education Sciences · doi:10.3390/educsci15030348 · Cited by 5
Physical Activity and Sport Interventions to Prevent Drug Use: A Systematic Review Including Different Intervention Paradigms
Asensio-Hernández, M., Jiménez-Martín, P. J., & Jiménez-Martín, A. (2026) · Substance Use & Misuse · doi:10.1080/10826084.2026.2628149 · Cited by 2
“(Butzer et al., 2017; Elliot et al., 2004, 2006, 2008; Fishbein et al., 2016; Goldberg et al., 2000; Mathews et al., 2007; Melnyk et al., 2013) and two rated at 40% (Goldberg et al., 1996a; Wicki et al., 2018).”
Influential
Gendered perspectives of yoga in the Key Stage 1 classroom: Qualitative content analysis indicates contrasting views of teachers and pupils
Wilkin, K., Thornton, C., & Allen, G. (2026) · PLoS ONE · doi:10.1371/journal.pone.0343622 · Cited by 2
“…yoga intervention studies, men are less likely to volunteer [18] and more likely to withdraw their participation than women [19], and in education settings, male students can be resistant to school-based yoga [20,21] and may feel peer pressure to distance themselves from yoga-based activities [22].”
Yogic Spirituality and Positive Psychology vis-à-vis the Mental Health of Adolescents During COVID-19
Lakshmi, R. K. R. R., Oinam, E., & Devi, K. G. (2023) · Pastoral Psychology · doi:10.1007/s11089-023-01061-3 · Cited by 3
“Yoga and meditation may enhance the states of flow and mindful awareness and reduce confusion in young adult musicians (Butzer et al., 2017).”
Background
Impulsivity and substance misuse among Turkish people: Serial mediating effect of emotion dysregulation and general anxiety disorder
Tekin, E. G., Yılmaz, F. B., & Satıcı, S. A. (2023) · Journal of Ethnicity in Substance Abuse · doi:10.1080/15332640.2023.2263742 · Cited by 3
“These results are consistent with existing literature indicating that impulsivity and emotion regulation are crucial factors in the initiation and maintenance of substance misuse (Butzer et al., 2017; De Wit, 2009; Moeller & Dougherty, 2002).”
Programas de intervención y prevención en trastornos por abuso de sustancias en población infanto-juvenil. Una revision sistemática
Mesas-Hueraman, R., Soto-Guaquin, J., & Salcedo, A. S. (2023) · Revista chilena de neuro-psiquiatría · doi:10.4067/s0717-92272023000300351 · Cited by 2
EFFECT OF DIFFERENT RELAXATION TECHNIQUES ON DEPRESSION IN ADOLESCENT GIRLS: A RANDOMIZED CLINICAL TRIAL
(2020) · Egyptian Journal of Applied Science · doi:10.21608/ejas.2020.142521 · Cited by 2
“Yoga is a comprehensive system of practices for physical and psychological health and well-being that consist of four techniques: physical postures/exercises to promote strength and flexibility, breathing exercises to enhance respiratory functioning, relaxation strategies that focus on reducing tension and stress, and…”
Background
Spirituality and health
Dorais, S., Burgin, E. E., & Gutiérrez, D. (2022) · Elsevier eBooks · doi:10.1016/b978-0-12-818872-9.00148-5 · Cited by 2
Substance Use Disorders and Role of Complementary and Integrative Medicine/Functional Medicine
Verma, S. (2023) · Child and Adolescent Psychiatric Clinics of North America · doi:10.1016/j.chc.2022.08.007 · Cited by 1
A School-Based Life Skills Program for Preventing Adolescent Substance Use: Insights from Türkiye
Gazioğlu, E. İ., Erus, S. M., Çelebi, Ç. D., Yaman, N., Eryiğit, D., Aydogdu, B. N., Yıldırım, H., & Arslan, Ş. (2025) · IntechOpen eBooks · doi:10.5772/intechopen.1010003 · Cited by 1
The role of yoga in education
Cvitković, D. (2021) · Metodički obzori · doi:10.32728/mo.16.1.2021.04 · Cited by 1
Yoga in the Management of Arterial Hypertension
Roche, L. T., Menon, P., & Tiwari, S. (2022) · Springer eBooks · doi:10.1007/978-981-16-6913-2_23 · Cited by 1
Efeitos de práticas de yoga na saúde mental de adolescentes: revisão integrativa
Barros, T. F., Vivian, G. F., Farre, A. G. M. D. C., & Batista, P. D. C. (2022) · Revista Brasileira em Promoção da saúde · doi:10.5020/18061230.2022.11742 · Cited by 1
Effect of yogic breathing practice on all-round well-being of teenagers
Subramanian, S., Saisudha, B., & Kanchibhotla, D. (2025) · Clinical Child Psychology and Psychiatry · doi:10.1177/13591045251315210 · Cited by 1
“The bene ﬁ cial effects of yoga even extended to diminishing the willingness to smoke cigarettes in both genders, as well as improving emotional self-control in females in early adolescence (Butzer et al., 2017).”
The effect of sport-based group work on the social emotional learning skills and self-respect of visually disabled adolescents
KALAYCI, E., & Serpen, A. S. (2025) · Social Work With Groups · doi:10.1080/01609513.2025.2472885 · Cited by 1
“Butzer et al. (2016) stated that in the school-based yoga program they applied to students, the social emotional learning skills of the students who participated in the study improved more than the social emotional learning skills of the students who did not participate in the study.”
Improving Adolescent Mental Health Development through Therapeutic Group Therapy in Saint Beatrix Orphanage, Sidoarjo
Cempaka, A. A., & Aryanti, P. I. (2021) · Jurnal Pengabdian Kepada Masyarakat · doi:10.22146/jpkm.60035 · Cited by 1
The role of yoga in the management of essential hypertension
Grewal, H., Zhuang, C., & Basu‐Ray, I. (2024) · Elsevier eBooks · doi:10.1016/b978-0-323-99645-7.00027-5 · Cited by 1
Effectiveness of a blended school-based mindfulness program for the prevention of co-rumination and internalizing problems in Dutch secondary school girls: a Cluster Randomized Controlled TrialPreprint
Vuijk, P., Bul, K., Buil, J. M., Rauws, M., Curie, K., Amesz, C., Weerheijm, R., & Riper, H. M. (2023) · Research Square · doi:10.21203/rs.3.rs-3265929/v1 · Cited by 1
A Randomized Controlled Trial of a Hatha Yoga Intervention for Smokers
Jeffries, E. R. (2018) · Louisiana State University · doi:10.31390/gradschool_dissertations.4692
Association of overweight/obesity in the development of physical aggression in children and adolescents
Tso, M. K. W. (2019) · Deakin Research Online (Deakin University)
Environmental Factors Linked to Opioids, Drugs, and Alcohol Abuse
Dasgupta, A. (2020) · Elsevier eBooks · doi:10.1016/b978-0-12-820075-9.00005-3
Managing with Mindfulness: Connecting with Students in the 21st Century
Yeigh, T. (2020)
A Consideration of Transpersonal Research Methods for Studying Yoga and Mindfulness in Schools
Butzer, B. (2022) · doi:10.24972/ijts.2021.40.2.31
“…multifaceted aspects of school-based contemplative programs, often by capturing stories and narratives from study participants, school staff and intervention instructors (Butzer et al., 2017a; Cook-Cottone et al., 2018; Cook-Cottone et al., 2017; Cook-Cottone et al., 2020; Hyde & Johnson, 2019).”
BackgroundMethodResultInfluentialSelf-citation
Sport und gesunder Lebensstil im Kindes- und Jugendalter
Kothgassner, O. D., & Plener, P. L. (2022) · Springer Reference Medizin · doi:10.1007/978-3-662-49289-5_77-1
Efetividade de intervenções baseadas em Mindfulness sobre o abuso de substâncias
Thiago, J. V. M., Santos, E. R., Vida, H. C. O., & da Silva, E. E. A. (2023) · Research Society and Development · doi:10.33448/rsd-v12i6.42205 · Cited by 1
A mixed method evaluation of the quasi-experimental yoga-based intervention for the behavioural issues of school-going early adolescents in Jaffna, Sri Lanka
Sivashankar, J. T., Surenthirakumaran, R., Sathyakumar, N., & Coonghe, P. A. D. (2024) · Journal of the College of Community Physicians of Sri Lanka · doi:10.4038/jccpsl.v30i2.8626
Improving Self-Regulation: Resiliency Skills in the Classroom
Neal, A. M., Donohoe, M., & Gaffney, K. C. (2024) · Journal of Psychosocial Nursing and Mental Health Services · doi:10.3928/02793695-20240813-04 · Cited by 1
Sport und gesunder Lebensstil im Kindes- und Jugendalter
Kothgassner, O. D., & Plener, P. L. (2024) · Springer Reference Medizin · doi:10.1007/978-3-662-66744-6_77
A translational framework for personalizing intervention models to prevent substance use disorder
Fishbein, D. H., & Rose, E. J. (2025) · Addiction Neuroscience · doi:10.1016/j.addicn.2025.100206
Yoga and Substance Use
Scaletta, S., Pershyn, C. L., & Cook‐Cottone, C. P. (2025) · Mindfulness in behavioral health · doi:10.1007/978-3-031-83418-9_16
Future Directions in Yoga Applications: Depression, Anxiety, and Self-Harm
Muehlenkamp, J. J. (2025) · Mindfulness in behavioral health · doi:10.1007/978-3-031-83418-9_17
Random Assignment in School Settings: A Systematic Review of Yoga Interventions for Adolescents
Schelly, D., & Watts, M. P. (2025) · Journal of Child and Family Studies · doi:10.1007/s10826-025-03084-1
“Like Butzer et al. (2017), Fishbein et al. (2016) analyzed data on more measures than can be reliably counted (e.g., 20 + ), and the authors discussed trends toward signi ﬁ cance, a topic that we will also return to later.”
Influential
Yoga for Cognition Enhancement and Emotion Regulation of Students
Gulati, K., Bhargav, H., Telles, S., & Hankey, A. (2025) · Springer eBooks · doi:10.1007/978-981-96-8039-9_3
Effect of 12-week yoga practices on physical parameters and quality of life of individuals with substance use disorder: An open-label study
Rawat, S., Tripathi, M., Chetri, S., Bhasin, G., Kaushik, A., & Kar, N. (2025) · Odisha Journal of Psychiatry · doi:10.4103/ojp.ojp_11_25
Physical Therapy for Addiction
Xiao, L., Yin, Q., Tao, R., & Wu, J. (2025) · Advances in experimental medicine and biology · doi:10.1007/978-981-95-2411-2_11
The implementation and effectiveness of sports-based mental health programmes in schools: a systematic review
Kegelaers, J., Hove, L. V., Heel, M. V., & Baetens, I. (2025) · International Review of Sport and Exercise Psychology · doi:10.1080/1750984x.2025.2596585
Additional file 8 of Individual-, family- and school-based interventions to prevent multiple risk behaviours relating to alcohol, tobacco and drug use in young people aged 8-25 years: a systematic review and meta-analysis
Tinner, L., Palmer, J. C., Lloyd, E. C., Caldwell, D. M., MacArthur, G. J., Dias, K., Langford, R. M., Redmore, J., Wittkop, L., Watkins, S., et al. (2022) · Figshare · doi:10.6084/m9.figshare.20000485
Additional file 11 of Individual-, family- and school-based interventions to prevent multiple risk behaviours relating to alcohol, tobacco and drug use in young people aged 8-25 years: a systematic review and meta-analysis
Tinner, L., Palmer, J. C., Lloyd, E. C., Caldwell, D. M., MacArthur, G. J., Dias, K., Langford, R. M., Redmore, J., Wittkop, L., Watkins, S., et al. (2022) · Figshare · doi:10.6084/m9.figshare.20000461

Authors: Butzer, B., LoRusso, A., Shin, S. H., & Khalsa, S. B. S.
Affiliations: University of New York in Prague (CZ)
Brigham and Women's Hospital (US)
Virginia Commonwealth University (US)
Corresponding author: Butzer, Bethany
ORCID: Butzer, Bethany
Shin, Sunny H.
Khalsa, Sat Bir S.
Venue: Journal of Youth and Adolescence
Publisher: Springer Science and Business Media LLC
Published: 2016-05-31
Volume: 46
Issue: 3
Pages: 603-632
ISSN: 0047-2891 (ISSN-L)
1573-6601
DOI: 10.1007/s10964-016-0513-3
PMC: PMC5133199
OpenAlex: W2410483379
Cited by: 118
References: 120
Citations by year: 2026: 7 · 2025: 15 · 2024: 13 · 2023: 12 · 2022: 30 · 2021: 9 · 2020: 13 · 2019: 5 · 2018: 7 · 2017: 6 · 2016: 1
FWCI: 5.93
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.springer.com/tdm (tdm)
www.springer.com/tdm (vor)
Locations: Journal of Youth and Adolescence (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: National Institute on Drug Abuse (R34 DA032756)
Topics: Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Smoking Behavior and Cessation
Keywords: yoga, adolescent substance use prevention, substance use risk factors, school-based intervention, mind-body practices, emotion regulation, perceived stress, impulsivity, smoking initiation, physical education, gender differences, junior high school students
MeSH terms: Self-Control, Adolescent, Female, Humans, Male, Surveys and Questionnaires, Risk Factors, Schools, Students, Yoga, Health Behavior, Substance-Related Disorders

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Evaluation of Yoga for Preventing Adolescent Substance Use Risk Factors in a Middle School Setting: A Preliminary Group-Randomized Controlled Trial

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