Cited by 237Substance Abuse Treatment and OutcomesYouth, Drugs, and ViolenceSchool Health and Nursing Education

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School Effects on Young People’s Drug Use: A Systematic Review of Intervention and Observational Studies

Fletcher, Adam, Bonell, Chris, Hargreaves, James·2008·Journal of Adolescent Health

DOI 10.1016/j.jadohealth.2007.09.020

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Abstract

Purpose This systematic review examined the hypothesis that school institutional factors influence young people's use of drugs. We aimed to (1) identify the effect of school-level changes on drug use and (2) explore the possible mechanisms by which school-level influences on individual drug use might occur. Methods Systematic review. Experimental/quasi-experimental studies of "whole-school" drug prevention interventions and longitudinal observational studies on the association between school-level and individual-level school-related exposures and drug use were included. Experimental studies were included because they are the most reliable available source of evidence about causation. Observational studies of school-level and individual-level school-related exposures were included with the aim of providing evidence about a wider range of possible school-level effects and how school-level influences might be mediated by individual-level factors. Results Experimental studies suggested that changes to the school social environment that increase student participation, improve relationships and promote a positive school ethos may be associated with reduced drug use. School-level and individual-level observational studies consistently reported that disengagement and poor teacher-student relationships were associated with drug use and other risky health behaviors. Conclusions There is evidence of school effects on young people's drug use. Interventions that promote a positive school ethos and reduce student disaffection may be an effective complement to drug prevention interventions addressing individual knowledge, skills, and peer norms. Such approaches should now be piloted in a wider range of settings. Further research is also needed to explore mechanisms by which schools may influence young people's drug use.

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Authors: Fletcher, A., Bonell, C., & Hargreaves, J.
Affiliations: London School of Hygiene & Tropical Medicine (GB)
Corresponding author: Fletcher, Adam
ORCID: Fletcher, Adam
Bonell, Chris
Hargreaves, James
Venue: Journal of Adolescent Health
Publisher: Elsevier BV
Published: 2008-03
Volume: 42
Issue: 3
Pages: 209-220
ISSN: 1054-139X (ISSN-L)
DOI: 10.1016/j.jadohealth.2007.09.020
OpenAlex: W1998500101
Cited by: 237
References: 53
Citations by year: 2026: 4 · 2025: 4 · 2024: 6 · 2023: 7 · 2022: 10 · 2021: 11 · 2020: 9 · 2019: 16 · 2018: 25 · 2017: 15 · 2016: 29 · 2015: 27 · 2014: 13 · 2013: 16 · 2012: 8
FWCI: 1.32
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Journal of Adolescent Health (publishedVersion)
PubMed (publishedVersion)
ORCA Online Research @Cardiff (Cardiff University) (submittedVersion)
Funders: London School of Hygiene and Tropical Medicine
Medical Research Council
Economic and Social Research Council (ES/E003818/1)
Topics: Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Youth, Drugs, and Violence
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › School Health and Nursing Education
Keywords: school influence, adolescent drug use, school-wide intervention, school climate, school disaffection, teacher-student relationship, student engagement, health risk behaviors, mediating mechanisms
MeSH terms: Smoking Prevention, Adolescent, Adolescent Behavior, Alcohol Drinking, Australia, Child, Educational Status, Faculty, Female, Humans, Interpersonal Relations, Longitudinal Studies, Male, Netherlands, Risk Factors, Schools, Smoking, Social Conditions, United States, Health Behavior, Age Distribution, Observation, Substance-Related Disorders

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School Effects on Young People’s Drug Use: A Systematic Review of Intervention and Observational Studies

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