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School Effects on Young People’s Drug Use: A Systematic Review of Intervention and Observational Studies
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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“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 [65].”
From Interventions for Adolescent Substance Abuse: An Overview of Systematic Reviews (2016) · cites this paper as [65]
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Metadata
- Authors
- Fletcher, A., Bonell, C., & Hargreaves, J.
- Affiliations
- London School of Hygiene & Tropical Medicine (GB)
- Corresponding author
- Fletcher, Adam
- Venue
- Journal of Adolescent Health
- Publisher
- Elsevier BV
- Published
- 2008-03
- Volume
- 42
- Issue
- 3
- Pages
- 209-220
- ISSN
- 1054-139X (ISSN-L)
- 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
- 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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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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