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Learning How to Say "No" to Alcohol Advertising and Peer Pressure Works for Inner-City Adolescents

Teens who can recognize and resist the persuasive tactics used in alcohol ads are less likely to succumb to alcohol advertising and peer pressure to drink.

The results of a three-year study of inner-city middle school students by Weill Cornell Medical College researchers appears online in the journal Addictive Behaviors (April print edition). Previous research has shown the connection between advertising and adolescent alcohol, use as well as the influence of peers in promoting adolescent alcohol use.

"There are many pressures on teens to drink. One very powerful influence is advertising — from television to billboards, it's everywhere. Our study found their ability to be critically aware of advertising as well as their ability to resist peer pressure are both key skills for avoiding alcohol," says Dr. Jennifer A. Epstein, lead author and assistant professor of public health in the Division of Prevention and Health Behavior at Weill Cornell Medical College.

Results were taken from surveys of over 2,000 predominantly African-American adolescents from 13 inner-city junior high schools in New York City over three years. The study found that seventh graders better able to be critically aware of advertising — something the study terms "media resistance skills" — were significantly less likely to drink alcohol as ninth graders.

These same seventh graders were more likely to have developed better skills for resisting peer pressure by the eighth grade, further reducing their likelihood of drinking. Armed with media resistance and peer refusal skills (saying "no"), these students were less likely to succumb to advertising and peer pressure to drink alcohol subsequently in the ninth grade.

Alcohol is the number one drug of choice in this country and among our nation's youth. A recent report by the Surgeon General found that despite laws against it, underage drinking is deeply embedded in American culture, viewed as a rite of passage and facilitated by adults.

"Our findings point to the need for prevention programs that teach adolescents media resistance skills and peer refusal skills to reduce the likelihood that they will succumb to the powerful dual influences of alcohol advertising and peer pressure," says Dr. Gilbert J. Botvin, the senior author; professor of psychology in public health and professor of psychology in psychiatry; and chief of the Public Health Department's Division of Prevention and Health Behavior.

Dr. Botvin, who developed the award-winning Life Skills Training (LST) substance-abuse prevention program for junior high and middle school students more than 25 years ago, continuously works with his colleagues to refine and disseminate the program through research and teaching. (Dr. Botvin has a financial interest in LST, and his consulting company provides training and technical assistance for the program.)

This study was supported by a grant to Dr. Epstein from the National Institute on Alcohol Abuse and Alcoholism (NIAAA) and to a grant to Dr. Botvin from the National Institute on Drug Abuse (NIDA).

Weill Cornell Medical College
Weill Cornell Medical College, Cornell University's medical school located in New York City, is committed to excellence in research, teaching, patient care and the advancement of the art and science of medicine, locally, nationally and globally. Weill Cornell, which is a principal academic affiliate of NewYork-Presbyterian Hospital, offers an innovative curriculum that integrates the teaching of basic and clinical sciences, problem-based learning, office-based preceptorships, and primary care and doctoring courses. Physicians and scientists of Weill Cornell Medical College are engaged in cutting-edge research in areas such as stem cells, genetics and gene therapy, geriatrics, neuroscience, structural biology, cardiovascular medicine, infectious disease, obesity, cancer, psychiatry and public health — and continue to delve ever deeper into the molecular basis of disease in an effort to unlock the mysteries of the human body in health and sickness. In its commitment to global health and education, the Medical College has a strong presence in places such as Qatar, Tanzania, Haiti, Brazil, Austria and Turkey. Through the historic Weill Cornell Medical College in Qatar, the Medical College is the first in the U.S. to offer its M.D. degree overseas. Weill Cornell is the birthplace of many medical advances — including the development of the Pap test for cervical cancer, the synthesis of penicillin, the first successful embryo-biopsy pregnancy and birth in the U.S., the first clinical trial of gene therapy for Parkinson's disease, the first indication of bone marrow's critical role in tumor growth, and most recently, the world's first successful use of deep brain stimulation to treat a minimally-conscious brain-injured patient. For more information, visit

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