Table 1.

Principal approaches guiding universal and selected prevention of substance use disorders in schools

	Assumption	Training methods
SRST	Adolescents begin to use drugs largely because they lack the confidence or skills to resist social influences to smoke, drink, or use illicit drugs	Teaching students to recognize high-risk situations
		Increasing the awareness of media influences
		Refusal skills training
NE	Adolescents generally overestimate the prevalence of smoking, drinking, and illicit drug use among other adolescents and adults	Information about the prevalence of drug use from national or local surveys
		Conduct own surveys
CEST	Drug use behavior is learned through a process of modeling, imitation, and reinforcement, and is influenced by an adolescent’s prodrug cognitions, attitudes, and beliefs	Self-management and social skills
		Decision-making and problem-solving skills
		Assertiveness skills
		Increasing personal control
		Enhancing self-esteem
		Adaptive coping strategies for managing stress and anxiety

CEST: Competence enhancement skills training, NE: Normative education, SRST: Social resistance skills training