Programs that Work
Healthy and Safe Children
Youths not using alcohol, tobacco, or illegal drugs
Youths abstaining from sexual activity or not engaging in risky sexual behavior
Children and youth not engaging in violent behavior or displaying serious conduct problems
Age of Child
Middle Childhood (9-12)
Type of Setting
Type of Service
Type of Outcome Addressed
Substance Use and Dependence
Teen Sex / Pregnancy
Evidence Level (What does this mean?)
The LifeSkills Training (LST) program is a school-based substance abuse prevention curriculum. LST originally targeted middle and junior high school students, but is now used with elementary and high school students as well. The LST program was developed in the late 1970s and aims to modify drug-related knowledge, attitudes, and norms; teach skills for resisting social influences that encourage drug use; and foster the development of general personal and social skills.
The LST program originally focused on preventing cigarette smoking, and the curriculum was later expanded to include preventing the use of alcohol and other drugs. The LST curriculum is taught over three consecutive school years, beginning in the 6th and 7th grade. The program consists of 15 lessons in the first year, followed by 10 "booster" lessons during the program's second year and 5 booster lessons in the third year. The booster lessons are designed to reinforce earlier material and to provide additional opportunities for skill development and practice. There is also an LST curriculum for elementary school children, beginning in 3rd or 4th grade, and for high school students, beginning in 9th or 10th grade. Regular classroom teachers usually implement the LST curriculum; however, the program can be implemented by outside health professionals or older student peers.
The LST program may be used with elementary, middle and junior high, or high school students. It has been studied extensively with white, middle-class participants from suburban and rural areas of New York State, as well as with African-American and Hispanic youth in urban New York City.
The LST program has been evaluated in various formats and for effectiveness at reducing risky behaviors in several samples of students since its inception. Program impacts have been assessed immediately following program completion and at intervals up to six years later. Implementation of the program has varied somewhat in length (12 to 20 sessions, with the average being 15) and format of program delivery (e.g., teacher-led versus peer-led, intensive mini-course versus regular weekly sessions, and implementation feedback for teachers versus no feedback). More recently, the program has been modified for use with elementary students. In addition, studies have tested the effects of an added violence-reduction component and whether LST concepts are effective when infused into the content of students' daily classroom curricula. Outcomes measured include impacts on driving behavior, HIV-risk behavior, aggression, and substance use—cigarette use only, alcohol use only, or cigarettes, alcohol, and marijuana use.
A study by Botvin, Renick, and Baker (1983) sought to provide a test of the effectiveness of the LST program at preventing the initiation of cigarette smoking, compare the relative efficacy of two different scheduling formats of the curriculum, and test the effectiveness of booster sessions. The sample consisted of 902 7th graders from seven public schools in suburban New York, and the majority of participating students were white and from middle- to upper-middle-class families. Schools were randomly assigned to (1) LST using an integrated weekly scheduling format (two schools), (2) LST using an intensive mini-course scheduling format (two schools), or (3) control group (three schools). We report the combined experimental group, short-term results only. After excluding pretest smokers, 831 students remained in the analysis sample.
Botvin, Batson, et al. (1989) conducted a study of smoking among 608 7th grade students from nine urban junior high schools in northern New Jersey. The sample was predominantly African-American (87 percent) and 10 percent Hispanic. Three schools were randomly assigned to the treatment group, and six schools were assigned to the control group. Three months following the pretest, a total of 520 students completed the posttest.
Botvin, Dusenbury, et al. (1989) assessed the effects of the LST program on smoking among 471 7th graders from eight public schools in the metropolitan New York area. Students were predominantly Hispanic (74 percent). Schools were randomly assigned to treatment and control group groups, and 73 percent (345) of students completed posttest data 3.5 months after the pretest. Based on an analysis of program implementation data—i.e., researcher observations of the extent to which the curriculum was taught and how effectively participating teachers taught it—a high-implementation subgroup and a low-implementation subgroup were formed from the original treatment group.
Botvin, Baker, et al. (1990) report results from a three-year longitudinal study initiated in 1985. This study assessed LST program effects on cigarette smoking among 3,684 students, who started the study in 7th grade, from 56 predominantly white middle/junior high schools in New York State. The intervention began with 15 class sessions in year one, followed by 10 class booster sessions in year two and five sessions in year three. Schools were randomly assigned to one of three groups: (1) a prevention program with annual one-day teacher workshops and implementation feedback by project staff (workshop group, 18 schools); (2) a prevention program with teacher training provided by videotape and no implementation feedback (videotape group, 16 schools); and (3) a comparison control group (22 schools). Posttest data were collected following completion of the intervention program and analyses were conducted on only those experimental schools with implementation scores of 60 percent. A six-year follow-up study was conducted on 3,597 12th-grade students (60 percent of the initial 7th grade sample); it assessed cigarette, alcohol, and marijuana use (Botvin, Baker, et al., 1995). No differential attrition effects were found among treatment and control groups.
To test the efficacy of the program on Hispanic students in a larger sample, Botvin, Dusenbury, et al. (1992) assessed smoking among 3,153 predominantly low-income, Hispanic 7th graders from 47 schools (11 public and 36 parochial schools) in New York City. Schools were randomly assigned to either a treatment group (25 schools with 1,795 students) or control group (22 schools with 1,358 students). Posttest data were collected four months after the pretest.
A study by Botvin, Epstein, et al. (1997) assessed cigarette, alcohol, marijuana, and multidrug use among 833 predominantly minority (70 percent Hispanic and 26 percent African-American) 7th grade students from seven urban schools in New York City. Schools were assigned to either a treatment (LST) or control group (the latter received the standard drug prevention program in New York City schools). Posttest data were collected three months after program implementation and included 721 students (87 percent of the initial sample).
A fourth LST evaluation using the Botvin, Griffin, et al. (2001a) sample focused on the effects of LST on cigarette smoking among female students only (Botvin, Griffin, et al., 1999). The sample consisted of 2,690 low-income, minority (60 percent were African-American and 23 percent Hispanic) 7th grade girls. Schools were randomly assigned to treatment and control groups, and posttest data were collected after one year. The final sample contained 2,209 students (82 percent), including 1,278 treatment group students and 931 control group students.
Botvin, Griffin, et al. (2001a) examined the effects of LST among a sample of 5,222 predominantly low-income minority students in the 7th grade attending 29 New York City schools. The sample was 47 percent male, 61 percent African-American, and 22 percent Hispanic, and 62 percent of the students qualified for a free lunch at school. Prior to randomization, schools were divided into high, medium, or low smoking prevalence and randomly assigned to treatment (16 schools) and control (13 schools) groups. Treatment group students received the LST program in 7th grade, followed by booster sessions in the 8th grade, while control group students received the regular public school substance abuse prevention program. Pretest data were collected in 7th grade, initial posttest data were collected three months later, and one-year follow-up data were collected when students were in 8th grade. A total of 3,621 students (69 percent of the initial sample) provided data at both initial posttest and one-year follow-up, including 2,144 students from the treatment group and 1,477 students from the control group. Attrition analyses found that pretest smokers, drinkers, and marijuana users were more likely to drop out of the study than nonusers (rates were equivalent across both experimental groups).
Botvin, Griffin, et al. (2001b) followed up the same sample in the 8th and 9th grade, assessing program effects on binge drinking among 3,041 students (including 1,713 treatment group and 1,328 control group students). Of the 5,222 7th grade students who completed the pretest survey, 4,190 (80 percent) completed the one-year follow-up, and 3,041 (58 percent) completed the survey at both the one- and two-year follow-up assessments. Attrition rates were similar across both experimental conditions.
A third study (Griffin et al., 2003) using the Botvin, Griffin, et al. (2001a) sample examined the effects of LST among a subsample of youth at high risk for substance use initiation. Students were identified as high "social risk" if they had friends that smoked cigarettes and drink alcohol, and at high "academic risk" if they reported poor academic achievement in school (average grades equivalent to a C or less). A total of 758 (15 percent) of the original sample of 5,222 students were classified as high risk for substance use initiation based on social and academic risk, including 426 students in the treatment group and 332 students in the control group. The sample was 49 percent male, 58 percent African-American, and 29 percent Hispanic, and 61 percent of students qualified for free lunch at school.
Spoth et al. (2002) studied the effects of the LST program on student use of alcohol, cigarettes, and marijuana among 1,664 white 7th graders from 36 rural Midwestern schools. The authors combined the Strengthening Families Program for Parents and Youth 10-14 (SFP) parent and youth skills-building program with the LST curriculum, then randomly assigned 12 schools each to the (1) SFP + LST group (549 students), (2) LST-only group (621 students), or (3) control group (494 students). Participants were also given LST booster sessions when students were in the 8th grade, including four sessions for the SFP + LST group and five sessions for the LST-only group. Outcomes were examined at program completion and one year after the first posttest. At the first posttest, 517 of the SFP + LST students (94 percent), 583 of the LST-only students (94 percent), and 463 of the control group students (94 percent) remained in the study. At the one-year follow-up, 453 (83 percent) of the SFP + LST, 503 (81 percent) of the LST-only, and 416 (84 percent) of the control group students remained in the sample.
Botvin, Griffin, et al. (2003) examined LST program effects on early stage tobacco and alcohol use in elementary students. A total of 426 students located in nine schools were randomly assigned to receive the LST intervention over a three-year period, with eight 30-45 minute LST sessions per year, in grades 3 to 5. The randomly assigned control group, 664 students across 11 schools, received no psychosocial prevention programming during this time. Using data from those students who were tested just before and three months after the prevention period, changes over time were compared between control group and LST group students on measures of substance use (tobacco and alcohol), attitudes toward substance use (student and peer attitudes), knowledge (substance use knowledge, advertising knowledge, decisionmaking, social skills, refusal skills), normative expectations (smoking and drinking behavior of peers, teens and adults), and psychosocial factors (risk-taking and self-esteem.) Pre- and post-intervention surveys were able to be matched for approximately 56 percent of students participating in the study. These students had lower rates of having ever smoked than students whose pre- and post-intervention surveys were unable to be matched. Of the matched survey students, 70 percent came from two-parent families, and 73 percent of children's fathers had completed high school. Forty-eight percent of these students were white, 26 percent were Hispanic and 13 percent were African-American. Prior to the intervention, students in the LST intervention group who had matched surveys were more likely to report having ever used chewing tobacco, were less likely to be white, and were more likely to come from two-parent families than control students with matched surveys.
Trudeau et al. (2003) collected data at three time points to measure effects of LST on 7th grade students in 36 schools in the rural Midwest. To be included in the study, schools must have had at least 20 percent of students eligible for free or reduced-price lunch, must have had a district average of less than 1,200 students per school, and must have been middle schools where grades six, seven, and eight were located on the same campus. Using a randomized block design, the study assigned schools to an LST intervention group, a control group, or another experimental condition not included in this analysis. Students in the LST intervention group received 15 40-45 minute sessions in the 7th grade and five booster sessions in the 8th grade. A total of 847 intervention and control group students across 24 schools were measured at three time points: just prior to intervention in the fall of their 7th grade year, just after intervention in the spring of their 7th grade year, and just after the booster sessions in the spring of their 8th grade year. Students who completed all three testing sessions were less likely to report substance use before the intervention study began. Seventy-seven percent of analyzed students lived with both parents, 97 percent were white, and 21 percent were eligible for free or reduced-price lunch. The study measured differences between the LST intervention group and control group in changes over time for the following measures: expectancies (negative social and personal consequences of substance use), refusal intentions (self-reported likelihood of saying no to tobacco, alcohol or marijuana), and substance initiation (has student ever used tobacco, alcohol or marijuana). Students assigned to the LST intervention group were more likely to report having ever used tobacco, alcohol or marijuana and had lower levels of negative expectancies and refusal intentions than control students before the intervention began.
Griffin et al. (2004) performed an after-the-fact analysis to test whether students who had received LST programming were less likely to engage in risky driving behavior. The study reviewed DMV records for 2,042 students that had participated in a randomized LST study approximately six years earlier. Of these, 1,360 students had been in the LST intervention group and 682 had been in the control group. Using the DMV records, the study compared the presence of traffic violations and "points" on students' driver's licenses accumulated by students from the LST and control groups. Points on the driver's license accumulated based on traffic violations. For example, a student would receive 11 points on his/her driver's license for speeding 40 miles per hour above the speed limit and 3 points for driving 10 miles per hour above the speed limit. Points were cleared from DMV records 18 months after the violation occurred. Of the 2,042 students for which DMV records were available, 79 percent had no points on their DMV record and 77 percent showed no traffic violations on their record.
Smith, Swisher, and Vicary (2004) compared the standard LST intervention with an I-LST, a version that infused the LST curriculum into teacher's regular classroom lessons. The study cites doing an exercise in math class, such as graphing the percentage of students who do not use marijuana, as an example of infused LST. In this study, 84 percent of LST topics were covered in the I-LST version, while 81 percent of topics were covered in the standard LST condition. To test program effectiveness, nine schools in rural Pennsylvania were randomly assigned to one of three groups: a group that would receive the standard LST intervention, a group that would receive I-LST, and a control group that would not receive any intervention. To be included in the study, schools must have been classified as having low socioeconomic status and must have had a student enrollment less than 1,000. Students were 96.6 percent white and 54.4 percent male. All students in the study were surveyed just prior to the intervention at the beginning of their 7th grade year, just after the standard LST first year session period at the end of 7th grade, and then at the end of students' 8th grade year. The total number of students who participated in the study was 234 in the LST group, 297 in the I-LST group, and 201 students in the control group; however, by the third testing period, only 659 total students had completed surveys. The study measured differences between the LST, I-LST, and control groups in changes in tobacco, alcohol, marijuana and inhalant use over time.
Vicary et al. (2006) also evaluated the infused version of LST (I-LST), in rural settings with nine middle schools that had student enrollments less than 1,000 and only one middle school per district. This study compared the standard LST (which covered an average of 90 percent of lessons) with the I-LST (which covered an average of 95 percent of LST topics) and a control group whose students did not receive any LST until they were in 10th grade. Students were assigned to conditions by school, with 234 students in the standard LST condition, 297 students in the I-LST condition, and 201 students in the control condition. All students participating in the study were surveyed just before the intervention period, at the end of 7th grade, at the end of 8th grade, and at the end of 9th grade. Surveys measured the students' self-reported use of alcohol, cigarette and marijuana, skills in communication, decision-making, substance refusal, media resistance, coping and assertiveness, and students' norms, attitudes and knowledge about alcohol, tobacco and marijuana. Approximately 78.9 percent of students completed surveys at all four time points, with no significant differences in response rates between experimental groups. Taking initial substance use into account, the study compared self-reported differences in survey responses between LST, I-LST and control group students.
Botvin, Griffin, and Bichols (2006) studied the effects of an LST intervention adapted to address violence among adolescents. This version of LST consisted of 15 classroom sessions that included material related to violence, such as anger management and conflict resolution skills, in addition to the standard substance use curriculum. In this study, 41 New York City public and parochial schools were assigned to receive the adapted LST (a total of 2,374 students in 20 schools) or to serve as a control group (a total of 2,484 students in 21 schools). Students were surveyed in the sixth grade, before the intervention period and then once again three months after the intervention period ended. The study compared the difference in change over time between students receiving any part of the LST intervention and control students and between students receiving at least half of the LST intervention and control students. The surveys measured students' self-reported levels of verbal aggression, physical aggression, fighting behavior, and delinquency (destroying property, throwing objects, stealing or vandalizing). Of the students participating in the study, 51 percent were male, 39 percent were African-American, 33 percent were Hispanic, and 10 percent were white, and 55 percent received free or reduced-price lunch and 30 percent lived with their mothers only. While students in the LST intervention group did not differ significantly from the control group on any of the baseline measures of aggression and delinquency, there was a higher percentage of Hispanic students and a lower percentage of African-American students in the LST intervention group.
Using a sample of youth from New York middle class suburban and rural areas, Griffin, Botvin, and Nichols (2006) studied the effectiveness of the standard LST intervention on reducing behaviors that put youth at risk for contracting the HIV virus. In 1985, 56 schools were randomized to a "treatment as usual" control group or to an LST intervention group, which received 15 LST sessions in 7th grade, 10 booster sessions in 8th grade, and five booster sessions in 9th grade. In 1998, 2,042 youth (63.3 percent of the original sample) who had participated in the study completed 10-year follow-up surveys; of these, 66.6 percent were from the LST intervention group. In this sample of 2,042 youth, 77.6 percent had lived in two-parent families while in junior high, 91.2 percent were white, 49.6 percent had graduated college, and the median age at 10-year follow-up was 24.6 years. In addition, students who completed the 10-year follow-up surveys were less likely to have reported smoking, drinking, or marijuana use in the initial survey, taken prior to the LST intervention. Controlling for youth characteristics present in the baseline 1985 survey, this study measured the difference in HIV risk behavior between students who had received LST and those who had not.
Spoth et al. (2008) examined the long-term effects of LST through surveys taken when students were in their 12th grade year, five and a half years after baseline measurement. Students in the study came from 36 schools in the rural Midwest that enrolled less than 1,200 students and were located in districts with at least 20 percent of students eligible for the free or reduced-price lunch program. Prior to baseline measurements, schools were split into groups according to authors' ratings of risk factors present at the school. Twelve groups of three schools each were created, with one school in each group assigned to one of three experimental conditions: (1) standard LST program; (2) standard LST program plus seven sessions of another program, called the Strengthening Families Program (SFP); or (3) a control condition in which students' parents were mailed brochures on teen development. Approximately 622 students assigned to the LST group and 489 students assigned to the control group completed baseline surveys in 7th grade, prior to the study intervention. Five and a half years later, when students were scheduled to be in 12th grade, 428 students assigned to the LST group and 347 students assigned to the control group completed follow up surveys. There were no significant differences in study dropout rates between students assigned to LST group and those assigned to control group. Surveys measured whether students had ever used alcohol, tobacco or marijuana, how often students used each of the three substances and whether students used at least two substances at the same time. Using all students that had completed surveys, regardless of their participation in their assigned intervention, this study measures the difference between LST and control students in substance use change over time.
Key Evaluation Findings
LST program studies that measured tobacco use included analyses of the program's direct and mediating effects on adolescent cigarette smoking or tobacco use. Cigarette smoking was usually assessed in terms of past-month, past-week, or past-day smoking. Mediating effects were typically assessed by surveying students' skills—for example, their ability to resist media influences—and students' norms and attitudes, such as expectations about smoking or alcohol use. The majority of the findings indicate that the LST program significantly lowers the risk that participating students will become new or frequent users of cigarettes.
Botvin, Renick, and Baker (1983) found that, shortly after LST program completion, significantly more control group students (13 percent) than the combined experimental group students (6 percent) reported smoking during the past month. There were no significant differences among groups for weekly or daily cigarette use.
Botvin, Batson, et al. (1989) found that, following program completion, significantly fewer students in the LST treatment group than in the control group reported smoking in the past month, but they found no significant differences between groups for "current" smoking or smoking in the past week or past day.
Botvin, Dusenbury, et al.'s (1992) four-month posttest found that there was significantly less past-month smoking for the LST treatment group than control group students (5.2 percent versus 7.2 percent). There were no significant differences between groups for smoking during the past week or the past day.
Botvin, Epstein, et al. (1997) reported that, at the three-month posttest, students in the LST treatment group used cigarettes significantly less frequently than students in the control group.
Among elementary students, Botvin, Griffin, et al. (2003) found that a significantly lower proportion of students at LST schools reported smoking in the past year and LST students smoked less often than control students.
Botvin, Griffin, et al.'s 1999 study of female students one year after program initiation found that significantly more control group than intervention group students reported:
While Botvin, Griffin, et al. (2001a) found no significant differences between treatment and control groups for frequency or quantity of cigarette smoking at three-month posttest, at one-year follow-up, treatment group students showed a lower frequency and a lower quantity of smoking than did control group students.
- "ever" having smoked a cigarette (34.5 percent versus 28.3 percent)
- having initiated cigarette smoking (23.9 percent versus 19.6 percent)
- having smoked during the past month (12.3 percent versus 8.8 percent)
- having increased smoking frequency to "monthly" smoking (9.9 percent versus 6.7 percent).
Griffin et al. (2003) reported significantly lower rates of smoking at one-year follow-up among LST treatment group students than control group students.
Several LST program studies also included analyses of program effects on alcohol use. The majority of the findings indicate that the program significantly lowers the risk that participating students will become new or frequent users of alcohol.
Botvin, Epstein, et al.'s 1997 study found that, at three-month posttest, students in the LST treatment group had significantly more positive outcomes than control group students for less frequency of alcohol use, drank significantly less alcohol when drinking, and had lower rates of drunkenness.
In addition, Botvin, Griffin, et al. (2001a) that, at three-month posttest, after taking into account the effects of differences between the 29 schools participating in the study, LST treatment group students exhibited a lower frequency of drunkenness than did control group students. No significant differences were found between groups for frequency of drinking or for quantity of alcoholic beverages consumed when drinking.
Among elementary students, Botvin, Griffin, et al. (2003) found marginally significant positive effects of the LST program on students' anti-drinking attitudes, marginally significant positive effects on students' beliefs about drinking "norms" among peers, and marginally significant reductions in the proportion of students reporting drinking alcohol in the past year, compared to control students. Botvin, Griffin, et al. (2003) found significant positive effects on student's friends' anti-drinking attitudes for students who participated in LST schools, compared with control students.
Botvin, Griffin, et al.'s (2001b) study on binge drinking found:
At one-year follow-up, Botvin, Griffin, et al. (2001a) found that LST treatment group students reported significantly less frequent drinking, less frequent drunkenness, and a lower quantity of alcohol consumed per occasion than did control group students.
- At one-year follow-up (8th grade), the proportion of binge drinkers in the LST treatment group was significantly less than the proportion in the control group, with rates of 1.8 percent and 4.3 percent, respectively.
- At two-year follow-up, the proportion of binge drinkers in the LST treatment group remained significantly lower than that of the control group (2.2 percent compared with 5.2 percent).
Finally, Griffin et al. (2003) reported significantly lower rates of drinking at one-year follow-up among LST treatment group students than among control group students.
LST program studies also measured the program's impact on students' marijuana use. Overall, results suggest the program was moderately effective at reducing marijuana use initiation and frequency of use, although findings were not as consistent as those for cigarettes and alcohol.
Botvin, Epstein, et al.'s 1997 three-month posttest found that students in the LST treatment group reported significantly less frequent use of marijuana than students in the control group (mean score of 1.16 versus 1.26 on a nine-point scale assessing frequency of use).
Spoth et al. (2002) found significant program effects for rates of new users of marijuana. The authors reported significant differences between the LST + SFP and control groups (4.1 percent versus 7.9 percent) and between the LST-only and control groups (4.3 percent versus 7.9 percent).
After taking into account the effects of differences between the 29 schools participating in the study, Botvin, Griffin, et al. (2001a) did not find any differences between treatment and control groups for frequency of marijuana use at either three-month posttest or at one-year follow-up.
Similarly, Griffin et al. (2003) did not report any significant differences between groups for frequency of marijuana use.
The 6.5-year longitudinal study (Botvin, Baker, et al., 1995) reported that, at six years, there were no significant differences among groups for monthly or weekly marijuana use.
"Any" Substance Use and Other Outcomes
Self-Esteem: Among elementary students, Botvin, Griffin, et al. (2003) found that students assigned to LST schools scored significantly higher on self-reported measures of self-esteem than control group students.
Any substance use: Trudeau et al. (2003) found that, by the spring semester of 8th grade, rural Midwestern students who received LST treatment showed significantly higher growth in substance use refusal intentions than control students and significantly lower growth in substance use initiation. In addition, by 8th grade LST treatment students had marginally higher growth in negative expectancies of substance use than control students.
Violence: Botvin, Griffin, and Nichols (2006) found that, shortly after the intervention period, youth assigned to the modified (for violence prevention) LST program reported significantly lower rates of delinquency, frequent fighting and frequent delinquency in the past year.
HIV-Risk Behavior: Griffin, Botvin, and Nichols (2006) found that, ten years after receiving the standard LST intervention, young adults who had participated in the LST group reported significantly lower rates of behavior putting them at risk for contracting HIV than control group young adults (10.3 percent versus 13.6 percent.)
Risky Driving: Griffin et al. (2004) found that significantly fewer students who had participated in the LST group in middle school had driving violations on their DMV records six years after the intervention (25 of control students versus 20 percent of LST students). Also, significantly fewer students who had participated in the LST group had negative points on their driver's licenses six years after the intervention (23 percent of control students versus 18 percent of LST students).
Botvin, Dusenbury, et al. (1989) found that the high-implementation group reported marginally significantly lower rates of smoking during the past month compared with control group students (with a probability of error of 0.10). No significant differences were found in past-month smoking between the low-implementation group and the control group, or among any of the groups for smoking rates over the past week or past day.
Teacher training mode: Botvin et al. (1990) found that, at the end of the third year of intervention, students in both experimental conditions were significantly less likely to report smoking than students in the control condition. Additionally, students in the teacher workshop condition were significantly less likely to report marijuana use than control students.
The 6.5-year longitudinal study (Botvin, Baker, et al., 1995) found significantly less cigarette smoking among adolescents in the workshop and videotape treatment groups than in the control group for the monthly smoking measure, as well for as the weekly smoking measure. Additionally, the prevalence of heavy smoking (pack-a-day) was significantly lower for the videotape group (but not the workshop group) than the control group.
Also, at six years, the prevalence of monthly drunkenness was significantly lower for adolescents in both the workshop and videotape intervention groups than those in the control group. There were no significant differences among groups for monthly, weekly, or heavy drinking.
Life Skills Training Plus Strengthening Families Program:
Spoth et al. (2002) found that the LifeSkills Training + Strengthening Families Program (LST + SFP) treatment group reported significantly lower rates of alcohol use than the control group (25.7 percent versus 36.7 percent) and the LST-only group (25.7 percent versus 35.2 percent). There were no significant differences between the LST-only students and the control group students.
Spoth et al. (2008) found that, five and a half years after baseline, the rate of change in alcohol initiation was significantly lower for students in the LST and LST + SFP groups, compared with control students. Both of these treatment groups also showed significantly lower rates of increase in drunkenness initiation, compared with control students. Further, the LST group students showed overall lower rates of drunkenness initiation than both the control students and students in the LST + SFP.
Overall rates of cigarette initiation and rates of growth in cigarette initiation were significantly lower for both LST and LST + SFP students than control students, at the five and a half year follow up.
Overall rates of marijuana initiation were also lower for both LST and LST + SFP students at the five and a half year follow up. LST students also had significantly lower rates of growth in cigarette initiation.
Smith, Swisher, and Vicary (2004) found no program effects of LST or I-LST on any tested variables. For females, the LST program was found to significantly lower alcohol use, binge drinking, marijuana use, and inhalant use one year after baseline. One year after baseline, females in the I-LST group showed significant improvements in binge drinking, smoking, and marijuana use.
Two years after baseline, no significant effects from LST were detected for males or females. However, females in the I-LST program showed significantly lower cigarette use than control females two years after baseline.
At the end of 7th grade, Vicary et al. (2006) found that females in both the LST and I-LST groups reported significantly lower binge drinking and marijuana use than control students. The LST program females also reported significantly lower overall alcohol use than both I-LST and control students at the end of 7th grade, while I-LST females reported lower overall smoking than the other two groups at this time.
At the end of students' 8th grade year, I-LST females continued to show significantly lower overall smoking than both LST and control females. By the end of students' 9th grade year, neither I-LST nor LST programs showed significant effects on substance use for any of the students.
For mediating factors, the study found that females in LST showed significantly improved decisionmaking, communication, coping, norms, attitudes, and knowledge regarding substance use at the end of 7th grade; significantly improved media resistance, assertiveness, and coping at the end of 8th grade; and significantly improved communication and coping by the end of 9th grade. LST males did not show any significant improvements on any of the mediating factors at any time point.
I-LST females showed significant improvements in substance use knowledge at the end of 7th grade, significant improvement in coping and norms regarding substance use at the end of 8th grade, and significant improvement in substance use knowledge at the end of 9th grade. I-LST males showed significant improvement in substance use norms at the end of 7th grade only.
Elementary schools, middle schools, and high schools
Funding for LST programs comes from a variety of sources, including the U.S. Department of Education (Safe and Drug-Free Schools); the U.S. Office of Juvenile Justice; the U.S. National Guard; state and local school, mental health, and parks and recreation funds; and from PTAs and other local organizations.
The complete LST curriculum consists of a Teacher's Manual, Student's Guide, and a relaxation tape available through the National Health Promotion Associates (NHPA). A version of the program is available for both middle and elementary school students. Materials can be found on the Life Skills Training website (http://www.lifeskillstraining.com/), under "Programs." Cost of materials range from $50 to over $1,000 (in 2011 dollars).
The NHPA also provides online, on-site or one- or two-day open training workshops. Prices begin at $235 (in 2011 dollars) for online or one-day open training.
The LST program uses social-resistance skills training and techniques designed to develop adolescents' key personal and social skills. The prevention curriculum addresses the major cognitive, attitudinal, psychological, and social factors related to adolescent cigarette smoking.
LST incorporates five major components that:
- Provide information concerning the short-term consequences of substance use, prevalence rates, and the current social acceptability of smoking and other drug use
- Facilitate critical thinking and independent decisionmaking
- Help students develop skills for coping with anxiety
- Teach social skills and assertiveness skills
- Facilitate self-improvement and a sense of personal control.
A combination of teaching techniques is used to teach substance use-prevention skills to students, including group discussion, demonstration, modeling, behavioral rehearsal, feedback and reinforcement, and behavioral "homework" assignments for out-of-class practice.
In addition to teaching skills for the enhancement of personal and social competence, the LST program teaches students specific skills related to resisting pressures for substance use, including how to apply assertiveness skills in situations in which they might experience pressure to smoke, drink, or use drugs. Unlike traditional prevention approaches, only minimal information concerning the long-term health consequences of drug use is provided. Instead, information hypothesized to be more relevant to prevention is given, such as information concerning the immediate negative consequences of drug use, the addictive nature of certain substances, the decreasing social acceptability of use, and the actual prevalence rates among adults and adolescents.
LST program materials and curriculum length vary by targeted population: elementary, middle or junior high, and high school. Program components for all three include a teacher's manual with detailed lessons plans and student guide. High school materials also include a companion website, while the junior high program components include a stress management CD-ROM in addition to the website, teacher manual, and student guide.
Regular classroom teachers usually teach the LST program. Peer leaders may be used to assist classroom teachers in presenting the program, or they may implement the curriculum themselves. Training is provided online, on-site, or through open training workshops provided by National Health Promotion Associates. Open training workshops are one- or two-day training sessions that familiarize teachers with the program and its rationale. Teachers also have an opportunity to learn and practice the skills necessary to deliver the curriculum.
Issues to Consider
This program received a "proven" rating. The majority of the evaluations of the LST program used a randomized experimental design, which accounted for the grouping of students in classrooms, and some studies conducted long-term follow-ups. Participants in most of the studies experienced significantly reduced levels of cigarette smoking, alcohol use, and marijuana use when compared with control groups. However, it should be noted that the program developer has been an author on the majority of evaluations of the program.
A number of additional evaluations have been conducted for this program, but we included only those studies with methodologies meeting the Promising Practices Network criteria.
Albany, New York
Syracuse, New York
Long Island, New York
New York City
National Health Promotion Associates, Inc.
711 Westchester Avenue
White Plains, NY 10604
Phone: (914) 421-2525 or (800) 293-4969
fax: (914) 421-2007
Information about the LifeSkills Training program, program materials, and information about provider training can be found on the LifeSkills Training website: http://www.lifeskillstraining.com
Botvin, Gilbert J., Eli Baker, Linda Dusenbury, Elizabeth M. Botvin, and Tracy Diaz, "Long-Term Follow-up Results of a Randomized Drug Abuse Prevention Trial in a White Middle-Class Population,"
Journal of the American Medical Association,
Vol. 273, No. 14, 1995, pp. 1106-1112.
Botvin, Gilbert J., Eli Baker, Linda Dusenbury, Stephanie Tortu, and Elizabeth M. Botvin, "Preventing Adolescent Drug Abuse through a Multimodal Cognitive-Behavioral Approach: Results of a 3-Year Study," Journal of Consulting and Clinical Psychology, Vol. 58, No. 4, 1990, pp. 437-446.
Botvin, Gilbert J., Horace W. Batson, Sylvia Witts-Vitale, Valerie Bess, Eli Baker, and Linda Dusenbury, "A Psychosocial Approach to Smoking Prevention for Urban Black Youth," Public Health Reports, Vol. 104, No. 6, 1989, pp. 573-582.
Botvin, Gilbert J., Jennifer A. Epstein, Eli Baker, Tracy Diaz, Michelle Ifill-Williams, "School-Based Drug Abuse Prevention with Inner-City Minority Youth," in Gilbert J. Botvin and Steven Schinke, eds., The Etiology and Prevention of Drug Abuse Among Minority Youth, Binghamton, N.Y.: The Haworth Press, Inc., 1997, pp. 5-19.
Botvin, Gilbert J., Kenneth W. Griffin, and Tracy Diaz Nichols, "Preventing Youth Violence and Delinquency through a Universal School-Based Prevention Approach," Prevention Science, Vol. 7, 2006, pp. 403-408.
Botvin, Gilbert J., Kenneth W. Griffin, Elizabeth Paul, and Araxi P. Macaulay, "Preventing Tobacco and Alcohol Use among Elementary School Students through Life Skills Training," Journal of Child and Adolescent Substance Abuse, Vol. 12, No. 4, 2003, pp. 1-17.
Botvin, Gilbert J., Kenneth W. Griffin, Tracy Diaz, and Michelle Ifill-Williams, "Drug Abuse Prevention among Minority Adolescents: Posttest and One-Year Follow-Up of a School-Based Preventive Intervention," Prevention Science, Vol. 2, No. 1, 2001a, pp. 1-13.
Botvin, Gilbert J., Kenneth W. Griffin, Tracy Diaz, and Michelle Ifill-Williams, "Preventing Binge Drinking During Early Adolescence: One- and Two-Year Follow-Up of a School-Based Preventive Intervention," Psychology of Addictive Behaviors, Vol. 15, No. 4, 2001b, pp. 360-365.
Botvin, Gilbert J., Kenneth W. Griffin, Tracy Diaz, Nicole Miller, and Michelle Ifill-Williams, "Smoking Initiation and Escalation in Early Adolescent Girls: One-Year Follow-up of a School-Based Prevention Intervention for Minority Youth," Journal of the American Medical Women's Association, Vol. 54, 1999, pp. 139-143.
Botvin, Gilbert J., Linda Dusenbury, Eli Baker, Susan James-Ortiz, and Jon Kerner, "A Skills Training Approach to Smoking Prevention among Hispanic Youth," Journal of Behavioral Medicine, Vol. 12, No. 3, 1989, pp. 279-296.
Botvin, Gilbert J., Linda Dusenbury, Eli Baker, Susan James-Ortiz, Elizabeth M. Botvin, and Jon Kerner, "Smoking Prevention among Urban Minority Youth: Assessing Effects on Outcome and Mediating Variables," Health Psychology, Vol. 11, No. 5, 1992, pp. 290-299.
Botvin, Gilbert J., Nicole L. Renick, and Eli Baker, "The Effects of Scheduling Format and Booster Sessions on a Broad-Spectrum Psychosocial Smoking Prevention Program," Journal of Behavioral Medicine, Vol. 6, No. 4, 1983, pp. 359-379.
Griffin, Kenneth W., Gilbert J. Botvin, and Tracy R. Nichols, "Effects of a School-Based Drug Abuse Prevention Program for Adolescents on HIV Risk Behavior in Young Adulthood," Prevention Science, Vol. 7, No. 1, 2006, pp. 103-112.
Griffin, Kenneth W., Gilbert J. Botvin, and Tracy R. Nichols, "Long-Term Follow-Up Effects of a School-Based Drug Abuse Prevention Program on Adolescent Risky Driving," Prevention Science, Vol. 5, No. 3, 2004, pp. 207-212.
Griffin, Kenneth W., Gilbert J. Botvin, Tracy R. Nichols, and Margaret M. Doyle, "Effectiveness of a Universal Drug Abuse Prevention Approach for Youth at High Risk for Substance Use Initiation," Preventive Medicine, Vol. 36, 2003, pp. 1-7.
Smith, Edward A., John D. Swisher, Judith R. Vicary, Bechtel, Lori J., Minner, Daphne, Henry, Kimberly L., and Palmer, Raymond, "Evaluation of Life Skills Training and Infused-Life Skills Training in a Rural Setting: Outcomes at Two Years," Journal of Alcohol and Drug Education, Vol. 48, No. 1, 2004, pp. 51-70.
Spoth, Richard L., Cleve Redmond, Linda Trudeau, and Chungyeol Shin, "Longitudinal Substance Initiation Outcomes for a Universal Preventive Intervention Combining Family and School Programs," Psychology of Addictive Behaviors, Vol. 16, No. 2, 2002, pp. 129-134.
Spoth, Richard L., G. Kevin Randall, Linda Trudeau, Chungyeol Shin, and Redmond, Cleve, "Substance Use Outcomes 5-1/2 Years Past Baseline for Partnership-Based, Family-School Preventive Interventions," Drug and Alcohol Dependence, Vol. 96, 2008, pp. 57-68.
Trudeau, Linda, Richard Spoth, Catherine Lillehoj, Cleve Redmond, and K. A. S. Wickrama, "Effects of a Preventive Intervention on Adolescent Substance Use Initiation, Expectancies and Refusal Intentions," Prevention Science, Vol. 4, No. 2, 2003, pp. 109-122.
Vicary, Judith R., Edward A. Smith, John D. Swisher, Abigail M. Hopkins, Elvira Elek, Lori J. Bechtel, and Kimberly L. Henry, "Results of a 3-Year Study of Two Methods of Delivery of Life Skills Training," Health Education and Behavior, Vol. 33, 2006, pp. 325-338.
Vicary, Judith R., Kimberly L. Henry, Lori J. Betcchel, John D. Swisher, Edward A. Smith, Richard Wylie, and Abigail M. Hopkins, "Life Skills Training Effects for High and Low Risk Rural Junior High School Females," Journal of Primary Prevention, Vol. 25, No. 4, 2004, pp. 399-416.