Family-Based Interventions

Although poor parenting causes many of the problems associated with children's drug abuse, there are few studies and as yet no evidence that family-based interventions alone are successful in preventing drug abuse (IOM, 1996a). However, one study found lower rates of alcohol initiation when parent training was used in conjunction with modified teaching practices (IOM, 1996a).

Media-Based Prevention Interventions

The positive portrayal of smoking and alcohol use on TV programs and in movies has been seen as a major influence on attitudes toward the use of these drugs. Efforts to use television overtly to counteract those messages have been made repeatedly over the years.

Public service announcements and other media-based interventions are relatively inexpensive efforts to attempt to influence the knowledge and attitudes of a large number of children and youth. However, there are no rigorous studies of their impact on the audience's later drug use or abuse. Media interventions aimed at preventing adolescent smoking have been found to affect knowledge and, in some cases, attitudes, but have not shown a sustained impact on behavior (IOM, 1996a; Murray et al., 1994). However, TV anti-smoking messages have been found to be effective in combination with school-based programs at preventing or limiting adolescent smoking behavior (Flynn et al., 1992).

Laws to Prevent Teen Alcohol Use and Smoking

Epidemiological and public health research has been conducted in states and communities that have enacted new laws or policies to prevent or limit adolescent drinking and smoking by raising the age at which an individual can buy alcohol and tobacco products. The research examines how the environment, including the cost and availability of drugs, influences the likelihood of addiction and related problems.

In 1983, Hingson et al. published a seminal study that evaluated the impact of raising the legal drinking age in Massachusetts from 18 to 20. They compared drinking, drinking and driving, and nonfatal accidents in Massachusetts and New York, which kept its drinking age at 18. Results indicated that the law was unevenly enforced, but that nighttime single-vehicle fatal car crashes declined more for 18- and 19-year-olds in Massachusetts than they did in New York (Waller, 1995). Other studies in different states clearly indicated that raising the legal drinking age decreased teenage drinking and driving and involvement in



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