JAMA Netw Open. 2025 Dec 1;8(12):e2550176. doi: 10.1001/jamanetworkopen.2025.50176.
ABSTRACT
IMPORTANCE: Substance use is a leading cause of burden of disease worldwide. Selective prevention programs can help reduce the development of problematic substance use and disorders.
OBJECTIVE: To examine effects of a selective, personality-targeted substance use prevention program on alcohol, cannabis, tobacco, nonmedical opioid, and illicit polysubstance use among adolescents with elevated levels of personality traits associated with frequent and risky substance use.
DESIGN, SETTING, AND PARTICIPANTS: This prespecified secondary analysis of a cluster-randomized clinical trial assessed the effectiveness of a personality-targeted cognitive-behavioral intervention (PreVenture) in reducing substance use during adolescence. Participants included grade 7 students attending 31 secondary schools in the Greater Montreal Area, Canada (2012-2013 school year), who screened as having elevated levels of anxiety sensitivity, hopelessness, impulsivity, or sensation seeking. Schools were randomized to either the intervention (15 schools) or the control group (16 schools). Data were analyzed in January to March 2025.
INTERVENTIONS: Schools delivered a 2-session, personality-targeted group-based cognitive-behavioral intervention designed to help students recognize, challenge, and manage personality-specific emotions, behaviors, and cognitions associated with substance use in adolescence.
MAIN OUTCOMES AND MEASURES: Self-reported frequency of alcohol, cannabis, smoking tobacco, nonmedical use of opioids, and illicit polysubstance use were measured by the Detection of Alcohol and Drug Problems in Adolescents.
RESULTS: A total of 3861 students from 31 schools were screened; 1669 students (847 [50.7%] female; mean [SD] age, 12.83 [0.47] years) were at elevated risk of substance use and included in the intention-to-treat sample. The 31 schools were randomized, with 16 schools with 964 students in the control group and 15 schools with 705 students in the intervention group. Multilevel bayesian mixed-effects models indicated that students in the intervention group had slower increases in the frequency of alcohol (odds ratio [OR], 0.92; 95% credible interval [CrI], 0.85-1.00), cannabis (OR, 0.75; 95% CrI, 0.66-0.86), tobacco smoking (OR, 0.79; 95% CrI, 0.70-0.96), and illicit polysubstance use (OR, 0.56; 95% CrI, 0.35-0.89) over 4 years. Effects did not differ by sex.
CONCLUSIONS AND RELEVANCE: This secondary analysis of a cluster-randomized clinical trial found that personality-targeted interventions protected against the escalation in substance use during adolescence, with similar effects for males and females.
TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01655615.
PMID:41632121 | DOI:10.1001/jamanetworkopen.2025.50176
