Adolescent substance use, parental monitoring, and leisure-time activities: 12-year outcomes of primary prevention in Iceland

Objective: To examine 12-year changes in alcohol use and cigarette smoking in response to community-based prevention activities among Icelandic adolescents. Methods: This study used a quasi-experimental, non-randomized control group design to compare outcomes in 4 Icelandic communities (n=3117) that participated in community-based substance use prevention activities designed to increase levels of parental monitoring and adolescent engagement in healthy leisure-time activities and a matched group of 7 comparison communities (n=1,907). Annual, nationwide, population-based cross-sectional surveys of the prevalence of adolescent substance use were conducted among cohorts of Icelandic adolescents, aged 14-15. years (N=5,024), in all communities from 1997 to 2009. Results: Parental monitoring and adolescent participation in organized sports increased in communities that adopted the intervention program compared to communities that did not, whereas unmonitored idle hours and attendance at unsupervised parties decreased. Over time, alcohol use (OR. =0.89, 95% CI 0.82, 0.98, p=0.012) and being intoxicated during the last 30. days (OR. =0.86, 95% CI 0.78, 0.96, p=0.004) decreased more in the intervention than control communities. Conclusion: Community-based prevention designed to strengthen parental monitoring and participation in organized sports may confer some protection against adolescent substance use.