***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: Epidemiological studies have repeatedly shown that cannabis is the most commonly used illegal drug in the United States . Furthermore , individuals with cannabis dependence have high rates of comorbid substance use disorders and depression . A significant proportion of individuals with addictive disorders develop withdrawal symptoms , can not control their drug use despite substantial adverse psychosocial consequences , and frequently have a coexisting psychiatric disorder . Nevertheless , only a minority of persons with cannabis dependence ever seek treatment . We were unable to locate epidemiological reports regarding treatment seeking behavior among persons with cannabis dependence . Epidemiological studies of population s with substance disorders have observed that employment , higher educational level , previous use of treatment , major depression , and a co‐occurring substance dependency increased the probability of seeking treatment for alcohol dependence . Thus we hypothesized that the same variables would predict service use among persons with cannabis dependence . The main findings of this study were that persons with cannabis dependence were more likely to contact a professional during the past year if they previously sought treatment and had alcohol dependence with major depression . Prospect i ve , longitudinal studies of adolescents would increase our underst and ing of the processes by which individuals identify themselves as having problems related to their habitual use of marijuana , and why some seek help while others do not AIM To evaluate the effectiveness of a school-based substance abuse prevention program developed in the EU-Dap study ( EUropean Drug Addiction Prevention trial ) . MATERIAL S AND METHODS Cluster R and omized Controlled Trial . Seven European countries participated in the study ; 170 schools ( 7079 pupils 12 - 14 years of age ) were r and omly assigned to one of three experimental conditions or to a  control condition during the school year 2004/2005 . The program consisted of a 12-h curriculum based on a comprehensive social influence approach . A pre-test  survey assessing past and current substance use was conducted before the implementation of the program , while a post-test survey was carried out about 18 months after the pre-test . The association between program condition and change in substance use at post-test was expressed as adjusted prevalence odds ratio ( POR ) , estimated by multilevel regression models . RESULTS Persisting beneficial program effects were found for episodes of drunkenness ( any , POR=0.80 ; 0.67 - 0.97 ; frequent , POR=0.62 ; 0.47 - 0.81 ) and for frequent cannabis use in the past 30 days ( POR=0.74 ; 0.53 - 1.00 ) , whereas daily cigarette smoking was not affected by the program as it was at the short-term follow-up . Baseline non-smokers that participated in the program progressed in tobacco consumption to a lower extent than those in the control condition , but no difference was detected in the proportion of quitters or reducers among baseline daily smokers . CONCLUSION The experimental evaluation of an innovative school curriculum based on a comprehensive social influence approach , indicated persistent positive effects over 18 months for alcohol abuse and for cannabis use , but not for cigarette smoking BACKGROUND Although numerous interventions have been demonstrated to reduce targeted adolescent risk behaviors for brief periods , sustained behavior changes covering multiple risk behaviors have been elusive . OBJECTIVE To determine whether a parental monitoring intervention ( Informed Parents and Children Together [ ImPACT ] ) with and without boosters can further reduce adolescent truancy , substance abuse , and sexual risk behaviors and can alter related perceptions 24 months after intervention among youth who have all received an adolescent risk-reduction intervention ,  Focus on Kids ( FOK ) . DESIGN R and omized , controlled , 3-celled longitudinal trial . SETTING Thirty-five low-income , urban community sites . PARTICIPANTS Eight hundred seventeen African American youth aged 13 to 16 at baseline . Intervention All youth participated in FOK , an 8-session , theory-based , small group , face-to-face risk-reduction intervention , 496 youth and parents received the  1-session ImPACT intervention ( a videotape and discussion ) , 238 of the ImPACT youth also received four 90-minute FOK boosters delivered in small groups . MAIN OUTCOME MEASURES Responses at baseline and 24 months after intervention to a question naire assessing risk and protective behaviors and perceptions . Analyses used General Linear Modeling , intraclass correlation coefficient , analysis of covariance , and multiple comparisons with least significant difference test adjustment . RESULTS After adjusting for the intraclass correlation coefficient , 6 of 16 risk behaviors were significantly reduced ( P < or = .05 ) among youth receiving ImPACT compared with youth who only received FOK ( respectively , mean number of days suspended , 0.65 vs 1.17 ; carry a bat as a weapon , 4.1 % vs 9.6 % ; smoked cigarettes , 12.5 % vs 22.7 % ; used marijuana , 18.3 % vs 26.8 % ; used other illicit drugs , 1.4 % vs 5.6 % ; and , asked sexual partner if condom always used , 77.9 % vs 64.9 % ) . Four of the 7 theory-based subscales reflected significant protective changes among youth who received ImPACT . ImPACT did not produce any significant adverse effects on behaviors or perceptions . CONCLUSION A parent monitoring intervention can significantly broaden and sustain protection beyond that conferred through an adolescent risk-reduction intervention BACKGROUND Universal school-based prevention programs for alcohol , tobacco , and other drug use are typically design ed for all students within a particular school setting . However , it is unclear whether such broad-based programs are effective for youth at high risk for substance use initiation . METHOD The effectiveness of a universal drug abuse preventive intervention was examined among youth from 29 inner-city middle schools participating in a r and omized , controlled prevention trial . A sub sample of youth ( 21 % of full sample ) was identified as being at high risk for substance use initiation based on exposure to substance-using peers and poor academic performance in school . The prevention program taught drug refusal skills , antidrug norms , personal self-management skills , and general social skills . RESULTS Findings indicated that youth at high risk who received the program ( n = 426 ) reported less smoking , drinking , inhalant use , and polydrug use at the one-year follow-up assessment compared to youth at high risk in the control condition that did not receive the intervention ( n = 332 ) . Results indicate that a  universal drug abuse prevention program  is effective for minority , economically disadvantaged , inner-city youth who are at higher than average risk for substance use initiation . CONCLUSIONS Findings suggest that universal prevention programs can be effective for a range of youth along a continuum of risk CONTEXT Selective interventions targeting personality risk are showing promise in the prevention of problematic drinking behavior , but their effect on illicit drug use has yet to be evaluated . OBJECTIVE To investigate the efficacy of targeted coping skills interventions on illicit drug use  in adolescents with personality risk factors for substance misuse . DESIGN R and omized controlled trial . SETTING Secondary schools in London , United Kingdom . PARTICIPANTS A total of 5302 students were screened to identify 2028 students aged 13 to 16 years with elevated scores on self-report measures of hopelessness , anxiety sensitivity , impulsivity , and sensation seeking . Seven hundred thirty-two students provided parental consent to participate in this trial . INTERVENTION Participants were r and omly assigned to a control no-intervention condition or a 2-session group coping skills intervention targeting 1 of 4 personality profiles . MAIN OUTCOME MEASURES The trial was design ed and powered to primarily evaluate the effect of the intervention on the onset , prevalence , and frequency of illicit drug use over a 2-year period . RESULTS Intent-to-treat repeated- measures analyses on continuous measures of drug use revealed time x intervention effects on the number of drugs used ( P < .01 ) and drug use frequency ( P < .05 ) , whereby the control group showed significant growth in the number of drugs used as well as more frequent drug use over the 2-year period relative to the intervention group . Survival analysis using logistic regression revealed that the intervention was associated with reduced odds of taking up the use of marijuana ( beta = -0.3 ; robust SE = 0.2 ; P = .09 ; odds ratio = 0.7 ; 95 % confidence interval , 0.5 - 1.0 ) , cocaine ( beta = -1.4 ; robust SE = 0.4 ; P < .001 ; odds ratio = 0.2 ; 95 % confidence interval , 0.1 - 0.5 ) , and other drugs ( beta = -0.7 ; robust SE = 0.3 ; P = .03 ; odds ratio = 0.5 ; 95 % confidence interval , 0.3 - 0.9 ) over the 24-month period . CONCLUSION This study extends the evidence that brief , personality-targeted interventions can prevent the onset and escalation of substance misuse in high-risk adolescents . TRIAL REGISTRATION clinical trials.gov Identifier : NCT00344474 OBJECTIVES To determine risk factors of incident onset of use , abuse and dependence of cannabis in a community sample of adolescents and young adults . METHODS Risk factors were examined in a prospect i ve longitudinal design across 4 years in a representative sample ( N = 2,446 ) aged 14 - 24 at the outset of the study ( EDSP ) . Patterns of DSM-IV defined cannabis use , abuse and dependence were assessed with the Composite International Diagnostic Interview ( M-CIDI ) . Potential risk factors were assessed at baseline . Incident cannabis use , abuse and dependence at second follow-up ( on average 42 months after baseline ) were the main outcome measures in this study . Associations were analyzed with logistic and negative binomial regressions . RESULTS Using 11 of a total of 56 variables examined , the predictive value of the final multiple logistic regression for incident cannabis use was moderately good ( area under the ROC curve = 0.78 ) . Cannabis use frequency was predicted in the final model by 18 variables , cannabis abuse by two variables in the younger sub sample and nine factors in the older group , and dependence by eight variables ( dependence : ROC curve area = 0.97 ) . Incident cannabis use was predicted mainly by availability of drugs , peers ' drug use , a more ' positive ' attitude towards future drug use , and regular previous use of licit drugs , while cannabis dependence was predicted primarily by parental death before age 15 , deprived socio-economic status , and baseline use of other illicit drugs . CONCLUSION Different factors predict the onset or severity of cannabis use and the progression to abuse and dependence . In addition to well-documented risk factors such as peer group pressure , drug availability , and low self-esteem , findings suggest that family history ( e.g. parental mental disorders , early parental death ) , and prior experiences with legal drugs play a significant role in the initiation of cannabis consumption and the transition to cannabis use disorders in adolescents and young adults . Findings suggest that early intervention and prevention might be improved by better targeted treatment This paper reports on the evaluation of a culturally grounded prevention intervention targeting substance use among urban middle-school students . The curriculum consists of 10 lessons promoting antidrug norms and teaching resistance and other social skills , reinforced by booster activities and a media campaign . Three versions were delivered : Mexican American , combined African American and European American , and Multicultural . Thirty-five middle schools were r and omly assigned to 1 of the 3 versions or the control . Students completed baseline and follow-up question naires over a 2-year period ( total 6,035 respondents ) . Analyses utilizing a generalized estimating equations approach assessed the overall effectiveness of cultural grounding and the cultural matching hypothesis . Support was found for the intervention 's overall effectiveness , with statistically significant effects on gateway drug use as well as norms , attitudes , and resistance strategies but with little support for the cultural matching hypothesis . Specific contrasts found the Mexican American and Multicultural versions impacted the most outcomes This study evaluated the substance initiation effects of an intervention combining family and school-based competency-training intervention components . Thirty-six rural schools were r and omly assigned to 1 of 3 conditions : ( a ) the classroom-based Life Skills Training ( LST ) and the Strengthening Families Program : For Parents and Children 10 - 14  , ( b ) LST only , or ( c ) a control condition . Outcomes were examined 1 year after the intervention posttest , using a substance initiation index ( SII ) measuring lifetime use of alcohol , cigarettes , and marijuana and by rates of each individual substance . Planned intervention-control contrasts showed significant effects for both the combined and LST-only interventions on the SII and on marijuana initiation . Relative reduction rates for alcohol initiation were 30.0 % for the combined intervention and 4.1 % for LST only Study objective : The aim of this study was to determine the effect of a multilevel school based intervention on  adolescents ’ emotional wellbeing and health risk behaviours . Design : School based cluster r and omised controlled trial . Students were surveyed using laptop computers , twice in the first year of intervention and annually thereafter for a further two years . Setting : Secondary schools . Participants : 2678 year 8 students ( 74 % ) participated in the first wave of data collection . Attrition across the waves was less than 3 % , 8 % , and 10 % respectively with no differential response rate between intervention and control groups at the subsequent waves ( 98 % v 96 % ; 92 % v 92 % , and 90 % v 89 % respectively ) . Main results : 
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Given that the preponderance of significant effect sizes were trivial to small and that percentages of statistically significant and non-statistically significant findings were often equivalent across program type and individual components , the effectiveness of primary prevention for cannabis use should be interpreted with caution .
Universal multi-modal programs appeared to outperform other program types ( i.e , universal uni-modal , targeted multi-modal , targeted unimodal ) .
Specifically , universal multi-modal programs that targeted early adolescents ( 10–13 year olds ) , utilised non-teacher or multiple facilitators , were short in duration ( 10 sessions or less ) , and implemented boosters sessions were associated with large median effect sizes .