METHODS OF PREVENTING ADOLESCENT DRINKING

METHODS OF PREVENTING ADOLESCENT DRINKING Theoretical background In each human culture, there has always been a kind of psychoactive substance playing an important role. In different cultures, the dominant substance has built in social interactions and conflict management mechanisms. Alcohol is the most spread, the most frequently used and the most easily reachable legal drug in the world. European culture is dominated by alcohol. The dominant drug determines some significant cultural features of the given culture: the European culture might have become more expansive and work-centred than the South Asian cultures because alcohol increases aggression (Lajtai, 2007). According to Järvinen and Room (2007), in the different regions of the world, the most alcohol is consumed in Europe; however, there are significant differences in the way of consumption as well as the type of the most frequently consumed alcohol. As far as the type of alcohol is concerned, Southern European countries (France, Portugal, Italy, Malta) are called wine countries, the Western European ones (United Kingdom, Denmark, Germany, Ireland) are called beer countries, while in Northern Europe (Finland, Sweden, Norway, Poland) the typical alcohol is spirits. It must be stated that in wine cultures people drink more frequently but smaller quantity, while in spirits cultures people drink less frequently but bigger quantity at a time. (Room, 2007) Hungary is the part of Europe so its dominant drug is alcohol. In the last one or two centuries in Hungary, alcohol consumption has become the legal and socially accepted way of stress management due to several social traumas (Lajtai, 2007). By today, alcohol consumption has become the part of social life: drinking alcohol is not considered deviation, while alcohol addiction is (Pikó, 2005b). As far as alcohol abuse is concerned, there are three endangered groups: people with low education, women, and adolescents. The time of alcohol initiation is different in different countries: according to researches, in Hungary – like in other European countries – drinking alcohol for the first time takes place at the age of 11-13 (Aszmann et al, 1999; Room, 2007); however, initiation could sometimes start at the age of 9-10, or even under 9 (Pikó, 2005b). Room (2007) determined according to the previous ESPAD1 researches that youngsters’ alcohol consumption habits are different from that of the adult generation’s. Firstly, the difference between the typical European alcohol regions has been disappeared: adolescents quite often drink spirits. Due to this change, Ahlström (2007) drops the original categories of wine, beer, and spirits countries and forms the categories of ’drunken’ and ’non-drunken’ countries. While the former group is formed by the Northern and Western European countries, the latter one is typical in Southern Europe. The Hungarian results of ESPAD 2007 somehow contradict to the European tendencies as, according to month prevalence, the leading alcohol in Hungary is wine (Elekes, 2009). The other generation difference is the fact that today adolescents drink more that the previous generations at a time. Moreover, the way of alcohol consumption has become especially hedonistic: its aim is getting drunk. Among adolescents, the typical Mediterranean alcohol consumption (small quantity daily) is disappearing; instead a new tendency, the so called binge drinking is appearing and these adolescents mainly drink spirits and beer. What is strange that 1 European School Surves on Alcohol and Other Drugs 1 the adolescents who drink 5+ drinks (the measurement of binge drinking) at the weekends consider their parents’ Mediterranean drinking habit the sign of alcohol addiction (Järvinen – Room, 2007). Binge drinking is thought to be problematic not only in short run and because of getting drunk. Researchers suppose there is a link between binge drinking and life long alcohol consumption (Pikó, 2000). According to Parker (2007), the other problem is that the function of social drinking has recently changed: the main purpose of social drinking is relaxing and forgetting problems, which is often connected to drinking large quantity. This attitude can perfectly be fitted to today life style: work hard and play hard, which has a great effect on adolescents’ way of thinking as well. As it was mentioned, initiation of alcohol consumption can be put at earlier and earlier age. However, the real danger is not in the initiation itself but in the fact that “the conditioning phenomena which form a link between smoking, drinking, drug taking and pleasant effects, such as chatting with friends, a relaxed state, or handling stress and strain, get fixed in that period of life” (Pikó, 1999: 337.). That is why adolescent health behaviour has a significant role in adult lifestyle: whether the factors of risk behaviour become the part of life, to what extent they become determining in adulthood, and so how they influence diseases and death (Pikó, 1999). Another typical adolescent phenomenon is co-morbidity: using different psychoactive substances parallel. As nicotine and alcohol are the frequently used and legal drugs, they often form the so called entrance to illegal drugs, especially when the adolescent starts smoking and drinking at young age (Lajtai, 2007; Aszmann, 2003). Skultéti (2005) found that there is a strong positive correlation between smoking and dinking. According to Järvinen and Room (2007a), co-morbidity is mostly typical to adolescents at the time of binge drinking. By some researchers (Lajtai, 2007) the later period of life and the more controlled conditions the adolescent tries alcohol for the first time, the smaller is the chance they consume alcohol regularly or try illegal drugs. According to both national and international researches, the use of psychoactive substances is involved in adolescents’ lives, which refers to the necessity of prevention programs. Prevention is one of the key words of health-conscious behaviour. Prevention techniques applied since the 60s have gradually improved: they have intended to adapt to the needs of the target population. First, the only aim was to inform and terrify teenagers, later the focus was put on teaching adolescents how to defend themselves from the direct influences of the society, such as the effects of advertisements and the peer group (Sussman – Ames, 2008). Nowadays, the most effective prevention is considered to be the competence-based approach. This method focuses on improving personal and social skills, as well as on forming adaptive coping techniques (Botvin – Griffin, 2006). According to experts, programs based on only cognitive models could not be fully successful because they do not take the environmental and irrational motives of behaviour into consideration, and so, they do not make the motivation background of risk behaviour evident: e.g. risk behaviour provides real or alleged advantages to the users in short run. Today, experts intend to include computer in drug prevention programs, as it is very popular with youngsters (Bosworth, 2006). According to WHO, the purpose of health improvement is to change our life style, as most civilisation illnesses are in close connection with our way of living. On the other hand, the way of life mirrors, as well as reproduces social relations (Pikó, 2002). In adolescence, taking on risk behavioural patterns carries out as a learning process. That gave the idea of the positive adaptation training, the main part of which is the improvement of social competencies, which refer to interpersonal skills, such as assertiveness, successful communication, or forming positive self-esteem (Pikó, 2005a). The most significant scene for these trainings is school. 2 According to Rácz (2003), school intervention programs must contain several elements: passing the knowledge (give as exact information as possible), affective education (self-esteem, tolerant atmosphere), peer programs (refusing techniques, social skills), and offering alternative programs (positive or challenging activities). Introduction of the research Hypotheses of the research Before starting the research the following hypotheses were put down: 1. There are significant differences between age groups and school types but no difference between genders. 2. There are various consequences of school drinking in the three school types. 3. Teachers apply mainly primary prevention methods. 4. Among prevention methods there are several unique and effective ones. The surroundings, tools, and methods of the research The research was carried out in a middle-sized Hungarian city. In the preparatory phase of the research, in spring 2006 semi-structured interviews were made with the principals or deputy principals of six secondary schools. Based on this information and our own experience, a questionnaire was worked out. Since it was a non-standardised questionnaire, a pilot survey was carried out in autumn 2007 among students and in January 2008 among teachers. The real questionnaire survey was done in autumn 2008 both among students and teachers. The basis of taking a sample was the stratified grouped method in two steps: the target population was put into strata according to the type of school (grammar, technical, and vocational secondary schools) and to the maintainer (local government, the Church, and foundation). Primary groups were formed by the schools taking part in the research, while the secondary groups – by classes: 9th, 12th, and 13th forms. The selection of both the schools and the classes was done according to probability sampling; and the aim was to have a representative sample according to the school type as well as the maintainer (Csíkos, 2009). In the research at last, nine secondary schools took part: 1 local governmental grammar school, 1 ecclesiastical grammar school, 1 foundational grammar school, 4 technical secondary schools run by the local government, and 2 vocational schools run by the local government too – precisely a 9th and a 12th or a 13th form from each school. 489 students and 153 teachers participated in the questioning. Data processing was done by the mathematical-statistical software: SPSS 17.0. The most frequently used tests to figure out the results were frequency, chi-square test, and Spearman correlation. Although there were some open questions in both the student and teacher questionnaires, it had been decided during the planning of the survey to apply semi-structured interviews to be able to collect more exact information and data about the problem. Selecting interview sample was about to do by the strategy of maximum variation. This purpose was nearly fulfilled: there was only one school from which no interviews could be done either with a student or with a teacher. As interviewees took part in the research voluntarily, this might deform the results of the survey, as teachers undertaking the interview could be supposed to apply prevention techniques during education – perhaps more than one. There were altogether 31 people: 13 students and 18 teachers with whom the semi-structured interviews were made; from the middle of March to the end of June 2009. Processing the data gained from the interviews was done by open, axial, and selective coding techniques; while systematisation of the data was done manually, with the so called ‘paper-scissors’ technique (Sántha, 2009) – of course digitally. 3 In this survey, a great emphasis was put on researcher ethic, as the fact of criminal responsibility might have appeared in several questions of the research. That is why it was obvious to handle the material confidentially. So the aim was in all phases of the research to guarantee the persons safety taking part in the survey. While the students were questioned, we intended to gain their confidence and convince them that filled-in questionnaires would not be seen by anyone but the researcher. Both students and teachers’ questionnaires were obviously anonymous. Before interviews, people were informed about who the researcher was, what the research was about, how the collected data would be handled, and how the people’s anonymity would be guaranteed; moreover, interviewees’ acceptance was required. Results of the empirical study The extent of alcohol consumption and the possible consequences Although many researches have indicated that the difference between genders is disappearing, and this tendency is especially typical to adolescent generation, the results of the present survey did not prove that. There is a significant difference between boys and girls’ alcohol consumption: boys drink significantly more than girls (2=33,26; p<0,001). Parallel to this, the difference between age groups is significant too: the 14-16-year old students drink significantly less alcohol than 17-20 –year old ones. The data indicate that the rate of occasional drinkers is similar in both groups; however, there are remarkably differences in the other two categories. While a quarter of freshers never drinks alcohol and only 7% of them drinks regularly; only about 10% of school leavers never drinks and nearly a quarter of them consumes alcohol regularly. boy (N=219) girl (N=257) 14-16 (N=244) 17-20 (N=232) never 35 (16%) 53 (21%) 62 (25%) 26 (11%) occasionally 129 (59%) 188 (73%) 164 (67%) 153 (66%) regularly 55 (25%) 16 (6%) 18 (7%) 53 (23%) 2 =33.26; p<0.001 2 =32.08; p<0.001 1 chart: Alcohol consumption regarding gender and age Alcohol consumption is mainly connected to adolescents’ leisure time activities so it hardly appears in teaching period. However, it often causes big problems in school events (class excursions, parties, balls, etc.) (This phenomenon later referred to ‘school drinking’.) Since alcohol consumption is forbidden both at school and in school events by school regulation, but earlier it was experienced that students do not always keep the rule, the quantity of both students’ own and their classmates’ alcohol consumption were asked in the questionnaire. The data indicated significant difference between students’ own and their classmates’ drinking (2=362.69; p<0.001). Nearly twice more students stated about themselves than about their classmates that they never drink alcohol in school events. It is supposed that the real alcohol consumption should be in between students’ own (admitted) and classmates’ (supposed) ones. 4 250 219 200 150 118 145 126 100 100 65 Drinking - own 26 50 48 18 43 Drinking classmates 0 2 chart: Alcohol consumption in school events: students’ own – classmates’ (N=454) Comparing students’ own and their classmates’ consumption, it can be stated that there is moderate positive significant correlation between these data: r=0.566; p<0.001. This correlation suggests that the students who drink alcohol more frequently in school events are likely to suppose that their classmates drink more often. However, the opposite of this conclusion could be true: the students who think that their classmates often drink in school events are likely to drink more frequently themselves, too. It was researched whether there is a difference between school types in the prevalence of alcohol consumption. The results showed that the difference is significant (2=18.932; p<0.05): there is a remarkable fall from never drinkers towards the regular ones among grammar school and secondary technical school students; while this decrease is not so crucial among vocational school students. Moreover, nearly 10% of vocational school students stated that they regularly drink alcohol in school events – compared with the 2% of grammar and secondary technical school students. grammar school 60% 50% secondary technical vocational 53% 48% 47% 40% 28% 28% 30% 22% 18% 20% 13% 13% 10% 9% 9% 4% 4% 2% 2% 0% never rarely sometimes often generally 3 chart: Alcohol consumption according to school types by students (N=475) The bar chart displays only one strange phenomenon: twice more (9%) grammar school than technical school students implied that they often drink alcohol in school events. Having studied the data from the three different grammar schools, the researcher experienced that 19% of foundational grammar school students stated that they drink alcohol in school events frequently, while this proportion was 5% among local governmental and 7% among ecclesiastical grammar school students. The reasons of this big difference could be either the fact that the parents of 5 foundational school students have more liberal principles in education; or the expectance of the society (teachers, parents, etc.) that the students of an elite grammar school (both the local governmental and the ecclesiastical schools can be regarded that one) should not use too many legal and should not use illegal drugs at all. So adolescents of these grammar schools might not have wanted or dared to indicate their real consumption. After studying the teachers’ opinion whether there is a difference between school types in alcohol consumption in school events, it must be stated that the difference is significant (2=20.32; p<0.01). According to the teachers, the difference is the smallest in the ‘never’ category, while in the other categories the difference is remarkable. Nearly 60% of grammar school teachers but only 20% of vocational school teachers think that their students drink alcohol in school events very rarely. However, the two last categories of the bar chart indicate that hardly more that 10% of grammar school teachers but one quarter of vocational school teachers and one third of technical school teachers suppose that their students often or regularly consume alcohol in school events. 70% 59% 60% grammar school 50% secondary technical 45% 38% 40% 30% 20% vocational 24% 21% 18% 15% 20% 10% 7% 10% 9% 7% 15% 4% 7% 0% never rarely sometimes often generally 4 chart: Alcohol consumption according to school types by teachers (N=142) It is obvious that secondary school teachers know that students drink alcohol in school events. The researcher wanted to know the consequences of alcohol consumption. Students could choose any ones among the five given options and they could give their own answer, too. According to adolescents’ opinion, teachers usually apply ways of soft punishment: they are more likely to warn students verbally and less likely to give written from teacher’s warning or even principal’s warning. One of the five items, ‘the student must give oral presentation in the next lesson’ was chosen by such few students that it was not taken into consideration when the data were analysed. It was examined whether there is a difference between the prevalence of applied consequences in the three school types. The difference was significant in all cases (p<0.001). Students’ opinion indicates that verbal warning is more typical in grammar schools and teachers are less likely to give form teacher’s written warning or inform the parents than in technical and vocational schools. However, the strict punishment (principal’s written warning) is more typical in vocational schools. 6 60% 55% 47% 50% 40% 43% 37%39% 38% 36% 33% 30% 25% 24% 20% 13% 15% 10% 0% Verbal warning Informing parents grammar school Form teacher's written warning secondary technical Principal's written warning vocational 2=29.45 2=18.11 2=30.99 2=15.93 5 chart: Consequences of drinking – according to students (N=470) Although there are several prevention and controlling methods applied by teachers, it is obvious that students sometimes drink alcohol – occasionally in abusive way – in school events. That is why teachers were also asked what they did if they noticed their students had drunk alcohol. Teachers could choose any ones among the six given options, as well as they could give their own answers. Most teachers do not give real punishment, they generally warn the students verbally (92 teachers) or inform the parents (54 teachers). However, several teachers suppose that alcohol consumption must be punished more strictly, so 58 teachers give form teacher’s written warning, 48 teachers principal’s written warning, and 26 teachers turn to the so called school ‘discipline jury’. As far as the frequency of consequences are concerned, there are significant differences between the three school types in three cases: verbal warning, principal’s written warning, and discipline procedure. Grammar school teachers significantly more frequently warn verbally (2=10.56; p<0.01) the students who drink alcohol in school events than the teachers in the other two school types. While teachers in technical and vocational schools significantly more frequently give a principal’s warning (2=8.5; p<0.05), and vocational school teachers significantly more frequently hear a discipline case (2=19.51; p<0.001). The bar chart displaying the differences among school types indicates that grammar school teachers are likely to give less strict, while technical and vocational school teachers stricter punishment as a consequence of alcohol consumption in school events. 7 grammar school 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% secondary technical vocational 84% 60% 53% 53% 42% 38% 33% 30% 36% 42%40% 16% Verbal warning Informing parents Form teacher's written warning 38% 12% 5% Principal's written warning Discipline procedure 6 chart: Consequences of drinking – according to teachers (N=143) Prevention techniques Prevention methods could be grouped by two viewpoints. According to the previously formed grouping on chronological basis, there are primary, secondary and tertiary preventions. However, today experts apply the grouping based on target population: universal, selective, and indicated preventions (Rácz, 2007). In the research, the prevention methods on chronological basis were applied. Prevention techniques were considered primary if they are used by teachers to prevent the early initiation of substance use, as well as to hold drinking on experimental level. On the other hand, the prevention techniques with which teachers intend to decrease the non-occasional substance use, as well as to minimalise the symptoms of it were thought to be secondary prevention methods. Taking apart answers regarding prevention techniques, the following categories were formed in both primary and secondary prevention methods: In School Mentioned Effective Social, personal Applied Effective Ineffective Effective 7 chart: Grouping prevention techniques Primary prevention techniques Students mentioned a lot of primary prevention techniques – much more than secondary ones. The reasons of this could be either the supposition that students find primary prevention methods more effective; or the fact that teachers must apply various primary techniques to be able to prevent alcohol abuse. Among methods thought to be effective there are several ones that aim real prevention: forming harmonious teacher-student relationship, fixing rules or making compromise in advance, permission of small quantity with the teacher’s control, etc. The common basis of all these 8 techniques is trust and respect between the students and the form teacher as well as democratic atmosphere both in the class and in the school. 1 table: Primary prevention methods by students As far as the permission of consuming small quantity of alcohol during class excursions is concerned, all the interviewed students implied that it might be possible only in the last one or two years of the secondary school – when a bigger part of the students has come to age. Moreover, during the teacher’s control, students could learn the rules of social drinking, which is mostly typical to adults. Peer control and support are based on discussing rules and making compromise with the form teacher in advance. Students make their own classmates obey the rules stated before the party or excursion to keep the form teacher’s trust and love. What is more, peer control might have a more significant role in prevention than adult control as the intention to meet peer group norms and values is the strongest in adolescence. Applying drama pedagogical elements in education must be effective in alcohol prevention too. On the one hand, playing the role of another personality might make students be more tolerant to other people. On the other hand, role plays alienate students from their real problems so they could speak about them in a more honest way. Some student suppose that talking to a former alcohol addict should also be effective as an ex-addict could speak about both physical and mental addiction, and so, they are more trustful than a medical worker giving a lecture on this topic. According to adolescents, an adequate person is one who has already used or abused a psychoactive substance or who has got into a dangerous situation. The problem is that people like that do not always communicate their negative experience in the most trustworthy and convincing way. 9 The techniques of strict control or threatening with punishment are considered to be partly effective. Firstly, it is impossible to reach total alcohol prevention in school events. Secondly, these methods work in case the teacher recognises the symptoms of drinking or the student is caught in drinking. Thirdly, it is not clear which student shows the symptoms of drinking. So it might happen that the teacher punishes students who have drunk just a small quantity but their organism is not used to drinking and the effects of alcohol can obviously be seen on their body and behaviour; and the students who have drunk more might avoid punishment as their body tolerates alcohol to a bigger extent. In addition, the situation when a teacher wants students to keep the school rules with regular night control makes the teacher ironical as well as playing the role of a policeman whose job is to find the ‘criminal’, i.e. the student drinking alcohol. The message of this situation totally contradicts to the ideal teacher-students relationship which is based on trust and respect. Besides effective methods, students mentioned absolutely ineffective ones too, such as giving verbal information on the consequences of alcohol abuse and radical forbidding. As far as information is concerned, students think they know most of it. Moreover, information on negative consequences of alcohol consumption is generally given once or twice a year, and so, it shocks adolescents only momentary. Nearly all the interviewed students thought that radical forbiddance is absolutely ineffective as the typical adolescent role is to rebel against adult society and a strong ban makes students break the rules stated by adults. Teachers mentioned several primary techniques applied in school event to be able to prevent drinking at all or alcohol abuse. Coding and analysing the interviews, two remarkable things could be seen. First, teachers apply various prevention methods at the same time and successful prevention could be resulted from their combination. Second, there are a lot of overlapping in students and teachers’ table regarding effective preventive methods. 2 table: Primary prevention methods by teachers 10 Among effective methods, teachers mentioned discussing rules as well the consequences of breaking them in advance, so several teachers try to teach their student self-regulating their behaviour. Teachers want to give students the attitude that drinking alcohol should never be the aim of a leisure time activity but it is just one of the tools to have fun. Most teachers recognised that the biggest danger of adolescents’ drinking habits is not consuming alcohol itself but binge drinking: drinking a lot at a time. That is why some teachers suppose that adolescents should be taught the way of the so called ‘cultural’ drinking, especially introducing Hungarian wine culture. On the other hand, some teachers think that they must not give the permission to their students to consume alcohol in school event because in that case they would be the ones who break both the school rules and the laws. Several teachers mentioned that interesting programs which provide joy for adolescents and through that form strong peer communities as well as strengthen the students-teacher relationship are very effective. The teachers try to form the conditions in the class excursion in the way that students have neither opportunities nor intention to drink alcohol. They arrange active programs for students, as one of the teachers mentioned: have regulated free time activities, such as a football match, singing and talking around the camp fire, or an exciting as well as exhausting night tour. Today life is too reliable but adolescents hunger for adventures. The effect of adventure parks, which are often specialised on class excursions, or that of night tours works in a similar way: while reducing the real risk, it increases the figured one. So teenagers can experience situations supposed to be risky or dangerous without getting into real danger. Moreover, games or exciting activities increase the adrenaline level in the human organism, as well as they provide positive experience through group activities. In that way adolescents do not need psychoactive substances to experience joy and satisfaction. However, some teachers want to avoid the risk of student drinking so that they go to a one-day excursion or do not go to an excursion at all. Although students find control just a partly effective method, several teachers implied that they regularly control their students whether they have drunk alcohol: during class excursions, students occasionally must report to the form teacher; or teachers examine students’ stuff and rooms; entering school parties students are checked – sometimes with the help of guards or with a breathalyser. Regarding these methods, there are two problems. Firstly, the school does not have legal right to examine students’ belongings. Secondly, in that case the teacher must play the role of the authority, which contradicts common trust and fair play, which is supposed to be the important part of prevention. Similar to students, teachers mentioned ineffective methods as well. Both teachers and students agree that giving verbal information is hardly effective, while radical forbiddance is totally ineffective – especially in case of older students. Secondary prevention techniques Both students and teachers listed only few secondary prevention techniques. According to the students’ opinion, punishment could be either an effective or an ineffective method. Some students indicated that through punishment the teacher unambiguously communicates to the other students that consuming alcohol is breaking the rules, and so, it has consequences. Moreover, alcohol abuse creates a very inconvenient situation not only for the teacher but the other students as well: it ruins the reputation both the class and the whole school. On the other hand, some students think that strict punishment, such as banning the students from visiting school programs, is ineffective, as it totally deprives the student breaking the school rules earlier from community experiences. 11 3 table: Secondary prevention techniques by students The situations when the teacher has no reputation or gives delayed feedback were considered to be ineffective by students. If there are no consequences of breaking the rules or the feedback is too late or too mild (e.g. verbal request); moreover, the punishment is collective, it does not affect students behaviour in the positive way. According to a student, a mild verbal warning mainly influences the students who did not abuse alcohol, and the ones who got drunk were laughing at the teacher’s rebuke. Teachers generally apply secondary techniques if the primary ones were ineffective. The coding indicated that all secondary methods were used as primary ones too; in these cases teachers applied them to reduce the consequences of alcohol abuse or to prevent it next time. 4 table: Secondary prevention techniques by teachers Both peer support and peer criticism are considered to be effective. While peer support is regarded to be direct help to students having drunk too much; peer criticism might be called indirect support the influence of which could be seen later but in longer run. Several teachers mentioned that drunken adolescents, especially girls, are harshly criticised by their peers, Since an adolescent’s model people are their peers, teenagers try to avoid behaviour criticised by their mates in the future to be able to maintain their place in the hierarchy of the micro society of the class. However, it must be stated that peer criticism works properly if the peer group does not tolerate alcohol abuse. 12 One of the teachers sometimes applies deliberate subsequent compromise. For the first time in a class excursion, the teacher let the students drink a lot pretending he does not care about it. When the next day the teenagers feel not only hangover but remorse and fear of parents and principal, the teacher makes the compromise for the future till the end of secondary school studies: he will excuse this mistake if the students never drink too much till school leaving. Although this method works, according to the teacher, it has several problems. Firstly, some teenagers might get ill due to drinking too much alcohol. Secondly, the teacher might get into trouble if either the parents or the principal got to know about the case. Thirdly, this method obviously does not work with all teenage groups as many adolescents may think that the teacher will let them drink next time if he did it once. Punishing the student who break the rule and drink too much is supposed to be mainly ineffective by teachers, too. One of the typical ways of punishment is to send the drunken student home from the class excursion. Although the teacher removes the problematic teenager from the group, this method has several risks as well. During the whole school excursion the teacher must take the responsibility for all the students. If the student travelling home had an accident, the teacher might get into serious trouble. Another way of punishment is the so called collective one when all the students pay the penalty (not going to excursion or not having school parties at all) regardless they consumed alcohol or not. Conclusion Testing the hypotheses 1. There were significant differences between age groups, school types, and even genders. 2. There are similar consequences of school drinking in the three school types; however, there are significant differences in the frequency of application. 3. Teachers apply much more primary prevention methods than secondary ones. 4. Among prevention methods there are several unique and effective ones. School intervention program Based on information given mostly from the interviews a complex school intervention program can be compiled the parts of which are: 1. Complex health education programs  Information, illustrations  Improving personal and social competencies 2. Training peer supporters 3. Enjoyable free time activities 4. Training teachers 1. Complex health education program A complex health education program should be introduced in all secondary schools. Complexity means both the variety of methods and the topics of the program; as an effective health education program should focus on preserving not only physical but also mental and spiritual health, as well as on forming teenagers’ attitudes. So besides drug prevention, it should contain topics, such as the manipulative influence of advertisements, the advantages and disadvantages of the Internet, healthy diet, doing sports regularly, human relationships, and verbal and non-verbal communication. 13 The complex program should include, except for passing information, the improvement of social competencies (communication skills, assertiveness, conflict management strategies, coping techniques) and the development of the community. The former might contain the following topics:    Various situations and role plays, in which adolescents may try how to solve different conflict situations, how to say ‘no’, how to resist peer pressure, and how to behave in the most suitable way in various situations. Discussing real situations debating the pros and cons. Education students to make decisions in a responsible way (e.g. dangers of drunken driving, disco accidents, offering drugs to underage kids, etc.) On the other hand, developing communities would be necessary because a strong and cohesive peer group functions as a protective factor. Community could be developed through the tasks which make group connections stronger, provide help to know each other better, and facilitate to trust each other absolutely. A complex program like this must be worked out by several different experts and provided with suitable extra materials (e.g. pictures, films, case studies) as well as methodology. After having worked out this subject, piloted with a control group for one or two years, and made the suitable modification in it, the program could be introduced in all Hungarian secondary schools. 2. Peer support Although both teachers and students mentioned in the interviews that the influence of peers might be protective, the research showed that schools do not exploit this technique to a possible extent. Since several teachers indicated that peer support could be the most effective if the supporters were some years older than the target group. 3. Exciting free time activities All the teachers agreed on the fact that exciting free time activities function as a protective factor, so they provide great help to prevent or at least decrease drinking. Exciting free time activities mean that schools may provide various afternoon programs for their students. On the other hand, class excursions lasting more than one day would absolutely be needed, when both the spot and the program were challenging for students. These longer excursions would provide a great opportunity for teachers and students to get closer and form a more personal relationship, which would influence (decrease) drinking in an indirect way. 4. Further training for teachers Teachers would need further training to be able to realise the symptoms of drinking at early phase. However, some indicated that the most important task of schools would be primary prevention. That is why other further trainings are needed: on the one hand, the ones that improve methodology, on the other hand, the ones that improve communication and conflict management strategies through situations and role plays. 14 Works cited: Ahlström, Salma et. al. (2007): Gender Differences in Youth Drinking Cultures. In: Järvinen, Margaretha – Room, Robin (2007, edit): Youth Drinking Cultures. European Experiences. England: Ashgate Publishing Limited. 65-80. Aszmann Anna és mtsai (1999): Magyar serdülők egészséget befolyásoló magatartása, a rizikómagatartás 1986-1997 közötti változása. In: Egészségnevelés, 40. 123-132. Aszmann Anna (2003): A serdülők egészségi állapota és egészségmagatartása. In: Kapócs Imre – Maár Márton – Szabadka Péter (2003, szerk.): Ifjú-kór 2. Budapest: Okker Kiadó. 180212. Bosworth, Kris (2006): Application of Computer Technology to Drug Abuse Prevention. In: Sloboda, Zili – Bukoski, William J. (2006, edit): Handbook of Drug Abuse Prevention. Theory, Science, and Practice. USA: Springer. 629-649. Botvin, Gilbert J. – Griffin, Kenneth W. (2006): Drug Abuse Curricula in Schools. In: Sloboda, Zili – Bukoski, William J. (2006, edit): Handbook of Drug Abuse Prevention. Theory, Science, and Practice. USA: Springer. 45-74. Csíkos Csaba (2009): Mintavétel a kvantitatív pedagógiai kutatásban. Budapest: Gondolat Kiadó. Elekes Zsuzsanna (2009): Az alkoholprobléma és társadalmi háttere. In: Demetrovics Zsolt (2009, szerk.): Az addiktológia alapjai II. Budapest: ELTE Eötvös Kiadó. 293-326. Järvinen, Margaretha – Room, Robin (2007): Youth Drinking Cultures: European Experiences. In: Järvinen, Margaretha – Room, Robin (2007, edit): Youth Drinking Cultures. European Experiences. England: Ashgate Publishing Limited. 1-16. Lajtai László (2007): Alkoholhasználat és alkoholfüggőség. In: Demetrovics Zsolt (2007, szerk.): Az addiktológia alapjai I. Budapest: ELTE Eötvös Kiadó. 73-106. Parker, Howard (2007): Consumption beyond Control. The Centrality of Heavy Social Drinking in the Lifestíle of English Youth. In: Järvinen, Margaretha – Room, Robin (2007, edit): Youth Drinking Cultures. European Experiences. England: Ashgate Publishing Limited. 119-130. Pikó Bettina (1999): Magatartáskutatás középiskolások körében: kockázatot növelő és egészséget védő tényezők a dohányzás alkohol- és drogfogyasztás kialakulásában. In: Pszichológia, 3. 337-354. Pikó Bettina (2000): Dohányzás serdülő- és ifjúkorban: az attitűdöktől a magatartásig. In: Szenvedélybetegségek, 3. 206-214. Pikó Bettina (2002): Egészségtudatosság serdülőkorban. Budapest: Akadémiai Kiadó. Pikó Bettina (2005a): Ifjúkori problémaviselkedés. In: Pikó Bettina (2005, szerk.): Ifjúság, káros szenvedélyek és egészség a modern társadalomban. Budapest: L’Harmattan. 20-29. Pikó Bettina (2005b): Az alkoholfogyasztás és az alkoholizmus szociológiája. In: Pikó Bettina (2005, szerk.): A deviáns magatartás szociológiai alapjai és megjelenési formái a modern társadalomban. Szeged: JATE Press. 129-140. Rácz József (2003): Preventív intervenciók. In: Fejlesztő Pedagógia. 2003. 2-3. 97-108. Rácz József (2007): A droghasználat megelőzése – prevenciós modellek és programok. In: Demetrovics Zsolt (2007, szerk.): Az addiktológia alapjai I. Budapest: ELTE Eötvös Kiadó. 419-445. Room, Robin (2007): Understanding Cultural Differences in Young People’s Drinking. In: Järvinen, Margaretha – Room, Robin (2007, edit): Youth Drinking Cultures. European Experiences. England: Ashgate Publishing Limited. 17-40. Sántha Kálmán (2009): Bevezetés a kvalitatív pedagógiai kutatás módszertanába. Budapest: Eötvös József Könyvkiadó. 15 Skultéti Dóra (2005): Társas hatások szerepe a fiatalok egészségkockázati magatartásában. In: Pikó Bettina (2005, szerk.): Ifjúság, káros szenvedélyek és egészség a modern társadalomban. Budapest: L’Harmattan. 104-120. Sussman, S. – Ames, S. L. (2008): Drug Abuse. Concepts, Prevention, and Cessation. New York: Cambridge University Press. 16