[Assessing senior high school students' resistance responses to offers of alcohol and tobacco from peers of the same age].

Objectives　The purpose of this survey was to clarify the characteristics of adolescents' resistance responses to offers of alcohol and tobacco by conducting a survey of Japanese senior high school students.Methods　An anonymous self-administered questionnaire was distributed at five high schools in A prefecture (A total of 2,498 students, comprising 1,713 boys and 785 girls, participated, with a valid response rate of 96.1%.). The contents of the questionnaire included the following: 1) a list of 9 resistance responses, 2) the drinking and smoking behavior of subjects (for the past month); alcohol-resistance self-efficacy and tobacco-resistance self-efficacy, 3) drinking and smoking behavior of close friends; an estimation of peers' alcohol and tobacco use (descriptive norms) as adjustment variables. Factor analysis (likelihood method, promax rotation) was used to clarify the type of resistance responses. In addition, we used multiple logistic regression analysis with current drinking and smoking behavior as dependent variables, and gender, grade, school type, and type of resistance responses as independent variables, simultaneously. Model 1 was not adjusted, model 2 was adjusted for alcohol-resistance self-efficacy and tobacco-resistance self-efficacy, and model 3 was adjusted for the drinking and smoking behavior of close friends, and the estimation of peers' alcohol and tobacco use.Results　Of the 9 types of resistance responses, the most common responses among participants were "simply say I don't want" "no," and "provide explanation for refusal." The responses for both drinking and smoking tended to be similar. From factor analysis, 3 factors were identified to explain optimal resistance reponses, namely, "non-responsive/forthright resistance responses," "ambiguous/reversal resistance responses," and "excuse/concise resistance responses." Regarding the relationship with current drinking behavior, only "ambiguous/reversal refusal" showed a significant odds ratio in all models (odds ratio (95%CI); 1.77(1.36-2.30), 1.66(1.27-2.17), 1.59(1.19-2.13)). Regarding the relationship with current smoking behavior, only "excuse/concise refusal" showed a significant odds ratio in all models (odds ratio (95%CI); 0.38(0.22-0.66), 0.47(0.25-0.87), 0.44(0.23-0.82)).Conclusion　Senior high school students' resistance responses to alcohol and tobacco offers tended to be similar. However, as a result of analyzing the relationship between current drinking or smoking behavior and resistence responses, only current smoking behavior showed a negative correlation with resistance responses.