Just as public health researchers have identified smoking and a diet high in fat as root causes (also known as risk factors) for heart disease, researchers have identified a set of risk and protective factors for adolescent health and behavior problems.  The research has shown that certain conditions in children’s community, school, family, and peer environments, as well as physiological and personality traits of the children themselves, are common risk and protective factors for problems such as drug abuse, delinquency, teenage pregnancy, and school failure

A root cause is an association between some characteristic or attribute of an individual, group, or environment and an increased probability of certain disorders or disease-related phenomena at some point in time.  In respect of illicit drug use, proponents of root causes argue that there is a range of social, individual and environmental factors which collectively increase the risk of a young person becoming involved in problem behaviors, including problem drug use. These root causes have been identified in the community, the family, in schools and in individuals.  While there are a number of root causes, the following are examples of root causes that can be addressed through community-wide environmental strategies.

Availability /access of drugs

The more available drugs are in a community and the more youth have access to these drugs, the higher the risk that young people will abuse drugs in the community. Retail availability refers to how available alcohol or other drugs from legal sources in the community.  Social access refers to alcohol obtained through sources such as parents and friends, at underage parties, and at home.   Perceived availability of drugs is also associated with risk. In schools where children just think that drugs are more available, a higher rate of drug use occurs. 

Community norms favorable toward drug use

Norms and values can be defined as informal social rules or proscriptions defining acceptable and unacceptable behavior within a social group, organization or larger community. Norms reflect general attitudes about substance use and societal expectations regarding the levels and types of consumption considered acceptable. What is considered acceptable behavior may vary according to the location (e.g., by country or region within a particular country), occasion (e.g. at a bar, a party or at home) and across demographic subgroups (e.g., by gender, race or ethnicity).

Laws and Enforcement

Enforcement refers to enforcing policies to decrease retail and social availability as well as youth use of alcohol through threat of sanctions. Official policies might call for arrest, prosecution, and punishment to help reduce alcohol availability and alcohol-related violations. Punishment might include fines to stores that sell alcohol to minors or stiff penalties for drinking and driving. The distinguishing characteristic of the enforcement domain is the reliance on the formal criminal justice system to implement penalties. “Informal enforcement” is also an important complement to formal mechanisms. For example, “informal enforcement” might come in the form of communities being unwilling to patronize stores that sell alcohol to minors.

Price and Promotion

Research has reported high recall of alcohol advertising among youth, and investigations of youth also indicate that expectancies related to the effects of alcohol and intentions to drink can be positively influenced by advertising. Increased exposure to alcohol ads is associated with increased consumption and with heavy or hazardous drinking.  Alcohol advertisements that were rated by youth as more likeable were also endorsed with greater intention to purchase the brand and products promoted. These findings are consistent with marketing research indicating that likeable advertisements are more affective and persuasive, and that liking of advertisements is one factor that affects attitudes toward brand and product.   In regards to price there is strong and consistent evidence to suggest that price increases and taxation (assuming increases pass through to retail price) have a significant effect in reducing demand for alcohol

Parental Attitudes Towards Drug Use

Parental attitudes and behavior toward drugs, crime, and violence influence the attitudes and behavior of their children. Parental approval of young people’s moderate drinking, even under parental supervision, increases the risk of the young person using marijuana. Similarly, children of parents who excuse their children for breaking the law are more likely to develop problems with juvenile delinquency. In families where parents display violent behavior towards those outside the family, there is an increase in the risk that a child will become violent. 

Favorable Youth Attitudes Towards Drug Use

During the elementary school years, children usually express anti-drug, anti-crime, and pro-social attitudes. They have difficulty imagining why people use drugs, commit crimes, and drop out of school. However, in middle school and later, as others they know participate in such activities, their attitudes often shift toward greater acceptance of these behaviors. This acceptance places them at higher risk.  Another aspect is the perception of risk which is the extent to which young people feel that people are at risk of harming themselves if they use specific drugs.  Young people who do not perceive drug use to be risky are far more likely to engage in drug use.

Primary sources:

Prioritizing Risk and Protective Factors, Community Health Institute


Risk and Protective Factor Definitions and Construction, State of Maine, Office of Substance Abuse


Logic Models for the Prevention of Alcohol, Tobacco and Other Drug Problems, PIRE.