# A Cognitive Model of Alcohol Use Among Taiwanese Adolescents: The Influence of Alcohol Expectancies and Drinking Refusal Self-Efficacy

## TL;DR

This study explores how beliefs about alcohol and confidence in refusing to drink influence alcohol use among Taiwanese adolescents.

## Contribution

The research introduces a cognitive model linking alcohol expectancies and refusal self-efficacy to drinking behavior in Taiwanese adolescents.

## Key findings

- Positive alcohol expectancies are strongly linked to higher drinking and drunkenness frequency.
- Higher drinking refusal self-efficacy is associated with lower drinking and drunkenness frequency.
- Social pressure is a significant predictor of both drinking and drunkenness frequency.

## Abstract

Background: Drinking alcohol of adolescents is an important issue in Taiwan. The purpose of the research is to determine how drinking expectancy and drinking refusal self-efficacy influence drinking behavior among Taiwanese adolescents based on a cognitive model of alcohol consumption. Methods: In this cross-sectional study, a total of 908 students, selected from 10th to 12th grade of six high schools in Taiwan, were stratified randomly. Pearson correlation, and multiple regression analyses were conducted to examine the relationships among drinking expectancy, refusal self-efficacy, and alcohol use, including drinking frequency and drunkenness frequency. Results: There was significant positive relationship between drinking expectancies, and drinking and drunkenness frequency; and negative correlation between drinking refusal self-efficacy, and drinking and drunkenness frequency. Multiple regression analysis revealed that (1) tension reduction, sexual enhancement, social pressure, emotional relief, and opportunity to drink significant predicted drinking frequency (Adjusted R2 = 0.352, p < 0.001) and (2) tension reduction, increased confidence, cognitive enhancement, and social pressure significant predicted drunkenness frequency (Adjusted R2 = 0.226, p < 0.001). Conclusions: Adolescents have positive outcome expectancies regarding increased drinking frequency. Under the pressure of social interaction, drinking was the most difficult to refuse. Alcohol expectancy and drinking refusal self-efficacy have both shown notable influences on Taiwanese adolescents.