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The present study examines the role of self-esteem (SE) in the prediction of drug and alcohol use. Consistent with research on the theory of reasoned action, we suggest that alcohol and drug attitudes and subjective norms are more useful in the prediction of self-reported drug and alcohol consumption than SE. In the present study, measures of SE, drug attitudes, subjective norms, and drug use behaviors were collected from 2,074 high school and college students. Results indicate that drug attitudes and subjective norms do predict drug and alcohol use, but that SE does not add significantly to the prediction of the drug and alcohol behaviors.

Although a causal connection between self-esteem and drug use might make intuitive sense, a critical evaluation of the research calls this relationship into question. The most fatal flaw in the “low self-esteem causes drug use” argument is the fact that only a very small proportion of the variance in drug use is associated with self-esteem across a variety of definitions of self-esteem. In addition, the literature is fraught with methodological and statistical problems that severely limit the conclusions that can be drawn. Methodological problems examined in the article include: measurement of self-esteem, measurement of drug use and abuse, inclusion of confounding variables, and tendency to infer causality from correlational data. Statistical problems explored are: differences between the results of studies employing multivariate and bivariate statistics, failure to report strength of association indices, inflated experimentwise error rate when conducting numerous statistical analyses, failure to collapse several highly correlated variables into fewer factors, tendency to misinterpret statistical data, and reporting insufficient statistical information to allow readers to draw their own conclusions. We conclude that the scientific evidence relating self-esteem and drug use is insufficient to justify making self-esteem enhancement the cornerstone of drug prevention efforts.

If adding mecamylamine to nicotine replacement therapy (NRT) improves the chances of success at stopping smoking, the results of this study suggest that the effect is very small.