Effective Refusal

Nancy Reagan’s 1982 “Just Say No’ campaign reached far and wide, even landing on my radar as a 12 year old (I’ll let you do the math). However, despite its catchphrase and good intentions, the evidence suggests that telling students to ‘just say no’ is ineffective and, coupled with scare tactics about the dangers of hard drugs, might even steer teenagers towards milder substances such as tobacco and alcohol.


In today’s #HealthEd classes our equivalent message comes from NHES standard 4 in which we provide our students with the opportunity to develop their interpersonal skills to enhance health and avoid or reduce health risks. Specifically NHES 4.12.2 asks students to demonstrate refusal, negotiation and collaboration skills.

The awesome Lesson Planning for Skills-Based Health Education book from Sarah Benes and Holly Alperin lays out their refusal skills with a clever acronym:

  • I statement
  • State a reason
  • Assertive voice
  • You are in control
  • N – The clear and direct “N O” statement
  • Options (what else can you do: leave the situation, get help)

For me, the best way to practice and assess these skills is through role play and a 2002 study from psychologist Pim Cuijpers of the Netherlands Institute of Mental Health and Addiction in Utrecht found that the most effective drug education programs “teach students the social skills they need to refuse drugs and give them opportunities to practice these skills with other students—for example, by asking students to play roles on both sides of a conversation about drugs, while instructors coach them about what to say and do.”


Saying no to temptation can help us stay on track if we are hoping to improve our heath behaviors. In addition to being central to our refusal strategies, saying no also plays a crucial role in goal setting (NHES 6) and decision making (NHES 5). An effective refusal helps our students in the short term (the semester that they’re with us?) and the long term (the rest of their lives).

I’ve previously blogged about how my school uses our own YRBS data to inform us of trends in student risk behavior and information from our survey tells me that the most common reasons given for saying no to alcohol include:

  • Wanting to be in control of their actions
  • It might affect their grades or their future
  • It goes against parent rules and expectations
  • It’s illegal
  • It breaks school code
  • I might lose my license


What if I told you there was a better way to say no? A more improved no. A more effective no. A no that’s so effective, it’s been proven to significantly increase the likelihood of you making a more healthy choice.

A 2012 study looked at two groups of students, one group were instructed to say “I can’t” when faced with temptation. The second group were instructed to say “I don’t”. Did you notice the subtle difference there? I can’t v I don’t.

When faced with the offer of a treat – a chocolate candy bar or a more healthy granola bar, the “I can’t” subjects chose a candy bar 61% of the time. The “I don’t” subjects chose the chocolate bar 36% of the time. That’s a significant difference in health-related behavior and it was caused by a simple change in the language used.

If you were wondering if that short term change in behavior was significant, consider these additional findings from the study. The researchers wondered if the way that we say no would also make it more likely that we would stick to our health goals and avoid the unhealthy alternatives.

A second study was created was created in which three groups of women were created and told to set a health and wellness goal. When faced with the temptation to break their goal one group was told to  “just say no”. A second group was told to say “I can’t”, while the third group were told to say “I don’t”. The results were impressive!

  • Group 1 had a success rate of 30% (just say no)
  • Group 2 had a success rate of 10% (I can’t)
  • Group 3 had a success rate of 80% (I don’t)

The theory behind this simple linguistic change is that when our students say “I can’t drink alcohol because it breaks academic code” they are reminding themselves that their behavior is being constrained. Effectively they are suggesting to themselves that they are being forced to do something.

When our students say “I don’t drink alcohol because it might affect my grades” they are reminding themselves that they are in control over the situation presented to them.

“I don’t” is a choice. I’m choosing not to give in to temptation. “I can’t” isn’t a choice. It’s a restriction. “I don’t” empowers our students, which inevitably increases their self-efficacy their belief in their ability to succeed in specific situations or accomplish a task.

Untitled Design (1)

How will you empower your students with the power of “I don’t”? Imagine being able to provide your students with this simple hack that makes it more likely that they’ll refuse temptation and remain in control of their physical and mental health.

I was inspired to write this blog by this article from James Clear who wrote the awesome book entitled Atomic Habits . It was selected as one of our #slowchathealth books of the month in November 2018. Clear’s article cites Heidi Grant Halvorson who is the author of Succeed: How We Can Reach Our Goals, which also looks like a good read.

If you liked this #slowchathealth blog post you might also like:

Self Efficacy and our Students – in which I shared my thoughts on the role of self-efficacy in the #HealthEd classroom.

Use of Language in the #HealthEd Classroom – in which I encourage teachers to think carefully about how they say what they say.

Book of the Month – Check out these great reading recommendations from educators.

This blog post was one, of many, that inspired me and helped shape the message of my October 2019 TEDx talk:

4 thoughts on “Effective Refusal

  1. Pingback: #Rewire | #slowchatPE

  2. I attended an Assertiveness Course many years ago. I learned that it is okay to say NO and that I don’t have to aplogise for saying No or even given a reason. I don’t do drugs or alcohol …..I just say NO THANKS and leave it at that.


  3. Pingback: Does Health Class Have an Image Problem? – #slowchathealth

  4. Pingback: This Is Not Your Parents’ Health Class – #slowchathealth

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