Refusal Assertion Versus Conversational Skill Role-Play Competence: Relevance to Prevention of Tobacco Use

Document Type



Community and Global Health (CGU)

Publication Date



Medicine and Health Sciences | Mental and Social Health | Psychology | Social and Behavioral Sciences | Substance Abuse and Addiction


Conversational and refusal assertion skills of 768 seventh grade youth were assessed through ratings of global (for example, effectiveness) and non-verbal (for example, eye contact) behaviour performed in two role-play scenarios. The ratings were completed after each scenario by the subjects themselves, as well as by classmate and trained adult observers. Use of the Hays and Hayashi multitrait scaling method to interpret these data revealed two results. First, the items used to measure role-play behaviour did not achieve sufficient internal consistency to create global and non-verbal composites. Second, inter-rater agreement and discriminant validity were obtained only for ratings of the global effectiveness of each of the two social skills. Next, a series of multiple regression analyses indicated that an index of the global effectiveness of refusal assertion skill, but not of conversational skill, was predictive of intention to use tobacco. Those who were relatively unskilful at refusing offers were more likely to intend to use tobacco. Analyses exploring relations of trained observer ratings of the effectiveness of both role-play types, trained observer ratings of the other global and non-verbal items, and subjects' intention to use tobacco indicated that only a hesitant voice pattern was both negatively predictive of effective refusal assertion and positively predictive of intention to use tobacco in the future. In other words, those who are hesitant when they refuse a tobacco offer are the ones most likely to report an intention to use tobacco in the future. The consistency of this last finding in the tobacco use prevention literature is discussed.

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© 1993 John Wiley & Sons, Ltd.