Similar findings were observed for daily cigarette smoking (Xiao et al., 2008). In a prospective study, nondrinkers who exhibited emotional decision deficits were more likely to progress to binge drinking over a year��s time than were those without deficits, supporting the conclusion that emotional decision capacity is a critical thenthereby determinant of substance abuse vulnerability (Xiao et al., 2009). Functional magnetic resonance imaging studies have provided support for the role of candidate orbitoprefrontal cortex and midbrain region involvement in the observed behavioral deficits, and these differences in brain function predict daily smoking and binge drinking (L. Xiao, A. Bechara, P. Palmer, & C. A. Johnson, in preparation).

Implications The research strongly suggests that advancement on smoking and alcohol use trajectories is multiply and interactively determined by individual, biological, and behavioral characteristics and the social environment. Strategies for prevention of tobacco and alcohol abuse should take into account the separate and potentially interactive influences. It is scientifically and logically fallacious to conclude that ��prevention does not work�� or equally that ��prevention works.�� Some prevention programs can and do work, conditional upon circumstance and constitution. The role of prevention science should be to identify catalytic and inhibitory agents in the biobehavioral and environmental realms and test ways to take advantage of these so as to produce more reliable, profound, and sustainable prevention effects.

Future research Current and planned research pursues potential catalysts and inhibitors of program effects. An ongoing trial is designed to elucidate underlying processes in the observed dispositional phenotype �� program effects interactions and to test cognitive and behavioral strategies for addressing critical characteristics. One critically hypothesized construct is social competence and/or the autism spectrum. Deficits in capacity for social perception and action, akin to emotional decision processes, may be a key ingredient. The current trial intervenes both individually and through environmental manipulations, some mediated by new technologies, to enhance students�� social decision and behavioral capacity and assesses the success and effects of these interventions on tobacco and alcohol abuse trajectories.

In an attempt to clarify the underlying genetic basis for program by dispositional phenotype interactions, the TTURC plans to genotype an additional 44,000 SNPs in 750 male students from the Wuhan Prevention Trial. These SNPs include 3,713 tag SNPs in 348 candidate genes, including several nicotinic receptors and other genes involved in the addictive Cilengitide process. In addition, more than 40,000 SNPs are implicated in a genome-wide scan of nicotine dependence by the NICSNP consortium (Bierut et al., 2007). The TTURC expects to finish the genotyping and analysis of these SNPs by summer 2009.