Involvement in pro-social activities, particularly religious services during adolescence, has been robustly identified as a deterrent to onset of substance use, particularly alcohol.1–11 The first effects of religiosity on substance use are likely to be embedded in early religious behaviors, typically during childhood and adolescence, and often involving familial practices. However, religious attendance tends to decay into adulthood, becoming more related to personal devotion.5 The role of religious involvement in the etiology of alcohol use and misuse is particularly intriguing. This influence may involve specific proscriptions against alcohol use in certain religious denominations (eg, Seventh Day Adventists) or it may be generally protective against deviant behavior through prosocial community level involvement. The associations between religiosity, both childhood and adult, and alcohol-related problems are also not well understood, even though self-help groups such as Alcoholics Anonymous incorporate elements of spiritual belief into their therapeutic framework.12
