C. Healthy Living · Healthy Living: Informed Choices for Body, Mind and Relationships

Under the Influence of Others: Social Factors, Substances and Addictive Behaviours

C3.4About 75 minutes

Learning goals

I can describe social factors that may influence the use of substances such as prescription drugs, alcohol, tobacco, chewing tobacco, nutritional supplements and performance-enhancing drugs.
I can describe social factors that may influence behaviours leading to addictions, such as gambling, gaming and eating disorders.
I can use a decision-making model to respond to these influences.
I can use communication and refusal skills to respond effectively to pressure.

Words to know

social influence
The effect other people, groups and media have on what we think and do.

peer pressure
Influence from people your age. It can be spoken ("Just try it") or unspoken (wanting to fit in).

social norm
What people believe is normal or expected in a group. Teens often overestimate how many peers use substances.

prescription drug misuse
Taking a medication not prescribed for you, or in a different way or amount than prescribed.

performance-enhancing drug (PED)
A substance used to try to improve athletic performance or appearance, such as anabolic steroids. Many are banned in sport and harmful to health.

nutritional supplement
A product like protein powder, creatine or a vitamin pill taken in addition to food. Most teens who eat well don't need them.

eating disorder
A serious mental illness involving harmful eating behaviours and thoughts about food, weight and body shape, such as anorexia nervosa, bulimia nervosa and binge-eating disorder.

refusal skills
Ways to say no clearly and confidently while keeping your relationships, like stating no, giving a reason, offering an alternative, and leaving.

A note before you start

This lesson covers substances and behaviours that can lead to addiction, including eating disorders, which are serious mental illnesses. If any of it is close to home, talk to a trusted adult or contact Kids Help Phone (1-800-668-6868) or ConnexOntario (1-866-531-2600).

Who's really making the choice?

A streamer you watch opens loot boxes on every stream. A team captain says the senior players "all take something" to bulk up. A cousin offers you his leftover pain pills for a sore shoulder. A sports-betting ad shows friends cheering a win. Each one is a social influence.

The Grade 9 curriculum asks you to describe social factors that may influence substance use (e.g., use of prescription drugs, alcohol, tobacco, chewing tobacco, nutritional supplements, performance-enhancing drugs) or behaviours leading to addictions (e.g., gambling; video, Internet, or computer gaming; eating disorders), and explain how decision-making and communication skills can be used to respond effectively to these influences (C3.4).

Remember from Grade 8

In Grade 8 you learned the warning signs of problematic substance use, gaming and gambling, and where to get help in Ontario. In the last lesson you saw how protective and risk factors shape choices. Now: the social pressures themselves and the skills to respond.

Eight social factors that push and pull on choices about substances and addictive behaviours. Naming the influence is the first step to deciding for yourself.

Substance or behaviour	Social influences	Key facts
Prescription drugs	Easy to find in home cabinets; belief that "a doctor prescribed it, so it's safe"; using stimulants to study	Medication is safe only for the person and dose it was prescribed for. Pills from friends or the street may be fake and contain fentanyl. Return unused medication to a pharmacy.
Alcohol	Parties, family celebrations, ads, movies	Legal age in Ontario is 19. Alcohol affects judgment and coordination; binge drinking can cause alcohol poisoning.
Tobacco and vaping	Flavours, friends, social media	Nicotine is highly addictive. Legal age in Ontario is 19.
Chewing tobacco	Some sports cultures (e.g. baseball traditions), role models	Still contains nicotine and is addictive; causes gum disease and can cause mouth cancer. Not a safe alternative to smoking.
Nutritional supplements	Gym culture, influencers, ads promising fast muscle	Most teens who eat well don't need them. Products may not contain what the label says, and some have been found to contain banned substances.
Performance-enhancing drugs (e.g. anabolic steroids)	Pressure to win, to get a scholarship, or to look muscular	Can cause acne, mood changes, liver damage and hormone problems, and can stop teens from reaching full adult height. Banned in sport.
Gambling (including sports betting)	Ads, friends betting, apps, loot boxes	Legal age in Ontario for casinos, online casino games and sports betting is 19. The odds favour the operator; chasing losses is a warning sign.
Gaming	Friends online, streamers, rewards built into games	The World Health Organization recognizes gaming disorder as a health condition.
Eating disorders	Diet culture, "perfect body" images, comments about weight, some sports with weight classes or a focus on appearance	Serious mental illnesses that can affect anyone. Early help matters. NEDIC (National Eating Disorder Information Centre, nedic.ca) offers support.

Substances and behaviours named in C3.4, with common social influences and key facts.

Myth: "Everyone's doing it"

Teens often overestimate how many of their peers use alcohol, cannabis or vapes. Ontario student surveys by the Centre for Addiction and Mental Health (CAMH) have found that most students your age do not use these substances. When you know the real norm, the pressure shrinks.

A six-step decision-making model. Under pressure you can run through it in a few seconds; for bigger choices, take your time.

Communication skills that work

Refusal skills (the "no" toolkit):

Say no clearly: "No thanks."
Give a reason (optional): "I've got a game tomorrow." "Not my thing."
Suggest an alternative: "Let's get food instead."
Repeat if needed (the "broken record").
Leave if pressure continues. Have an exit plan (text a parent a code word for a pickup).

Assertive communication: calm voice, eye contact, standing tall. "I" statements: "I'm not into that."

Talking to an adult: asking a doctor, pharmacist or coach a question ("Do I actually need protein powder?") is a communication skill too.

Supporting a friend: "I've noticed you're betting a lot. Are you okay?" Speak with care, not blame.

Worked example

Let's use the decision-making model on supplements

Nate, 15, plays football. An older teammate says, "Take this pre-workout and this other powder; it'll make you way bigger. Everyone on senior does." Walk through the model.

1. Stop: "I'm deciding whether to take an unknown supplement."
2. Options: take it; say no; ask the coach or a doctor first; focus on food, sleep and training instead.
3. Weigh: unknown ingredients could include stimulants or banned substances; possible health risks; could break sport rules. Asking first or focusing on training has no downside.
4. Values: "I want to play fairly and stay healthy for years."
5. Act: "Thanks, but I'm going to ask Coach first." He asks the coach and his doctor.
6. Reflect: he learns that good food (enough protein and carbohydrates), sleep and a training plan work for teens.

The model turns pressure into a reasoned choice. Communication skills (a clear refusal and asking an adult) carry it out.

Worked example

Let's respond to gaming and gambling pressure

In a group chat, friends are hyping a sports-betting app: "Use your brother's account, easy money!" How can Aisha respond?

Name the influence: peers plus advertising.
Facts: she's under 19, so it's illegal for her to bet; using someone else's account breaks the rules; gambling isn't "easy money" because the odds favour the operator.
Refusal: "Nah, I'm out. I'd rather keep my money."
Alternative: "Who's in for a pickup game Saturday?"
Care for friends: if a friend seems hooked (chasing losses, borrowing money), she can talk to them privately and suggest ConnexOntario or a trusted adult.

Clear facts plus a short, friendly refusal and an alternative keep both her values and her friendships.

Hands-on activity

Script and rehearse

You need: a family member or friend, and paper.

Write three pressure lines you might hear (e.g. "Just one sip", "Try my vape", "Take this pill, it helps you focus").
For each, write a response using all five refusal steps.
Role-play each scene twice: once with a calm partner, once with a pushy partner who repeats the pressure.
Agree on a family code word you can text to be picked up, no questions asked that night.

What to look for: a clear "no" in the first sentence, confident body language, a realistic alternative, and an exit plan.

Your turn

Name four social factors that can influence substance use.

What is prescription drug misuse? Give an example.

Why isn't chewing tobacco a safe alternative to smoking?

List the five refusal steps.

Name two health effects of anabolic steroids.

What is the legal age for sports betting in Ontario?

Name two social influences linked to eating disorders.

More practice: warm-up

Is nicotine addictive?

Do most teens who eat well need supplements?

What's the first step of the decision-making model?

True or false: most Ontario students your age use alcohol, cannabis or vapes.

Where should unused prescription medication go?

More practice: on your own

Explain how loot boxes in games connect gaming and gambling.

Write an assertive response to: "Come on, just one drink, it's a party!"

A teen believes pills from a friend are safe because "they're real prescription pills." Explain the risks.

How can media influence eating disorders, and how can someone respond?

Why is "suggest an alternative" an effective refusal step?

Challenge

A coach hints that athletes who "want it badly enough" will find "extra help" to bulk up. Analyse this social influence and plan a response using decision-making and communication skills.

Compare how social influences differ for alcohol and for gaming, and suggest one communication strategy for each.

Design a short social-norms poster campaign for your school to reduce vaping. Explain why it would work.

Check your understanding

Quiz

Which is an example of a social influence on substance use?

Which is prescription drug misuse?

Chewing tobacco...

Which is the best first refusal step?

Teens often believe more peers use substances than really do. This is called...

Which is a recognized behavioural addiction named by the World Health Organization?

Eating disorders are best described as...

For parents and teachers

About this content: This lesson covers C3.4 and quotes its wording and examples (prescription drugs, alcohol, tobacco, chewing tobacco, nutritional supplements, performance-enhancing drugs, gambling, gaming and eating disorders). No humour block is included.

Facts used: Ontario legal age 19 for alcohol, cannabis, tobacco and vaping, casinos, online casino games and sports betting; WHO recognizes gaming disorder (ICD-11); CAMH's Ontario Student Drug Use and Health Survey finds most Ontario students do not use alcohol, cannabis or vapes; counterfeit pills may contain fentanyl. Help: ConnexOntario 1-866-531-2600; Kids Help Phone 1-800-668-6868; NEDIC (nedic.ca).

How to help at home:

Agree on a no-questions-asked pickup code word.
Lock up and dispose of unused medications.
Avoid commenting on bodies and weight (yours or theirs); focus on strength, energy and health.
If your teen is asking about supplements, talk with your doctor or a registered dietitian.

Common difficulties: thinking prescription or "natural" means safe; believing everyone uses; long, wavering refusals that invite more pressure.