Associations of Health Belief Model Constructs and Self-Control with Drug Avoidance Intention Among University Students in the Republic of Korea: A Cross-Sectional Study

Drug use among young adults in the Republic of Korea has increased sharply, yet prevention at the university level remains limited, and the determinants of drug avoidance intention are poorly understood. Guided by the Health Belief Model extended with self-control, this study examined the associations of five health belief constructs and self-control with drug avoidance intention. A cross-sectional online survey was conducted among 280 university students aged 19–26 years. Drug avoidance intention, health beliefs, and self-control were assessed using validated instruments. Hierarchical multiple linear regression was used to test the hypothesized associations, and exploratory indirect-effect analyses were conducted for each Health Belief Model construct using 5000 bootstrap resamples, with robustness models adjusting for the remaining constructs. The mean drug avoidance intention score was 4.22, and the final model explained 58.5% of the variance. Drug refusal self-efficacy, perceived severity, perceived benefits, and self-control were positively associated with drug avoidance intention, whereas perceived barriers were negatively associated; perceived susceptibility, for which no directional hypothesis was specified, was not significant. Exploratory robustness analyses indicated indirect associations through self-control for perceived susceptibility and perceived benefits after adjustment for the remaining Health Belief Model constructs. These findings indicate that drug avoidance intention was associated with both health beliefs and self-regulatory capacity. Longitudinal and intervention studies are needed.