Considered a set of neuro-cognitive skills, executive cognitive function (ECF) may serve to protect children from initiating substance use, although its role relative to other protective influences that parents and physical activity might provide is not known. As part of a large multiple health risk behavior trial for prevention of substance use and obesity, Pathways, the present study evaluated the relative impact of ECF on lifetime substance use (tobacco and alcohol) and physical activity in a panel of fourth grade children over a 6-month period (N = 1005; 51 % female; 25 % on free/reduced lunch; 60 % Hispanic/Latino or multi-racial; 28 elementary schools). A self-report survey included measures of ECF, lifetime tobacco and alcohol use, out-of-school physical activity, exercising with parents, and parent rules about food/sedentary behavior, monitoring, and arguing, was adapted for use with children. A path analysis demonstrated that ECF was the major predictor of lower substance use and higher physical activity and exercising with parents. Physical activity and exercising with parents showed reciprocal positive relationships. Findings suggest that promoting ECF skills should be a major focus of child health promotion and substance use prevention programs, although the potential protective effects of physical activity and exercise with parents on substance use in this young age group are not yet clear.
Trial registration: ClinicalTrials.gov NCT00787709.