Abstract: Objective To assess the efficacy of "cognition-skill-coping style-self efficacy" program on prevention of drug abuse among middle school students in city and countryside of Guangxi.Methods Four general middle schools were randomly selected in Baise city,and every class was randomly assigned to the intervention and control groups.The intervention groups received a prevention and intervention program.A pretest and post-test self-administered questionnaire was used to evaluate the effectiveness of the prevention program.Results There was no significant difference in gender,living condition and singleton between intervention and control groups.Before the intervention,no significant difference was found on cognition,coping style,general self-efficacy and resistance skills.After the intervention,immediate effects of the intervention were found on cognition,coping style,general slf-efficacy and resistance skills,but there was no clear evidence for any effect on substance use.Conclusion The prevention program enhanced the cognition,self-efficacy and ability of coping with pressure and resistance on drug abuse,as well as improved resistance skills on companion's pressure among students in middle school.