<![CDATA[Background: Alcohol consumption among adolescents is an important public health concern due to its adverse physical, psychological, and social consequences. The Health Belief Model (HBM) provides a theoretical framework for understanding health-related behaviors based on individual perceptions and beliefs. This study aimed to analyze the relationships among HBM constructs and non-alcohol consumption behavior among adolescents. Subjects and Method: A case control study was conducted in Surakarta, Central Java, Indonesia, from May to June 2025. A total of 200 adolescents aged 15–19 years were recruited, consisting of 100 adolescents who had consumed alcohol and 100 who had never consumed alcohol. Participants were selected using fixed disease sampling. Data were collected using a structured questionnaire measuring perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, self-efficacy, and alcohol consumption behavior. Data were analyzed using path analysis. Results: Non-alcohol drinker behavior was negatively associated with high perceived susceptibility (β= −0.02; 95% CI= −0.05 to −0.01; p= 0.044). It was positively associated with strong self-efficacy (β= 0.98; 95% CI= 0.94 to 1.02; p<0.001). Non-alcohol drinker behavior was positively associated with strong cues to action, but it was statistically non-significant (β= 0.03; 95% CI= −0.01 to 0.07; p= 0.190). Self-efficacy decreased with high perceived severity (β= −0.08; 95% CI= −0.13 to −0.03; p= 0.002) but increased with high perceived barrier (β= 0.5; 95% CI= 0.93 to 0.96; p<0.001). Non-alcohol drinker behavior was indirectly associated with self-efficacy through cues to action (β= 0.98; 95% CI= 0.83 to 1.13; p<0.001). Conclusion: Strong self-efficacy was an important factor associated with non-alcohol drinker behavior among adolescents. Strengthening adolescents’ confidence to refuse alcohol and increasing awareness of alcohol-related risks may support alcohol prevention efforts.]]>
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