Methodology

The information presented in these webpages is based upon a systematic review of reviews, which was conducted to assess the effectiveness of policy options for addressing young people’s addictive behaviours, with an emphasis on the approaches identified through policy mapping.

Briefly, high quality systematic reviews of quantitative primary studies evaluating the effectiveness of policies or interventions were included if they were written in English, provided separate information on young people aged 25 years or under; reviewed a policy or intervention approach addressing substance use (alcohol, tobacco, illegal drugs) or gambling, or related health and social harms; and reported behavioural outcomes in young people related to substance use or gambling.

A lack of reviews specific to young people was anticipated in relation to gambling, and therefore reviews of studies in any population were eligible for inclusion and transferability of findings to young populations would be considered as part of the synthesis.

Searches were conducted using electronic databases (Medline, PsycINFO, Cochrane Library; 2000-2012), and supplemented by hand searches up until March 2013. Of the 2960 unique publications identified through these searches, 65 high quality reviews met the inclusion criteria. A bespoke framework of policies and interventions was developed using data from the surveys and literature search to review and synthesise the evidence, comprising eleven broad approaches:

  1. Control and regulation of supply
  2. Gambling/substance-free zones
  3. Age limits
  4. Taxation and pricing
  5. Control and regulation of advertising, marketing and sponsorship
  6. Warning labels
  7. Prevention programmes
  8. Treatment and social reintegration
  9. Harm reduction
  10. General delivery structures and quality assurance measures
  11. General approaches

The included review-level evidence concentrated on three areas: prevention; treatment; and harm reduction (mostly interventions to address the potential harms to children resulting from parental participation in addictive behaviours, rather than reduction of harm in young drug users).

For a complete description of project methodology, data tables, and the project report please contact the authors (h.sumnall@ljmu.ac.uk)

About the evidence presented

  • Entries under Typical measures included under this approach were identified through the policy mapping exercise or systematic review. Therefore, the list of approaches cannot be considered exhaustive, and will not include those policy actions not identified using these techniques.
  • Entries under Summary of available evidence for interventions and policies are drawn from our review of reviews. This review used strict quality criteria for study selection, considering only high quality review evidence (determined using the AMSTAR measurement tool]). Hence, for many of the approaches included under each policy type, no evidence of effectiveness was identified. Although individual primary studies may be of high quality and suggest an effective approach or intervention, if this study was not included in a high quality review then it is not included here. Key reviews from which this evidence is drawn from are cited under each summary.

Interpretation of evidence summary categories

Definition of evidence categories is based on those used by the EMCDDA in the Best Practice Portal

  • Beneficial – Interventions and approaches that the review team concluded showed robust evidence for positive effects on addictive behaviours. Research evidence for the intervention or approach is likely to be transferable to young people in other geographies
  • Likely to be beneficial – Interventions and approaches that the review team concluded that there was some, but limited, evidence for positive effects on addictive behaviours. Research evidence for the intervention or approach is likely to be transferable to young people in other geographies but caution is warranted and adaptation studies are recommended.
  • Mixed evidence – Interventions and approaches for which the review team concluded there was some evidence of positive effects in favour of the intervention, but that also showed some limitations or unintended effects that would need to be assessed before implementing them further.
  • Unknown effectiveness – Interventions and approaches for which the review team concluded there were not enough studies to demonstrate positive effects on addictive behaviours, or where available studies were of low quality (with few participants or with uncertain methodological rigour), making it difficult to assess if they were effective or not. NB cited ‘Typical approaches’ that do not appear in other evidence summary categories should be assumed to be of unknown effectiveness.
  • Ineffective – Interventions and approaches for which the review team concluded produced negative effects on addictive behaviours when compared to a standard intervention or no intervention. For ethical reasons, it must be considered whether such interventions and approaches should be discontinued as they may have iatrogenic effects (i.e. they increase a behaviour that is trying to be prevented).