Prevention programmes

Section title

Prevention programmes

Brief definition of policy approach

Prevention programmes implemented with schools pupils, families and/or communities

Description of policy approaches

Prevention programmes are usually implemented with schools pupils, families and/or communities. This approach includes a wide range of activities, such as structured, manualised programmes (e.g., drug education curriculum) and interventions tailored to the individual needs of participants (e.g., counselling); activities with a specific drug/addiction prevention focus and those that promote health more generally. For gambling, self- and operator-imposed exclusion are included. It is not always possible to distinguish clearly between indicated prevention and treatment along the continuum of care. As a general rule, we considered an intervention to be treatment if it was carried out with a population that was treatment-seeking or met diagnostic criteria for dependence, and prevention if it was carried out with an unselected/’at risk’ population. Where interventions may be carried out with either population, these are listed in both sections (i.e., prevention and treatment).

Typical measures included under this approach

  1. General prevention programmes
    • All behaviours – health promotion; general risk reduction programmes; universal, selective, and indicated prevention
    • Illegal drugs – interventions addressing non-medical use of prescription medicines
  2. School and higher education based prevention
    • All behaviours – ‘Healthy schools’ (i.e., multi-component school programmes to promote child health and wellbeing in several areas); environmental or classroom management programmes
    • Alcohol – school based programmes; institutional policies prohibiting use; college student normative education
    • Tobacco – school based programmes; institutional policies prohibiting use; non-smoking ‘competitions’
    • Illegal drugs – school based programmes; school drugs policies; drug testing in schools
    • Gambling – school based programmes; safe Internet use programmes
  3. Family based prevention
    • All behaviours – Family home visitation with disadvantaged families
    • Alcohol – family support; family skills training
    • Tobacco – family based prevention
    • Illegal drugs – family and parenting programmes, information on drug harms, parenting skills, early years education and care
    • Gambling – parental control tools
  4. Community based and multicomponent prevention
    • Alcohol – Multicomponent or community-based programmes
    • Tobacco – Multicomponent or community-based programmes
    • Illegal drugs – Multicomponent or community-based programmes
    • Gambling – No approaches identified
  5. Mass media approaches
    • All behaviours – Nation-wide awareness-raising activities / Information-based public education campaigns; social marketing; media advocacy; national telephone support
  6. Computer and web based prevention
    • All behaviours – Computer- and web-based interventions
    • Gambling – In-game messaging
  7. Mentor and peer led prevention
    • Alcohol – Mentoring and peer-led learning/information projects and initiatives
    • Tobacco – No approaches identified
    • Illegal drugs – Mentoring and peer-led learning/information projects and initiatives
    • Gambling – No approaches identified
  8. Leisure time
    • Alcohol – Approaches addressing the night-time economy
    • Tobacco – No approaches identified
    • Illegal drugs – Interventions in the night-time economy; outreach prevention programmes; alternative leisure activities
    • Gambling – Information and counselling services on gambling premises; reality checks (displaying at regular intervals information about the amount of time and money a player has spent on a machine); self-defined time limitations; self-exclusion; operator based exclusion; time-limited locking of online gambling accounts; self-assessment tool to judge risk of problematic gambling
  9. Targeted prevention, including prevention in health care settings
    • Alcohol – programmes in health care services; screening/referral; brief intervention/early intervention
    • Tobacco – health care services for prevention; screening/referral; brief interventions
    • Illegal drugs – screening; brief intervention/early interventions; motivational interviewing
    • Gambling – referral; brief interventions
  10. Workplace based prevention
    • Alcohol – Workplace policies; mandatory screening
    • Tobacco – Workplace policies; smoking cessation activities
    • Illegal drugs – Workplace policies; mandatory screening; employee assistance programmes
    • Gambling – No approaches identified
  11. Criminal justice based interventions
    • Alcohol – No approaches identified
    • Tobacco – No approaches identified
    • Illegal drugs – drug education in criminal justice settings
    • Gambling – No approaches identified
  12. Specific delivery structures and quality assurance measures
    • Alcohol – Community alcohol action plans; statutory inclusion of education in national school curriculum; sanctions/penalties for students in breach of institutional policies; public funds ring-fenced for prevention; professional standards and guidelines; workforce development; public official specialists
    • Tobacco – ring-fenced funding for tobacco prevention; workforce development
    • Illegal drugs – enforcement in school setting; standardisation of prevention interventions; workforce development
    • Gambling – due diligence obligation from online gambling industry; post licensing monitoring; public funds ring fenced for prevention; workforce development

Summary of available evidence for interventions and policies

  1. Beneficial
    • No evidence identified
  2. Likely to be beneficial
    • Universal programmes such as the Good Behavior Game; Life Skills Training; and Unplugged in reducing alcohol misuse
    • Universal family based programmes in producing produce small medium to long term reductions in alcohol misuse
    • Web based and individual face-to-face feedback in reducing alcohol misuse up to 3 months after intervention
    • Brief motivational interviewing in producing short and medium term reductions in tobacco use
    • Multisectoral (including the school) and community based interventions at preventing tobacco use, particularly when delivered with high intensity and based on theory
    • Addition of media based components (supporting the core curriculum) to school based education at preventing tobacco use
    • Pre-school, family based programmes in producing long term reductions in the prevalence of lifetime or current tobacco use, and lifetime cannabis use
    • Multisectoral programmes with multiple components (including the school and community) in reducing illegal drug use
    • Motivational interviewing in producing short term reductions in multiple substance use
    • Some skills-development-based school programmes in preventing early stage illegal drug use
  3. Mixed evidence
    • Whole school approaches that aim to change the school environment on use of multiple substances
    • Pre-school, family based programmes showed mixed effects on alcohol use in later adult life
    • Manualised universal community based multi-component programme targeting alcohol misuse
    • Universal school based tobacco prevention programmes
    • Community based tobacco prevention programmes were more likely to be effective when delivered in combination with a school based programme
    • Mass media approaches to tobacco prevention, or the addition of mass media components to community activities
    • Some social influence programmes can produce short term reductions in cannabis use, particularly in low risk populations
    • Parental programmes for parents designed to reduce use of multiple substances by young people. Where effective, programmes included active parental involvement, or aimed to develop skills in social competence, self-regulation, and parenting skills
  4. Unknown effectiveness
    • Universal family based programmes for the prevention of illegal drug use
    • In-game gambling warning messages for the prevention of problematic gambling
  5. Ineffective
    • Mailed, group feedback, and social marketing based approaches to reduce alcohol misuse
    • Web and computer based interventions to prevent tobacco use
    • Universal family based programmes to prevent tobacco use
    • Use of competition incentives to prevent tobacco use in school children
    • Ethnically tailored tobacco prevention is ineffective in indigenous youth
    • School based curricula designed to increase knowledge about illegal drugs has no effect on use
    • Recreational/diversionary activities, and theatre/drama based education to prevent illegal drug use
    • Community based interventions to prevent illegal drug use
    • Mentoring programmes have no short or long term preventative effects on illegal drug use
    • Mass media programmes targeting illegal drug use
    • School based gambling programmes have no effect on gambling behaviour

Key Reviews

Fletcher et al., 2008; Jackson et al., 2012; Foxcroft et al., 2011; Carson et al., 2012; Faggiano et al., 2005; Johnston et al., 2012; Brinn et al., 2010; Carson et al., 2011; Thomas et al., 2013; Ranney et al., 2006; Müller-Riemenschneider et al., 2008; Petrie et al., 2007; D’Onise et al., 2011; Foxcroft and Tsertsvadze, 2011; Gates et al., 2006; Thomas et al., 2011; Moreira et al., 2009; Brinn et al., 2011; Hettema and Hendricks, 2010; Myung et al., 2009; Civljak et al., 2010; Hutton et al., 2011Full set of evidence tables (PDF)