Substance Abuse Prevention: Theory, Practice, and Effectiveness

Interventions developed to reduce or prevent substance use have taken many forms, including school-based prevention/education programs, mass media campaigns, youth clubs and activities designed as alternatives to substance use, and community-based movements. Evaluation studies indicate that these interventions have frequently increased knowledge and awareness and have occasionally had an impact on attitudes and other drug-related variables. However, rarely have any of these interventions had an impact on substance-use behavior. A major exception is a class of school-based primary prevention approaches that focus on the key psychosocial factors promoting adolescent substance use. These approaches include either resistance-skills training alone or in combination with life-skills training. Although the evolution of these programs is an encouraging development in a field replete with failures, the extant empirical and theoretical literature suggests the need for a comprehensive prevention strategy that combines school-based interventions with those affecting the family, social institutions, and the larger community. Considerably more research is needed both to develop effective prevention components for such a comprehensive approach and to determine the most appropriate combination of components.