Drug prevention approaches are very varied ranging from those that target society as a whole (environmental prevention) to interventions focusing on at-risk individuals (indicated prevention). The main challenges are in matching these different strategies to target groups and contexts and ensuring that they are evidence-based and have sufficient population coverage. Most prevention strategies focus on substance use in general, some also consider associated problems, such as violence and sexual risk behaviour; a limited number focus on specific substances e.g. alcohol, tobacco or cannabis.
Environmental prevention strategies aim to change the cultural, social, physical and economic environments in which people make choices about drug use. They include measures such as alcohol pricing and bans on tobacco advertising and smoking, for which there is good evidence of effectiveness. Other strategies aim to provide protective school environments e.g. by promoting a positive and supportive learning climate and teaching citizenship norms and values (France).
Universal prevention addresses entire populations, usually in school and community settings, with the aim of giving young people the social competences to avoid or delay initiation of substance use.
Selective prevention intervenes with specific groups, families or communities who are more likely to develop drug use or dependence because they have fewer social ties and resources.
Early intervention approaches may have different goals, but generally aim to delay or prevent the onset of problems (including substance use), rather than respond when problems appear.
Indicated prevention identifies individuals with behavioural or psychological problems that predict a higher risk of substance use problems later in life and intervenes with these individuals. In most European countries, indicated prevention continues to primarily involve counselling young substance users.