Drugs, illicit - primary prevention strategies

The use of tobacco, alcohol and other drugs is the predominant cause of the burden of disease in developed countries, including mortality excess, and wide-ranging effects on personal safety, mental health, and social well-being. This article identifies the programs, interventions, and policies effective for preventing tobacco and drug use, and alcohol misuse. Systematic reviews, reports of international agencies, and guidelines of preventive practice were searched. The Cochrane Library, the Medline database and the websites of NICE, CDC, European Union, WHO, SIGN, NIDA, and EMCDDA were explored. Bans and restrictions for tobacco and alcohol use, school-based comprehensive social influence programs, and family programs for selected populations appear to be effective. Mass media campaigns can be effective in reducing tobacco use, especially when associated with school-based and community programs. The availability of data on effectiveness of interventions is far from satisfactory, particularly for interventions at a population level. However, the evidence collected so far is sufficient on which to base effective public health policies. © 2008