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Primary Prevention Interventions for Problematic Substance Use in Adolescents: A Scoping Review
D Borkenhagen1,2, S Singh3,4, G Dimitropoulos5,4
1Department of Psychiatry, University of Calgary, CWPH 4D703280 ,Hospital Dr NW, Calgary, AB, T2N 4Z6, Canada. dbborken@ucalgary.ca.
Journal of Prevention (2022)
|July 4, 2026
Summary
Primary prevention programs for adolescent substance use show mixed results. School-based interventions improve knowledge and attitudes, but sustained behavioral change evidence is limited, requiring more research on long-term outcomes.
Area of Science:
- Public Health
- Adolescent Health
- Substance Use Prevention
Background:
- Rising adolescent substance use necessitates effective primary prevention strategies.
- Existing interventions show significant heterogeneity in design and outcomes.
- A comprehensive understanding of current prevention efforts is needed.
Purpose of the Study:
- To conduct a scoping review of primary prevention initiatives for adolescent substance use.
- To document intervention formats, content, goals, and measured outcomes.
- To assess the effectiveness of various prevention approaches.
Main Methods:
- Systematic literature search of major databases (PsycINFO, ERIC, Medline, CINAHL, SocINDEX) for articles published from 2020 onwards.
- Inclusion criteria: primary prevention, adolescent age 10-19, substance use outcomes, US/Canada/Australia, English language.
- Exclusion criteria: treatment-focused studies, diagnosed substance use disorders. Data charted by two independent reviewers.
Main Results:
- 71 studies met inclusion criteria from over 24,000 records.
- Interventions were predominantly school-based, followed by digital, media, community, and policy approaches.
- Improvements noted in knowledge, attitudes, and refusal skills; behavioral outcomes were mixed and varied by intervention type and substance.
Conclusions:
- School-based interventions show promise for improving adolescent knowledge and attitudes regarding substance use.
- Evidence for sustained behavioral change from current primary prevention interventions is limited.
- Future research should focus on long-term outcomes and evaluate digital and policy-level strategies.
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