Youth substance use prevention programs aim to promote abstinence from alcohol and illicit drugs and the misuse of over-the-counter drugs. They differ from treatment programs, which focus on youths who have been clinically diagnosed with a substance abuse problem. A variety of approaches have been developed that work with families, schools, and communities to help children and adolescents develop skills and approaches to prevent or reduce substance use (Griffin and Botvin, 2010; Hennessy and Tanner–Smith, 2015; Smedslund et al., 2017).
Early substance use initiation and continued heavy use can lead to numerous negative consequences (Hanson et al., 2011; Marshall, 2014; Newcomb and Bentler, 1988). Risky behaviors related to substance use include truancy or dropping out of school, unsafe sexual activity, driving while impaired, and interpersonal violence (Cherpitel, Bond, and Borges, 2003; Foran and O’Leary, 2008; DuPont et al., 2013). Additionally, harmful use of alcohol is a leading risk factor for death and disability for people ages 15 to 49 (WHO, 2014).
Rates of self-reported drug and alcohol use differ by type of substance. For example, 15.6 percent of 8th, 10th, and 12th graders surveyed for the Monitoring the Future study in 2020 reported past-year use of illicit drugs, 25.6 percent reported past-year use of alcohol, 19.1 percent reported past-year vaping, and 11.4 percent reported past-year marijuana use (Johnston et al., 2021). However, illicit drug and alcohol use has generally been on the decline since the 1980s.
This literature review focuses on initiation of substance use among children and youth. The review describes the scope of substance use among youth, risk factors that can lead to substance use, protective factors that can buffer against initiation, various types of prevention programs and outcome evidence, and limitations to the research currently available.