Defining Effective Drug Prevention Programs: What Works?
Tobler Research Associates conducted a systematic review of studies examining the
effectiveness of tobacco and substance abuse prevention programs. The Robert Wood
Johnson Foundation (RWJF) provided support for the study through a contract with
Tobler.
Under the contract, investigators conducted three separate meta-analyses examining:
 207 evaluations of school-based substance abuse prevention programs
 99 evaluations of non-school-based programs
 51 evaluations of family interventions that measured aggression and conduct disorder
— two commonly used predictors in studies of young-adolescent substance abuse
Among the investigators' findings, as reported in the Journal of Primary Prevention, are
the following:
 Interactive programs — which foster interpersonal skills and active engagement
between students and teachers — are more effective than noninteractive programs
— which are lecture oriented and stress drug knowledge. Interactive programs are
more effective at reducing, preventing or delaying adolescent drug use for all
substances combined and for each substance individually — tobacco, alcohol and
marijuana).
 As the number of participants in an interactive program increases, the program's
effectiveness decreases. Non-interactive programs are only marginally effective at
any size, yet are used in 90 percent of U.S. schools.
 Many of the reports that list "evidence-based best practices" or "research-based
model programs" include programs for which evidence of effectiveness is of
questionable quality or lacking altogether.
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Findings
The following findings were reported in the Journal of Primary Prevention (summer
2000).
 Interactive programs — which foster interpersonal skills and active engagement
between students and teachers — are more effective than noninteractive programs,
which are lecture oriented and stress drug knowledge. Interactive programs are
more effective at reducing, preventing or delaying adolescent drug use for all
substances combined and for each substance individually — that is, tobacco,
alcohol and marijuana).
 The magnitude of the effectiveness of interactive programs is equivalent across age
and ethnic groups and is the same for tobacco, alcohol and marijuana. These
programs take universal approaches.
 There are three distinctive types of interactive interventions, listed in descending
order of effectiveness: systemwide change, comprehensive life skills, and social
influences.
 Systemwide change programs include school-based programs that a family
and/or community actively supports and programs with a more singular
focus on creating a caring, supportive school environment.
 Comprehensive life skills programs focus on interpersonal skills
development, knowledge and life skills training, including assertiveness,
coping skills and setting goals. They also have a broad affective component,
which focuses on the individual's sense of self and perception of the world.
 Social influences programs focus primarily on interpersonal skills
development and include a knowledge component emphasizing refusal skills
training. These programs may include a limited affective component.
 As the number of participants in an interactive program increases, the program's
effectiveness decreases, probably due to implementation failures.
 Noninteractive programs are only marginally effective at any size, yet are employed in
90 percent of U.S. schools. Since enactment of the Drug Free School Act in 1986,
virtually all U.S. schools have adopted some kind of prevention program.
 Targeting tobacco alone, whether in an interactive or a noninteractive program, is
more effective than including tobacco with alcohol, marijuana and other drugs in a
general substance abuse prevention program.
 Targeting alcohol alone, however, does not increase program effectiveness.
 The success of interactive programs is related to program intensity (intensity is
measured by the amount of time devoted to the program). The more-intensive
interactive programs are more effective than those that are less intensive.
 Devoting more time to a noninteractive program did not increase its effectiveness.
 Many of the reports that list "evidence-based best practices" or "research-based
model programs" include programs for which evidence of effectiveness is of
questionable quality or lacking altogether.
Limitations
 Researchers were unable to confirm or refute their hypothesis that programs geared
toward a general population are less effective with high-risk youth.
 Due to insufficient data, the researchers could not isolate individual characteristics of
programs to determine their effects on high-risk youth. The implementation of
interventions targeting selected populations — that is, high-risk or nonmainstream
youth — varied much more than universal school-based interventions. For example
government agencies that had the power to incarcerate people who did not
successfully complete the program implemented some interventions, and these
programs were generally more effective than interventions not mandated by law.
Researchers were uncertain which factors most accounted for the apparent
effectiveness of involuntary programs.
Analyzing Data On Universal School-Based Drug Education Program Evaluations
Grant Results Report
Last Updated: January 2004
Summary
From 2000 to 2002, researchers at Social Capital Development Corporation, a
community development and social science research firm, analyzed outcome data from
more than 200 school-based drug education/prevention programs. The analysis was
designed to help the field understand which programs work with which students and
how best to deliver the programs. In contrast to earlier findings, the researchers found
that comprehensive life skills programs were not more effective than social influences
programs at all grade levels and with all types and levels of substance use and that the
difference between the effectiveness of interactive and non-interactive programs across
all grade levels was not statistically significant. The Robert Wood Johnson Foundation
(RWJF) supported the research with two grants, from April 200 through January 2003,
totaling $299,712.
Findings
Researchers reported these findings from the first phase of their work at the RWJFsponsored Prevention 2000 summit (ID# 039287) (see Communications):
 A reanalysis of data from the 1999 Tobler study indicated that comprehensive life
skills programs were not more effective than social influences programs, at all grade
levels and with all types and levels of substance use.
o Comprehensive life skills programs appeared to work better at the
elementary and senior high school levels, but only in terms of an impact on
students' use of cigarettes and hard drugs. There was no significant
difference in impact on students' use of marijuana or alcohol.
o At the middle school level, there was no difference between the effectiveness
of social influences and comprehensive life skills programs for reducing the
use of cigarettes, marijuana and other drugs. Social influences programs
were moderately effective at reducing heavy drinking among middle school
students, but ineffective at reducing alcohol use.
Researchers reported these findings from the second phase of their study in a poster
session at the June 2003 meeting of the Society for Prevention Research (see
Communications):
 Using new modeling techniques, the overall difference between the effectiveness of
interactive and non-interactive programs across all grade levels was found to be not
statistically significant. Interactive programs were found to be significantly more
effective than non-interactive programs at delaying, reducing, or preventing tobacco
use, but not the use of other substances. When broken down by grade level,
interactive programs worked better in middle school but not in high school.
 The duration of a school prevention program may account for the large differences
Tobler found between interactive and non-interactive programs. The beneficial effect
of interactive programs occurs more than 18 months after pretesting, rather than a
year, as Tobler reported