School-based substance prevention programs showed mixed and sometimes counterproductive results
Public health engagement in school substance use prevention showed no overall effect on student use, and some collaborative approaches were associated with increased alcohol and cannabis use in low-use schools.
Quick Facts
What This Study Found
Among 42,149 students in 84 schools, public health engagement in substance use prevention had no significant overall impact on student use. When public health agencies solved problems jointly with schools, odds of alcohol and cannabis use increased. Some methods decreased cannabis and cigarette use in high-use schools but increased alcohol and cannabis use in low-use schools.
Key Numbers
84 schools; 42,149 students; 70% of schools had public health engagement; joint problem-solving significantly increased odds of alcohol and cannabis use
How They Did This
Cross-sectional analysis of 2018/2019 COMPASS study data from 84 schools and 42,149 Canadian students. Multilevel logistic regression assessed associations between five methods of public health engagement and student substance use.
Why This Research Matters
Schools invest substantial resources in substance prevention programs. Finding that some approaches may backfire in low-use schools suggests that one-size-fits-all prevention strategies may be counterproductive.
The Bigger Picture
Prevention programs need to be tailored to school context. What works in a high-use school may not only fail in a low-use school but could potentially normalize substance use among students not previously at risk.
What This Study Doesn't Tell Us
Cross-sectional design cannot establish causation. Public health engagement was measured at the school level, not the student level. Cannot account for quality or fidelity of specific program implementation.
Questions This Raises
- ?Why did joint problem-solving increase substance use in some schools?
- ?Would evidence-based program selection reduce the risk of iatrogenic effects?
Trust & Context
- Key Stat:
- Some prevention methods increased cannabis use in low-use schools
- Evidence Grade:
- Large sample with multilevel modeling, but cross-sectional design and inability to assess program quality limit conclusions.
- Study Age:
- Published 2023 using 2018-2019 data
- Original Title:
- The association between public health engagement in school-based substance use prevention programs and student alcohol, cannabis, e-cigarette and cigarette use.
- Published In:
- Canadian journal of public health = Revue canadienne de sante publique, 114(1), 94-103 (2023)
- Authors:
- Burnett, Trish, Battista, Kate, Butt, Michelle, Sherifali, Diana, Leatherdale, Scott T, Dobbins, Maureen
- Database ID:
- RTHC-04439
Evidence Hierarchy
A snapshot of a population at one point in time.
What do these levels mean? →Frequently Asked Questions
Do school substance prevention programs reduce cannabis use?
In this study of 42,149 Canadian students, public health engagement in prevention showed no overall effect. Some approaches reduced cannabis use in high-use schools but increased it in low-use schools.
Can prevention programs backfire?
Yes. When public health agencies solved problems jointly with schools, the odds of students using alcohol or cannabis significantly increased, suggesting some collaborative approaches may normalize substance use.
Read More on RethinkTHC
Cite This Study
https://rethinkthc.com/research/RTHC-04439APA
Burnett, Trish; Battista, Kate; Butt, Michelle; Sherifali, Diana; Leatherdale, Scott T; Dobbins, Maureen. (2023). The association between public health engagement in school-based substance use prevention programs and student alcohol, cannabis, e-cigarette and cigarette use.. Canadian journal of public health = Revue canadienne de sante publique, 114(1), 94-103. https://doi.org/10.17269/s41997-022-00655-3
MLA
Burnett, Trish, et al. "The association between public health engagement in school-based substance use prevention programs and student alcohol, cannabis, e-cigarette and cigarette use.." Canadian journal of public health = Revue canadienne de sante publique, 2023. https://doi.org/10.17269/s41997-022-00655-3
RethinkTHC
RethinkTHC Research Database. "The association between public health engagement in school-b..." RTHC-04439. Retrieved from https://rethinkthc.com/research/burnett-2023-the-association-between-public
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.