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.
School health administrators, public health program designers, prevention researchers
Some prevention methods increased cannabis use in low-use schools
What the researchers 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.
Why it 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 numbers in context
84 schools; 42,149 students; 70% of schools had public health engagement; joint problem-solving significantly increased odds of alcohol and cannabis use
How the study worked
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.
What this study cannot 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.
How to read the evidence
Large sample with multilevel modeling, but cross-sectional design and inability to assess program quality limit conclusions.
When this study was published
Published 2023 using 2018-2019 data
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.
Questions still open
- Why did joint problem-solving increase substance use in some schools? Would evidence-based program selection reduce the risk of iatrogenic effects?
Common questions
Do school substance prevention programs reduce cannabis use?
Can prevention programs backfire?
Read the original research
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
Citation
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
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