Substance use prevention: the importance of improving environments to change human behaviour instead of applying informational approaches

Published On: 1 February 20243.5 min read699 words

Mapping Prevention Interventions

Context and Aim

In the scope of the Frontline Politeia project, 77 prevention interventions were mapped across 6 European countries between January and June 2023. The data were collected through semi-structured interviews and analysed with Qualtrics. One of the results of this mapping exercise was that out of the 200 intervention components (of those 77 mapped interventions, most of them consisted of more than one component), most of them used an informational approach (learning by reading and listening through, for example, lectures, brochures,…), followed by training skills and competences and education (learning by observing, experiencing and interaction). Only a minority of interventions used environmental restructuring techniques, which are highly effective. Although we know from the International Standards on Drug Use Prevention that “utilizing non-interactive methods, such as lecturing” (UNODC, 2015) have no adverse prevention outcomes (i.e. they can even be harmful), these are still predominantly used in the prevention interventions mapped.
This leaflet aims to provide all those developing and implementing substance use prevention interventions with effective ways to do so. It gives an idea of why to focus on the environment instead of using informational approaches to change human behaviour.

Results of the Mapping Activity

Most Used Behaviour Change Techniques

  • 57 activities used an informational approach (learning by reading and listening)
  • 52 activities focused on skills and competencies training
  • Forty-four activities used an educational approach (learning by observing, experiencing, and interacting).

Less Used Behaviour Change Techniques

  • 25 activities worked around setting norms and rules, limiting opportunities
  • Nine activities focused on incentivisation (providing incentives for desired behaviour)
  • Six activities used environmental restructuring

What kind of behaviour do we address?

Reflective and Automatic Behaviour

Humans shift during a day on a continuum between two categories of behavioural control: fully reflective and deliberate and non-reflective, almost automatic behaviour. Acting fully reflective implies being aware of what we do and why we do it and being able to adjust when needed. Less reflective actions do not undergo full rational and deliberate thoughts and depend on, for example, stimuli in the environment (Marteau, 2012). Both categories have advantages and disadvantages according to the complexity and urgency of tasks or challenges we face as humans.

Potentially harmful behaviours like substance use have a strong impulsive component, which makes them difficult to control, like eating and screen use, for example. The two broad categories of human behaviour can complement or conflict with each other. In many socially enticing situations, behavioural goals are more likely to come into conflict (e.g. when the goal of having fun with alcohol has to balance to get home safely and avoid harm to others).

So, if we want to change human health-related behaviour, we are confronted with impulse-driven behaviours that are often hard to change. Telling (young) people what to do or not to do is not an effective way to change this automatic behaviour, which forces us to use other techniques.

Environmental Prevention

What’s in a Name?

  • Environmental prevention interventions aim “to limit exposure to unhealthy and risky behavioural opportunities and promote the availability of healthier opportunities” (EUPC, 2019).
  • As written before, people often react to environmental cues. Environmental interventions target those cue- responses without leaning on people’s deliberate and conscious choices.
  • This kind of intervention should be used more in contexts where substance use takes place, such as entertainment venues or in stores, where consumption or purchase behaviours are shaped by salience, visibility, accessibility and social acceptance.
  • Of course, alongside these kinds of interventions, behavioural interventions, such as ‘correcting normative beliefs’ and self-control skills, should also be part of a comprehensive prevention approach.

Three Categories of Interventions

  • Regulatory approaches change the formal normative environment, e.g., by increasing the age of drinking alcohol, banning indoor smoking or alcohol commercials in movies.
  • Physical approaches change visual and spatial factors that influence behaviour, such as chill-out rooms in nightclubs to avoid overheating, the size and shape of serving containers, or the design of neighbourhoods.
  • Economic approaches focus on taxes and prices, such as increasing the levy on strong alcoholic beverages, making sure non-alcoholic drinks are cheaper, or subsidising healthier food offerings.

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