Introduction: A general causal model to guide alcohol, tobacco, and illicit drug prevention

Complex community systems produce substance use and related problems, and prevention practice can benefit from understanding and applying features of these systems to enhance effectiveness. What do we know from research literature about these systems to guide innovation and effectiveness in alcohol, tobacco, and other drug (ATOD) prevention practice? Recent developments in substance abuse prevention outline a general causal model to guide such efforts. The model is comprised of seven classes of intervening variables, factors that are strongly related to and influence the occurrence and magnitude of substance use and its consequences. Even amidst incomplete and limited clarity regarding complex interactions in such a system, research knowledge can significantly assist prevention practitioners and policy makers with a systematic approach to design and effectively intervene to change substance use and associated problems.

The purpose of this session is to clarify the evidence base for a set of intervening variables/causal factors that suggest various intervention points for change. Upon describing the research methodology for identifying variables across alcohol, tobacco, and illicit drugs, presenters will define seven classes of intervening variables and highlight substance-specific examples as well as summative evidence of their link to substance use and related consequences: (1) economic availability (price), (2) retail availability (money is exchanged), (3) social availability (family and friends), (4) promotion (attempts to increase attractiveness), (5) norms (informal standards or values), (6) enforcement (of laws and regulations beyond passage of a law), and (7) individual characteristics (i.e., genetics, attitudes, social associations that influence individual decisions to use).