Alcohol misuse: tackling the UK epidemic - London

24
is potential to use the media, not only to publicise the risks of smoking, drinking and drug use, but also to
disseminate information on substance abuse and how specifically to access medical services to help. 110
The intensity and duration over which health education messages are delivered appear to be important
factors. Research suggests that health education messages also need to come from a credible source; a
government or even NHS provenance may be rejected. 115
Campaigns should be adequately funded and
their messages must be kept simple and relevant. Consideration needs to be given to the information
presented in media campaigns, especially since, by its nature, it is not targeted at key populations.
Targeting interventions in adolescent smoking, drinking and drug use
As discussed earlier, some adolescents are more vulnerable than others to smoking, hazardous drinking
and the misuse of drugs. It is important that health policy recognises this fact and, especially where
resources are scarce, targets interventions to ‘at risk’ populations. Responses to widespread recreational
drug use and drinking should focus specifically on those who are most at risk of developing problematic
habits and long-term health problems, even though general use is widespread. 79
Because the most
vulnerable adolescents are often disengaged from the education system, targeted intervention must be
integrated into the wide range of other services provided for vulnerable young people. 93
This suggests that
successful intervention strategies will be multiprofessional in nature and necessitate a good awareness of
drugs issues among staff in all adolescent services.
Targeting interventions at the most vulnerable adolescents is often associated with early, pre-emptive,
interventions. In the context of substance misuse for example, it has been suggested that interventions
should focus on children who, in primary school, begin to display educational or behavioural problems,
or appear to be disengaging from education. Early, targeted intervention in these cases could consist of
extra support in the last few years of primary school to ease the transition to secondary schools. 93
The
government’s current drugs strategy is commendable in that it aims to target resources on the most
vulnerable adolescents.
Multifaceted interventions
There is evidence that community approaches involving multiple coordinated intervention components
can influence adolescent behaviour, particularly when multiple sites within a community are targeted. 104
For example, age restrictions for tobacco purchase, smoke-free public places, media campaigns and school
programmes can be combined in an integrated approach. Multifaceted approaches to smoking prevention
recognise the complex range of individual, social and environmental factors influencing decisions to
smoke, drink and use drugs. 104
There is evidence to suggest that restrictions on smoking at home, even when parents smoke, more
extensive bans on smoking in public places, and enforced bans on smoking at school may reduce
adolescent smoking. Such measures give an unequivocal message to adolescents about the unacceptability
of smoking. 116
The government’s Healthy Schools Programme recognises the influence of the school
environment. Although school smoking bans are common, they are often poorly complied with. Both the
absence of smoking policies in schools, or lapses in enforcement, may be instrumental in shaping
adolescents’ views about the acceptability of smoking. 105
Schools should aim to create supportive
environments by consistently enforcing bans on pupil smoking. 104,116,117
Harm minimisation approaches
Harm minimisation approaches to mainstream recreational drug use are common throughout the EU. 79
For example, simple, basic rules in the organisation of dance events can effectively prevent some
immediate harm caused by drugs such as ecstasy. Dissemination of information on long-term risks to
recreational drug users at nightlife venues may also be useful. 79
For injecting drug users, harm
minimisation interventions such as needle exchange schemes have been in operation for many years in an
attempt to prevent the transmission of blood borne diseases such as hepatitis C and HIV.
British Medical Association Adolescent health