Environmental Prevention Strategies:

Putting Theory Into Practice

(www.health.org)(www.health.org)

Prevention Strategies Attempt To Alter Two Kinds of Environments: Individualized Environments Individualized Environments

the environments in which the environments in which individualindividual children children grow, learn, and maturegrow, learn, and mature

Shared Environment Shared Environment the environment in which the environment in which allall children children

encounter threats to their health–including encounter threats to their health–including illicit drugs, alcohol, and tobaccoillicit drugs, alcohol, and tobacco

Strategies Targeting

Individualized Environments

Socialize, Instruct, Guide, Counsel

Family School

Health Care

Providers

INDIVIDUAL YOUTH

Faith Community

Strategies Targeting the

Shared Environment

Support, Thwart

Availability

RegulationsNorms

ALL YOUTH

Factors in the Shared Environment NormsNorms AvailabilityAvailability RegulationsRegulations

Norms BasicBasic orientations concerning the “rightness or orientations concerning the “rightness or

wrongness,” acceptability or unacceptability, and/or wrongness,” acceptability or unacceptability, and/or deviance of specific behaviors for a specific group of deviance of specific behaviors for a specific group of individualsindividuals

E.g.,E.g., it is it is wrongwrong for for anyoneanyone to use illicit drugs to use illicit drugs it is it is okayokay for for adultsadults to drink in moderation to drink in moderation

The basis for a variety ofThe basis for a variety of specific attitudes specific attitudes that support that support or undermine the particular prevention strategies we or undermine the particular prevention strategies we may wish to implementmay wish to implement

Availability

The inverse of the sum of resources (time, The inverse of the sum of resources (time, energy, money) that must be expended to energy, money) that must be expended to obtain a commodity (alcohol, marijuana, obtain a commodity (alcohol, marijuana, cigarettes)cigarettes)

The more resources required to get The more resources required to get something, the lower the availabilitysomething, the lower the availability

Regulations

Formalized laws, rules, policies that serve Formalized laws, rules, policies that serve to control availability and codify norms and to control availability and codify norms and that specify sanctions for violationsthat specify sanctions for violations

May be instituted by governments, public May be instituted by governments, public agencies (e.g., police departments, school agencies (e.g., police departments, school systems), or private organizations (e.g., systems), or private organizations (e.g., HMOs, hospitality establishments, HMOs, hospitality establishments, convenience stores)convenience stores)

The Probability of an Undesirable Behavior Is Decreased to the Extent That: There exist regulations that discourage There exist regulations that discourage

the behaviorthe behavior Community norms disapprove of the Community norms disapprove of the

behaviorbehavior The commodities needed to engage in the The commodities needed to engage in the

behavior are not easily availablebehavior are not easily available

A Basic Premise:

Strategies that address both individualized Strategies that address both individualized environments and the shared environment environments and the shared environment are important components of a are important components of a comprehensive approach to preventioncomprehensive approach to prevention

Shared Environment Strategies FastFast

EfficientEfficient

Shared Environment Strategies

Fast Strategies aimed at the shared environment often Strategies aimed at the shared environment often produce more rapid results than do strategies aimed produce more rapid results than do strategies aimed at individual environmentsat individual environments

E.g.,E.g., Enforcement of the minimum alcohol purchase age or Enforcement of the minimum alcohol purchase age or

increases in alcohol prices (manipulations of availability) increases in alcohol prices (manipulations of availability) can produce more or less immediate reductions in youth can produce more or less immediate reductions in youth alcohol usealcohol use

Pre-school programs to increase academic readiness and Pre-school programs to increase academic readiness and pro-social orientation may take many years to show resultspro-social orientation may take many years to show results

Shared Environment Strategies

Efficient Strategies directed at the shared Strategies directed at the shared

environment are efficient because they environment are efficient because they affect every member of a target populationaffect every member of a target population

E.g.,E.g., Removing dealers from street corners and Removing dealers from street corners and

training convenience store clerks to check IDs training convenience store clerks to check IDs reduces the availability of illicit drugs and reduces the availability of illicit drugs and tobacco for all neighborhood youth tobacco for all neighborhood youth

Environmental Strategy

Alcohol Tobacco Illicit Drugs

Examples of environmental policies to limit access

Purchase laws Minimum legal drinking age for purchasing and consuming alcohol 

Youth access laws prohibiting retail sales of tobacco to minors

Laws prohibiting possession and use

Price controls Sales taxes; bans on drink discounts and other price specials 

Excise taxes; bans on rebates after purchase

Using supply reduction efforts to drive up drug prices

Restrictions on retail sales or sellers (number, location, density, days and hours of sale)

Ordinances establishing minimum distance between outlets and schools and churches

Limits on the number of tobacco vendor licenses

Civil actions to eliminate places where drugs are sold (e.g., drughouse abatement); physical barriers to sales (gates, increased lighting) 

 

Table 1. Examples of Environmental Policies for Alcohol, Tobacco and Illicit Drugs

 

Environmental Strategy

Alcohol Tobacco Illicit Drugs

Environmental policies to influence the culture and contexts of use

Legal deterrence Lower blood alcohol concentration for young drivers; administrative license revocation for driving under the influence

Fines for selling tobacco to minors; media advocacy efforts to increase vendors’ perceptions of risk of apprehension

Use (drugs)-Lose (driver’s license) laws for youth; workplace drug testing; asset forfeiture

Controls on advertising and promotion

Bans on alcohol sponsorship of sporting and cultural events; advertising restrictions

Surgeon General’s warning on cigarette packs; restrictions on distribution of free samples and coupons 

Public service announcements regarding hazards associated with drug use

Environmental policies to reduce negative consequences of use

Measures that reduce consequences of excessive use

Safe rides for intoxicated patrons; nonbreakable drinking glassware

Designated nonsmoking areas to reduce nonsmokers’ exposure to secondary smoke 

Distribution of bleach for disinfecting drug paraphernalia

Substitution of less damaging products

Low alcohol beer Low-tar and self-extinguishing cigarettes 

Methadone maintenance

Table 2. The Prevention Effects of Environmental Strategies

Environmental Strategy Sales/Use

TrafficCrashes

DWI

ViolentCrime1 Suicide

Long-Term

HealthConsequences2

Price controls 3

Density restrictions  

Minimum purchase age laws   4  

Impaired driving laws        

Restrictions on use          

Selling/serving controls        

Counteradvertising 5          

1 violent or assaultive offenses = rape,robbery, assault, and homicide2 cancer or cirrhosis mortality3 rapes and robberies4 youth homicide5 effects for tobacco only

CSAP’s Western CAPT

www.westcapt.org

Reference: Center for Substance Abuse Prevention (CSAP). 1999. Environmental prevention strategies: Putting theory into practice, training and resource guide. Rockville, MD: National

Clearinghouse for Alcohol and Drug Information. www.health.org (see videos)