Prevention of Alcohol, Tobacco, and Illicit Drug Use Among Youth: A Scoping Review of European School-Based Programs with Insights on Mental Health

Alcohol, tobacco, and drug misuse continue to rise globally, with adolescents at particular risk. In response, school-based prevention programs have been widely implemented, yet their efficacy and long-term impact remain under-discussed. This scoping review synthesised evidence on the effectiveness of three commonly used programs (Preventure, Unplugged, and IPSYcare) in Europe. A search of four databases (PubMed, Embase, PsycInfo, and Web of Science) identified 21 peer-reviewed articles published between 2008 and 2023, spanning 12 European countries. Unplugged was most frequently evaluated (10 studies), followed by Preventure (6 studies) and IPSYcare (5 studies). Findings showed that Preventure yielded mixed outcomes, delaying binge drinking and reducing substance use among high-risk groups but with limited generalisability. Unplugged was associated with reductions in cannabis use and heavy drinking at 15 months post-intervention. IPSYcare demonstrated longer-term benefits, including improved school connectedness and reductions in alcohol and tobacco use. Results suggest that while standardised programs such as Unplugged enable scalability, contextual adaptations may enhance effectiveness, and tailored approaches are valuable for high-risk populations. Overall, the programs show potential, but variability indicate the need for further longitudinal and qualitative research in order to improve program delivery and sustain long-term impacts.