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Background:The prevention of initiation of tobacco, alcohol and drug use is a major societal challenge, for which the existing research literature is generally disappointing. This study aimed to test the effectiveness of adaptation of Motivational Interviewing (MI) for universal prevention purposes, i.e. to prevent initiation of new substance use among non-users, and to reduce risks among existing users. Results: This adaptation of MI was not demonstrated to be effective in either intention-totreat or sub-group analyses for any outcome. Unexpected lower levels of cannabis initiation and prevalence were found in the Drug Awareness control condition.Conclusions: This particular adaptation of MI is ineffective as a universal drug prevention intervention and does not merit further study.

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