Are mass-media campaigns effective in preventing drug use? A Cochrane systematic review and meta-analysis

Abstract

ObjectiveTo determine whether there is evidence that mass-media campaigns can be effective in reducing illicit drug consumption and the intent to consume.DesignSystematic review of randomised and non-randomised studies.MethodsWe searched four electronic databases (MEDLINE, EMBASE, ProQuest Dissertations & Theses A&I and CENTRAL) and further explored seven additional resources to obtain both published and unpublished materials. We appraised the quality of included studies using standardised tools. We carried out meta-analyses of randomised controlled trials and a pooled analysis of interrupted time-series and controlled before-and-after studies.ResultsWe identified 19 studies comprising 184 811 participants. Pooled analyses and narrative synthesis provided mixed evidence of effectiveness. Eight interventions evaluated with randomised controlled trials leaned towards no evidence of an effect, both on drug use (standardised mean difference (SMD) −0.02; 95% CI −0.15 to 0.12) and the intention to use drugs (SMD −0.07; 95% CI −0.19 to 0.04). Four campaigns provided some evidence of beneficial effects in preventing drug use and two interventions provided evidence of iatrogenic effects.ConclusionsStudies were considerably heterogeneous in type of mass-media intervention, outcome measures, underlying theory, comparison groups and design. Such factors can contribute to explaining the observed variability in results. Owing to the risk of adverse effects, caution is needed in disseminating mass-media campaigns tackling drug use. Large studies conducted with appropriate methodology are warranted to consolidate the evidence base.

Health communication campaigns to drive demand for evidence-based practices and reduce stigma in the HEALing communities study

“…Despite the demonstrated effectiveness of health communication and social marketing campaigns for addressing many public health challenges, their impact on behaviors associated with substance use outside of tobacco products have been less successful. One meta-analysis of mass media campaigns to prevent drug use noted inconsistent evidence for their effectiveness and could not identify any core features of either successful or unsuccessful campaigns ( Allara et al, 2015 ). Another review of mass media campaigns to reduce alcohol consumption and related harms found that while they can impact knowledge, attitudes, and beliefs about alcohol consumption, they do little to reduce consumption itself ( Young et al, 2018 ).…”

Youth Perspectives of Prescription Pain Medication in the Opioid Crisis

“…Educational interventions to raise public awareness in communities and schools are also needed but have historically demonstrated little effect. 9,[11][12][13] Stakeholders should neither assume that all youth are receiving relevant messages about the opioid crisis, nor that youth will be activated by adult-directed messaging. Potential opportunities to improve effectiveness of community-or school-based education may be through use of modern platforms such as social media.…”

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“…On the basis of the characteristics of our sample (ie, the majority did not show at risk or hazardous substance use), it was not entirely possible to draw valid consequences in terms of the app’s secondary prevention efficacy. Although a significant increase in substance use was not found among the app users, the possibility of iatrogenic harms cannot be neglected in case of the app, as it was already noted in case of other prevention programs as well [72,73]. As Dishion and colleagues [72] pointed out, such harms might be dependent on many factors, including the adolescent target group’s homogeneity (eg, containing only at-risk individuals) or the specific phase of adolescence (eg, early vs late adolescence) at the time of the intervention.…”