In Greece, Portugal and Sweden, prevention policies have progressed towards modern concepts and clearer structures, e.g. school-based prevention is better defined than it was in the past. Programmes for younger children in kindergarten and primary school have expanded, especially in Greece and Austria.
Among Member States, prevention policies that are subject to quality control systems (Figure 3) typically also exhibit a higher level of structure (e.g. delivery by means of sophisticated programmes (10)) and more attention to selective prevention (see Figure 2). Key factors in comparing European prevention policies are quality (evidence base of concepts), structure (how and by whom delivery is organised) and coverage (population size reached).
Quality control systems and standards exist in the Czech Republic, Lithuania, Slovenia and Sweden, while in Germany and Portugal new monitoring systems for prevention interventions are now operational or under development. Increasingly, concrete components of prevention interventions are defined and recommended in national strategies, e.g. promoting social and decision-making skills and increasing self-esteem in Lithuania and Sweden.
Coverage of school-based prevention, expressed as the proportion of pupils exposed to universal prevention, can be measured only for programme-based prevention, and extensive coverage is an objective of some strategies (Spain, Ireland, United Kingdom). In all Spanish Comunidades Autónomas, the proportion of school populations exposed to approved and recommended prevention programmes has increased further, and in other Member States (the Czech Republic, Greece, Norway) coverage has recently been assessed. As a result of these developments, drug prevention effort in many Member States, previously characterised by ‘low focalisation (predominantly unspecific interventions and few adequate prevention materials), low intentionality (low training level of the professionals working in the area), low pro-activity and evaluation (low level of research and lack of evaluation procedures), low continuity (frequent ad hoc interventions) and low coordination and participation (lack of coordination concerning the implemented activities)’ (Portuguese national report), is slowly improving.