Prevención ambiental de drogas en la Unión Europea. ¿Por qué es tan impopular este tipo de prevención?

Gregor Burkhart

Resumen


Los adolescentes pasan por transformaciones en su funcionamiento neuro-comportamental y psicosocial que resultan en la predominancia de estar conforme con las normas de sus pares en detrimento del control cognitivo de sus impulsos. Esto puede explicar que en la presencia de sus pares los comportamientos de los adolescentes no son influenciados por lo que saben sobre los riesgos y las consecuencias. Esta observación tiene implicaciones para la prevención porque destaca la importancia de estrategias que activamente influencian los medios ambientes donde se da el consumo de substancias y donde las normas de los jóvenes se forman y mantienen. No obstante, a pesar de la falta de pruebas, las estrategias meramente informativas siguen siendo practicadas a larga escala en Europa. Las razones de esta situación se discuten en este editorial. Se propone también una definición de prevención ambiental: estrategias que alteran las normas y los ambientes físicos, sociales y económicos sin basarse en persuasión. Se discuten las delimitaciones de este definición con la de la promoción de la salud y las pruebas de eficacia disponibles así como la información sobre la puesta en marcha de la prevención ambiental. Estos dados no apoyan las afirmaciones de varios estados miembros que sus políticas preventivas englobarían todas las substancias y comportamientos adictivos. En general, mientras que las medidas ambientales estén ganando importancia en Europa, se encuentran más en el Norte de Europa y se notan sobretodo en tres áreas: a nivel macro en forma de políticas de control de alcohol y tabaco, en estrategias de mejorar el clima y ethos en centros educativos y en políticas locales para ambientes de diversión.


Palabras clave


ambiental; prevención; normas sociales; adolescentes; neurociencias

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Referencias


Advisory Committee on Drug Misuse (2006). Pathways to problems.

London: Home Office.

Akbar, T., Baldacchino, A., Cecil, J., Riglietta, M., Sommer, B. & Humphris, G. (2011). Poly-substance use and related harms: A systematic review of harm reduction strategies implemented in recreational settings, Neuroscience and Biobehavioral Reviews, 35, 1186–1202.

Anderson, P., de Bruijn, A., Angus, K., Gordon, R. & Hastings, G. (2009).

Impact of alcohol advertising and media exposure on adolescent alcohol use: a systematic review of longitudinal studies, Alcohol, 44, 229–43.

Ashton, M. (2004). Doing it together strengthens families and helps

prevent substance use, Drug and Alcohol Findings, 10, 16-21.

ASPECT Consortium (2004). Tobacco or health in the European Union.

Luxembourg: Office for Official Publications of the European Communities.

Aveyard, P., Markham, W.A., Lancashire, E., Bullock, A., Macarthur, C. &

Cheng, K.K. (2004). The influence of school culture on smoking among pupils, Soc Sci Med, 58, 1767-80.

Babor, T., Caetano, R., Casswell, S., Edwards, G., Giesbrecht, N., Graham,

K., … Rossow, I. (2010). Alcohol: no ordinary commodity. New York: Oxford University Press.

Bava, S. & Tapert, S.F. (2010). Adolescent brain development and the

risk for alcohol and other drug problems, Neuropsychol Rev, 20, 398–413.

Bellis, M.A., Hughes, K., Calafat, A., Juan, M. & Schnitzer, S. (2009).

Relative contributions of holiday location and nationality to changes in recreational drug taking behaviour: a natural experiment in the Balearic Islands, European Addiction Research, 15, 78–86.

Bonell, C.P., Sorhaindo, A.M., Allen, E.E., Strange, V.J., Wiggins, M. Fletcher, A., …Rhodes, T. (2010). Pilot multimethod trial of a school-ethos intervention to reduce substance use: building hypotheses about upstream pathways to prevention, Journal of Adolescent Health, 47, 555–63.

Bronfenbrenner, U. (1979). The Ecology of Human Development: Experiments by Nature and Design, Harvard University Press. Cambridge, MA.

Brown, S.A., McGue, M., Maggs, J., Schulenberg, J., Hingson, R. Swartzwelder, S., … Murphy, S. (2008). A developmental perspective on alcohol and youths 16 to 20 years of age, Pediatrics 121, p. S290-S310.

Bühler, A. & Kröger, C. (2006). Prevention of substance abuse. Lisbon:

EMCDDA and BZGA.

Burkhart, G. (2009). Creencias normativas en estrategias preventivas:

una espada de doble filo. Efectos de la percepción de normas y normalidad en compañas informativas, programas escolares y medidas ambientales, Revista Española de Drogodependencias, 34, 376–400.

Calafat, A., Fernández, C., Juan, M., Anttila, A.H., Arias, R., Bellis, M.A.,

… Wijngaart, G. (2003). Enjoying the nightlife in Europe. The role of moderation. Palma de Mallorca: IREFREA.

Calafat, A., Juan, M., & Duch, M.A. (2009). Preventive interventions in

nightlife: a review, Adicciones, 21, 387–413.

Calafat, A., Blay, N.T., Hughes, K., Bellis, M., Juan, M., Duch, M.

& Kokkevi, A. (2010). Nightlife young risk behaviours in Mediterranean versus other European cities: are stereotypes true?, European Journal of Public Health, 30 September 2010 [Epub ahead of print]. doi: 10.1093/eurpub/ckq141

Casswell, S. (1993). Public discourse on the benefits of moderation:

implications for alcohol policy development. Addiction, 88, 459-65.

Chen, M.J., Grube, J.W., Nygaard, P. & Miller, B.A. (2008). Identifying

Social Mechanisms for the Prevention of Adolescent Drinking and Driving, Accident Analysis and Prevention, 40, 576–85.

CSDH (2008). Closing the gap in a generation: health equity through

action on the social determinants of health. Final Report of the Commission on Social Determinants of Health. Geneva: World Health Organization.

Cunningham, J.A. (2007). Implications of the normative fallacy in young adult smokers aged 19-24 years. The American Journal of Public Health, 97, 1399–400.

DeJong, W., Larimer, M.E., Wood, M.D. & Hartman, R. (2009). NIAAA’s

Rapid Response to College Drinking Problems Initiative: Reinforcing the Use of Evidence-Based Approaches in College Alcohol Prevention, Journal of Studies on Alcohol and Drugs Supplement, 5–11.

Desousa, C., Murphy, S., Roberts, C. & Anderson, L. (2008). School

policies and binge drinking behaviours of school-aged children in Wales — a multilevel analysis. Health Education Research, 23, 259–271.

Duerr, H.P. (1993). Obszönität und Gewalt, (2nd ed.). Frankfurt am Main: Suhrkamp.

Elias, N. (1939). Über den Prozeß der Zivilisation. Soziogenetische und

psychogenetische Untersuchungen. Erster Band. Wandlungen des Verhaltens in den weltlichen Oberschichten des Abendlandes. Zweiter Band. Wandlungen der Gesellschaft. Entwurf einer Theorie der Zivilisation. Basel: Verlag Haus zum Falken.

Elmeland, K. & Villumsen, S. (2007). Udviklingen i danskernes holdninger til alkoholforbrug og alkoholpolitiske spørgsmål — Developments in Danes’ attitudes toward alcohol consumption and alcohol political issues. Nordisk Alkohol & Narkotikatidsskrift, 1, 5–23.

Eloi, L. (2010). Environmental justice and environmental inequalities:

a European perspective, in Social investment seminar of the Institute for Futures Studies. Stockholm.

EMCDDA (2008). Selected Issue: Vulnerable groups of young people.

Luxembourg: Publications Office of the European Union. http://www.emcdda.europa.eu/publications/selected-issues/vulnerable-young

EMCDDA (2009a). Polydrug use: patterns and responses. Luxembourg:

Publications Office of the European Union.

EMCDDA (2009b). Annual report 2009: the state of the drug problems

in Europe. Luxembourg: Publications Office of the European Union.

EMCDDA (2009c). Preventing later substance use disorders in at-risk

children and adolescents — A review of the theory and evidence base of indicated prevention. Luxembourg: Office for Official Publications of the European Communities.

EMCDDA (2010). Annual report 2010: the state of the drug problems in Europe. Luxembourg: Office for Official Publications of the European Communities.

EUCAM (2009). Corporate Social Responsibility: the new marketing

tool. Trends in Alcohol Marketing. Utrecht: European Centre for Monitoring Alcohol Marketing.

Faggiano, F., Vigna-Taglianti, F.D., Versino, E., Zambon, A., Borraccino, A. & Lemma, P. (2008). School-based prevention for illicit drugs use: a systematic review. Preventive Medicine, 46, 385–96.

Farrelly, M.C., Pechacek, T.F. & Thomas, K.Y. (2008). The impact of

tobacco control programs on adult smoking. The American Journal of Public Health, 98, 304–9.

Federico, B., Costa, G. & Kunst, A. (2007). Educational inequalities in

initiation, cessation and prevalence of smoking among 3 Italian birth cohorts. American Journal of Public Health, 97, 383–45.

Fletcher, A., Bonell, C. & Hargreaves, J. (2008). School effects on young

people’s drug use: a systematic review of intervention and observational studies. Journal of Adolescent Health, 42, 209–20.

Fletcher, A., Bonell, C., Sorhaindo, A. & Strange, V. (2009). How might

schools influence young people’s drug use? Development of theory from qualitative case-study research. Journal of Adolescent Health, 45, 126–32.

Galvan, A., Hare, T.A., Davidson, M., Spicer, J., Glover, G. & Glover, C.

(2005). The Role of Ventral Frontostriatal Circuitry in Reward-Based Learning in Humans. The Journal of Neuroscience, 38, 8650–8656.

Gripenberg, J., Wallin, E. & Andréasson, S. (2007). Effects of a community-based drug use prevention program targeting licensed premises. Substance Use Misuse, 42, 1883–98.

Gruning, T., Gilmore, A.B. & McKee, M. (2006). Tobacco industry influence on science and scientists in Germany. American Journal of.Public Health, 96, 20–32.

Hastings, G., Anderson, S., Cooke, E. & Gordon, R. (2005). Alcohol marketing and young people’s drinking: a review of the research. Journal of Public Health Policy, 26, 296–311.

Hawe, P., Shiell, A., & Riley, T. (2009). Theorising interventions as events in systems. American Journal of Community Psychology, 43, 267–276.

Hawkins, J.D., Kosterman, R., Catalano, R.F. & Hil, K.G. (2005). Promoting Positive Adult Functioning Through Social Development Intervention in Childhood. Long-term Effects From the Seattle Social Development Project. Archives of Pediatrics and Adolescent Medicine, 159, 25–31.

Hawkins, J.D., Catalano, R.F., Arthur, M.W., Egan, E., Brown, E.C., Abbott,

R.D. & Murray, D.M. (2008). Testing Communities That Care: The Rationale, Design and Behavioral Baseline Equivalence of the Community Youth Development Study. Prevention Science, 9, 178–90.

Hoeflmayr, D. & Hanewinkel, R. (2008). Do school-based tobacco prevention programmes pay off? The cost-effectiveness of the ‘Smoke-free Class Competition’. Public Health, 122, 34–41.

Hornik, R., Jacobsohn, L., Orwin, R., Piesse, A. & Kalton, G. (2008). Effects of the National Youth Anti-Drug Media Campaign on youths’. The American Journal of Public Health, 98, 2229–36.

Hughes, K., Quigg, Z., Eckley, L., Bellis, M., Jones, L., Calafat, A, … van

Hasselt, N. (2011). Environmental factors in drinking venues and alcohol-related harm: the evidence base for European intervention. Addiction 106 Supplement 1, 37–46.

Kellam, S.G., Brown, C.H., Poduska, J.M., Ialongo, N.S., Wang, W., Toyinbo, P., …Wilcox, H. (2008). Effects of a universal classroom behavior management program in first and second grades on young adult behavioral, psychiatric, and social outcomes, Drug and Alcohol Dependence, 95, S5–S28.

Koutakis, N. (2008). Reducing youth alcohol drinking through a parent-targeted intervention: the Örebro Prevention Program. Addiction, 103, 1629-1637

Kuntsche, E., Kuntsche, S., Knibbe, R., Simons-Morton, B., Farhat, T. Hublet, A., … Demetrovics, Z. (2011). Cultural and Gender Convergence in Adolescent Drunkenness: Evidence from 23 European and North American Countries. Archives of Pediatrics and Adolescent Medicine, 165, 152–158.

Lipperman-Kreda, S., Grube, J.W. & Paschall, M.J. (2010). Community

Norms, Enforcement Of Minimum Legal Drinking Age Laws, Personal Beliefs And Underage Drinking: An Explanatory Model. J.Community Health, 35, 249–57.

Marmot, M. (1997). Inequality, deprivation and alcohol use. Addiction

Supplement 1, S13–S20.

Mayet, A., Legleye, S., Chau, N. & Falissard, B. (2010). The mediation

role of licit drugs in the influence of socializing on cannabis use among adolescents: A quantitative approach. Addictive Behaviors, 35, 890–5.

McAlaney, J., Bewick, B. & Hughes, C. (2011). The international development of the ‘Social Norms’ approach to drug education and prevention. Drugs: education, prevention and policy, 18, 81–98.

Meier, P. (2010). Polarized drinking patterns and alcohol deregulation.

Trends in alcohol consumption, harms and policy: United Kingdom 1990–2010. Nordic Studies on Alcohol and Drugs, 27, 383–408.

Miller, B.A., Holder, H.D. & Voas, R.B. (2009). Environmental Strategies

for Prevention of Drug Use and Risks in Clubs. J.Subst.Use, 14, 19-38.

Neighbors, C., Dillard, A.J., Lewis, M.A. & Bergstrom, R.L. (2006). Normative misperceptions and temporal precedence of perceived norms and drinking. Journal of Studies on Alcohol, 67, 290–9.

Neighbors, C., Lee, C.M., Lewis, M.A., Fossos, N. & Larimer, M. (2007).

Are social norms the best predictor of outcomes among heavydrinking

college students? Journal of Studies on Alcohol and Drugs, 68, 556–65.

Neuman, M. & Bitton, A. (2002). Tobacco industry strategies for influencing European Community tobacco advertising legislation. Lancet, 359, 1323–30.

Nutbeam, D., Smith, C., Moore, L. & Bauman, A. (1993). Warning! Schools can damage your health: alienation from school and its impact on health behaviour. Journal of Paediatric Child Health, 29, Supplement 1, S25–S30.

Olds, R.S. & Thombs, D.L. (2005). Relations between normative beliefs and initiation intentions toward cigarette, alcohol and marijuana. Journal of Adolescent Health, 37, 75.

Österberg, E. & Karlsson, T. (2007). Scaling alcohol control policies across Europe. Drugs: education, prevention and policy, 14, 499–511.

Perkins, H.W. (2002). Social norms and the prevention of alcohol misuse in collegiate contexts. Journal of Studies on Alcohol Supplement 14, 164–72.

Petras, H., Kellam, S.G., Brown, C.H., Muthén, B.O. & Ialongo, N.S. (2008). Developmental epidemiological courses leading to antisocial personality disorder and violent and criminal behavior: Effects by young adulthood of a universal preventive intervention in first- and second-grade classrooms. Drug and Alcohol Dependence, 95, S45-S59.

Phillips, R. & Kinver, A. (2007). Know The Score: Cocaine Wave 4 - 2006/07 Post-Campaign Evaluation. Scottish Executive Social Research.

Proctor, R.N. (2008). On playing the Nazi card, Tob Control, 17, 289–90.

Reid, R.J., Andrew, P.N., Hughey, J. & Garcia-Reid, P. (2006). School climate and adolescent drug use: mediating effects of violence victimization in the urban high school context. Journal of Primary Prevention, 27, 281–92.

Room, R., Babor, T. & Rehm, J. (2005). Alcohol and public health. The

Lancet 365, 519-30.

Rose, G., Kaw K-T. & Marmot, M. (2008). Rose’s Strategy of Preventive

Medicine. Oxford: Oxford University Press,.

Scheier, L.M. & Grenard, J.L. (2010). Influence of a nationwide social

marketing campaign on adolescent drug use. Journal of health communication, 15, 240-71.

Smith, G.D. & Ströbele, S.A. (1994). Smoking and health promotion in

Nazi Germany. J Epidemiol Community Health, 48, 220-3. Smith, J.R. (2008). Do as we say and as we do: the interplay of descriptive and injunctive group norms in the attitudebehaviour relationship. British Journal of Social Psychology, 47, 647–66.

Smith, L.A. & Foxcroft, D.R. (2009). The effect of alcohol advertising,

marketing and portrayal on drinking behaviour in young people: systematic review of prospective cohort studies. BMC, Public Health, 9, 51.

Spinney, L. (2007). Public smoking bans show signs of success in

Europe. Lancet, 369, 1507–8.

Steinberg, L. & Monahan, K.C. (2007). Age differences in resistance to

peer influence. Developmental Psychology, 43, 1531–43.

Steinberg, L. (2008a). A Social Neuroscience Perspective on Adolescent

Risk-Taking. Developmental Review, 28, 78–106.

Steinberg, L., Albert, D., Cauffman, E., Banich, M., Graham, S. & Woolard, J. (2008b). Age differences in sensation seeking and impulsivity as indexed by behavior and self-report: evidence for a dual systems model. Developmental Psychology, 44, 1764–78.

Stephenson, M.T. & Helme, D.W. (2006), Authoritative Parenting And

Sensation Seeking As Predictors Of Adolescent Cigarette And Marijuana Use. Journal of Drug Education, 36, 247–70.

Stern, P. (2005), Individuals’ Environmentally Significant Behaviour.

Environmental Law Reporter News and Analysis, 35, 10785–90.

Stewart-Brown, S. (2006), What is the evidence on school health promotion in improving health or preventing disease and, specifically, what is the effectiveness of the health promoting schools approach? Copenhagen: WHO Regional Office for Europe.

Strasburger, V., Wilson, B. & Jordan, A. (2009), Children, Adolescents, and the Media, (2nd ed.). Thousand Oaks, CA: Sage Publications. UK Home Office (2011), The likely impacts of increasing alcohol price: a summary review of the evidence base. Accessed at http://www.

homeoffice.gov.uk/publications/alcohol/impacts-alcohol-pricereview.

Vega, W.A. (2005), Research report revisiting drug progression: longrange

effects of early tobacco use. Addiction, 100, 1358–69.

Vigna-Taglianti, F., Vadrucci, S., Faggiano, F., Burkhart, G., Siliquini, R. & Galanti, M.R. (2009), Is universal prevention against youths’ substance misuse really universal? Gender-specific effects in the EU-Dap school-based prevention trial. J Epidemiol Community Health, 63, 722–728.

Wagenaar, A.C., Salois, M.J. & Komro, K.A. (2009), Effects of beverage

alcohol price and tax levels on drinking: a meta-analysis of 1003 estimates from 112 studies. Addiction 104, 179–90.

Wagenaar, A.C., Tobler, A.L. & Komro, K.A. (2010), Effects of alcohol

tax and price policies on morbidity and mortality: a systematic review. American Journal of Public Health, 100, 2270–8.

Wetzels, J.J.L., Kremers, S.P.J. & Vitoria, P.D. (2003), The alcohol tobacco

relationship - a prospective study among adolescents in six European countries. Addiction, 98, 1755–63.

White, D. & Pitts, M. (1998), Educating young people about drugs: a

systematic review. Addiction, 93, 1475-1487

Wilson, M. & Daly, M. (1993), An evolutionary psychological perspective on male sexual proprietariness and violence against wives. Violence and Victims, 8, 271–94.

Winlow, S. & Hall, S. (2005), Violent Night. Urban Leisure and Contemporary Culture. Oxford: Berg.

World Bank (1999), Curbing the Epidemic: Governments and the

Economics of Tobacco Control. Washington DC:The World Bank.




DOI: https://doi.org/10.20882/adicciones.151

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