A review of the effectiveness and cost-effectiveness of interventions delivered in primary and secondary schools to prevent and/or reduce alcohol use by young people under 18 years old. Final report

Background: Data from national surveys of drinking behaviour in young people indicate that by the age of 15-16 years, the vast majority of young people have tried their first alcoholic drink. In addition, at age 15-16 nearly half of young people are consuming alcohol on a weekly basis and around a quarter report drinking to intoxication regularly. Binge drinking habits continue into young adulthood, with more than a third of 16-24 year olds reporting that they drink over the sensible drinking daily limits.
Objectives: This review sought to determine which interventions delivered in primary and secondary schools are effective and cost-effective for preventing or reducing alcohol use in young people under the age of 18 years.
Methods: The methods for the review of effectiveness and cost-effectiveness followed NICE protocols for the development of NICE public health guidance. Twenty databases were searched for systematic reviews and meta-analyses, randomised controlled trials, controlled non-randomised trials, controlled before and after studies and economic evaluation studies published since 1990. Two reviewers independently screened all titles and abstracts. Data extraction and quality assessment of individual studies was undertaken independently by one reviewer and checked for accuracy by a second reviewer. Each study was also graded (++, +, or -) based on the extent to which the design and execution of the study minimised the potential sources of bias. Results of the data extraction and quality assessment for each study of effectiveness and cost-effectiveness were presented in structured tables and as a narrative summary. Further cost-effectiveness analyses were undertaken to determine a 'cost per case of hazardous/harmful drinking averted' for programmes identified in the effectiveness review.