The European Schools Project on Alcohol and other Drugs (ESPAD) was concern
ed with the substance use, beliefs, attitudes and risk factors among over 5
0,000 16-year-olds in 26 European countries. Based on this data, the presen
t paper focuses on critical issues in prevention and uses a country-level a
nalysis with focus on the extent that contextual and cultural factors inter
act with factors influencing the use of alcohol and other drugs. The result
s indicate that: (ii an emphasis on risks and dangers may be a poor prevent
ion strategy since many young people do not believe the widely accepted dan
gers of certain forms of substance use (e.g. cigarette smoking); (ii) mispe
rception of norms ill relation to substance use, that is, the belief that u
se of alcohol and other drugs is more common than it actually is, emerged i
n most countries with the exception of Nordic countries; (iii) the correlat
ion between perceived access to substances and actual use depended on the s
ubstance involved; correlations were strongest for cannabis but low for alc
ohol; (iv) the measure of problem behaviour was used in the ESPAD study (tr
uancy from school), is correlated with substance use in a way that is oppos
ite to that predicted in problem behaviour theory; and (v) there were no in
dications that the potential restraining factors that were examined in this
study (involvement in athletics and leisure) acted in a way that prevented
people from experimenting with drugs. The results of this analysis suggest
s that far from our having identified a core set of universal influences th
at act to determine substance use, the importance of cultural and contextua
l factors have been underestimated as has the importance of the specific su
bstance involved.