Prevention Evaluation: How Do We Know If Youth Programs Actually Work?
Most youth nicotine prevention programs are never evaluated. The ones that are evaluated often show no effect—or negative effects. The evaluation gap is a scandal hiding in plain sight: billions spent on programs, almost nothing spent on knowing if they work.
A school district implements an anti-vaping curriculum. The curriculum provider reports satisfaction surveys ('90% of students said they learned something'). No one measures whether vaping rates changed. **The evaluation gap in youth nicotine prevention is a scandal: billions of dollars have been spent on programs whose effectiveness is unknown. The programs that have been rigorously evaluated often show no effect on behavior—and some show negative effects (increased curiosity, increased experimentation). We don't know if most prevention programs work. We don't seem to want to know.**
