The theoretical foundations for current understandings of environmental prevention in Europe are ill-defined. This study set out to identify major theories informing current conceptualisations, and to highlight the ways in which they shape and delimit current discourses on environmental prevention.

The 2018 report of the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) and related publications on the topic were reviewed to identify key concepts informing current environmental prevention. These were then assessed through a comparison with alternative theoretical models.

Current conceptualisations of environmental substance use prevention in Europe rely on a behaviourist interpretation of a narrow range of theories from psychology, criminology and behavioural economics. The immediate environment appears as isolated physical cues, and personenvironment relationships tend to be construed within a stimulus-response paradigm. On this theoretical foundation, useful interventions strategies may be overlooked, restrictions and coercion may dominate, and our understanding of how interventions work may be reduced. A paradigm shift toward a greater interest in mechanisms is noticeable but progressing slowly. Alternative theories are available from sociology and cognitive psychology but are not yet utilised.

Current theoretical foundations of environmental prevention may limit intervention possibilities, effectiveness and produce undesirable effects. Examples of alternative theoretical models will be presented which could enrich current perspectives by detailing mechanisms, including novel moderators and mediators. New theoretical perspectives can help us approach environmental prevention in new ways, including a greater concern for potential iatrogenic effects and coproduction with target populations.