Evaluation findings from large mass-media advertising campaigns conducted in the United Kingdom, United States, Australia, and elsewhere indicates mixed success. Such campaigns can be effective in changing knowledge, influencing public debate, and reaching high-risk targets, but may have limited impact on attitudes and are unlikely to influence behavior. Integrated programs in which other activities complement mass-media advertising have been more successful in producing desired health behavior changes. Unpaid publicity and media advocacy are less costly than paid advertising. Using the media well in drug prevention requires attention to objectives, integration with other approaches, the audience, segmentation, types of messages, sources and channels, communications with gatekeepers and stakeholders, monitoring and evaluation, and costs. Social marketing provides one possible system for approaching media-based drug prevention. The steps in a typical marketing plan includes a situation analysis, the formulation of the marketing strategy, and the implementation of the marketing strategy. Social marketing also offers the concepts of pragmatism and flexibility. Figures and 93 references