It is because of their perceived vulnerability and malleability that youth have been the focus of most substance use prevention and intervention programs. The volume discusses the background of substance abuse prevention programs targeting high-risk youth, the evolution of prevention theory and programming, risk-focused prevention and protective factors by domain. It also examines eight model programs: Across Ages; Child Development Project; Creating Lasting Connections; Dare To Be You; Greater Alliance of Prevention Systems; Residential Student Assistance Program; SMART Leaders; and Family Advocacy Network. A synthesis of effective prevention programs evaluates strategies, information dissemination, education, alternatives, problem identification and referral, community-based process and environmental approach. Each of the programs, in its own setting and in its own manner, promoted supportive and caring relationships between youth and members of their families, communities and peer groups. Each of the effective programs implemented multifaceted interventions targeting the specific needs of its audiences. And each of the programs was successful either in increasing the latency of first alcohol, tobacco and drug use, reducing the frequency of use or in effectively reducing risk factors and/or enhancing protective factors. References, figures, tables, appendixes