The global substance use problem is a serious public health concern that affects not only health, safety and well-being of communities, but also social and economic development. It particularly affects children, young people and their families. All Member States should set substance use prevention measures and programmes as a priority in order to promote health and reduce social harm. During the past few decades there has been a significant advance in prevention science that has led to the development of international prevention standards and globally accepted evidence-based interventions. This review looks into the key requirements, components and strategic interventions needed for a public health approach to prevention of substance use and disorders, and its health and social consequences. It aims at supporting Member States and civil society to identify the key elements that support countries and local communities to increase the number of substance use protective approaches in relation to risk factors across all relevant domains.