This document presents a consensus approach produced through a Delphi process commissioned by Public Health Scotland (PHS). The Delphi process is a structured approach that uses a series of activities to gather information on  complex area from a panel of experts, including young people. The approach involves multiple rounds of engagement. The first is an open discussion on a range of key questions, from which main themes or statements are extracted. The second, and any subsequent rounds, presents outputs from the previous round of consultation to the expert panel and asks them to consider areas of agreement.

Delivery of the Delphi method is a stakeholder-led process and participants included public health officials, academics and educators, youth workers and individuals working in health, mental health, recovery, and addiction services, local authorities, Alcohol and Drug Partnerships, Health and Social Care Partnerships, Children and Family Services, third sector partners, those working in the community safety and justice sector, remote and rural communities, people with lived experience of substance use and NHS boards.

This process included dedicated development work and engagement activity with third sector youth partners Young Scot, Fast Forward, YouthLink Scotland, the Time 4 Us Children and Family service within Transform Forth Valley and Children's Parliament to involve children and young people between the ages of 10 to 18, plus the recruitment of students between the ages of 18 to 25 to participate in the process. The process explored the panel’s understanding of the most effective approaches to prevention. The work aims to establish what a whole-systems approach to substance use harm prevention among children and young people in Scotland should look like.

The consensus approach is structured around five key themes:
1. Foundations for developing a strategy and implementation plan
2. Essential components for delivering prevention in Scotland
3. Priorities for those at highest risk
4. Principles for universal prevention measures
5. Focus on structural factors