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Based on a definition of comprehensive prevention, the author submits prevention actions in alcohol and tobacco related problems to the question: "Education or control, must we choose?" After reviewing the history, the author describes the current panorama of health education actions and control before discussing some methodological and ethical questions concerning the methods and the actors of prevention. He tries to define "prevention ideal" - which must be distinguished from "ideal prevention" and its totalitarian abuse - to introduce the second part of his text which deals with the question of evaluation of the effectiveness of alcohol- and tobacco-related problems prevention. The author confirms the efficacy of control measures, but also shows that education has a certain degree of efficacy, despite the dominant trends in Anglo-Saxons countries. He also shows that education is necessary in the context of many European countries. After discussing the issue of cost-effectiveness ratio, the author emphasise the need for global prevention taking into account cultural and political elements to ensure efficient as well as effective prevention and social acceptance of this prevention.

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