Purpose: PRIME for Life is an alcohol risk reduction program that has been used and refined in the USA for over 20 years. A Swedish version of the program has recently been adapted for use among Swedish high-school students (age 18-19). The objective of the study is to evaluate the effects of the program on youth alcohol consumption (including high risk drinking), attitudes and knowledge about the effects of alcohol use. Design/methodology/approach: The authors conducted a randomised controlled trial involving 23 schools and 926 students. Data collection was conducted with questionnaires focusing primarily on drinking behaviour. Participants were followed up at five and 20 months to assess changes in drinking behaviour, knowledge and attitudes towards alcohol. Findings: No significant program effects on drinking behaviour were found. Knowledge about the effects of alcohol consumption on health increased after the intervention, as did negative attitudes towards alcohol, but these effects eroded over time. Originality/value: Despite being widely used in the USA and Sweden, the impact of PRIME for Life is under-reported in the literature. This is the first independent evaluation of the program focusing on high school age youth. The findings do not support the efficacy of the program as a risk reduction or behaviour change tool in a school environment. (Contains 7 tables and 2 figures.)