ESPAD: Smoking, drinking by teens down, but concerns about new addictive behaviours

Smoking and drinking among 15–16-year-old school pupils are showing signs of decline, but there are concerns over potentially risky cannabis use and the challenges posed by new addictive behaviours.

These are among the findings released on November 12 in a new report from the European School Survey Project on Alcohol and Other Drugs (ESPAD). The study, published in collaboration with the EU drugs agency (EMCDDA), is based on a 2019 survey in 35 European countries, including 25 EU countries.

ESPAD ( is a collaborative network of independent research teams in over 40 European countries and the largest cross-national research project on adolescent substance use in the world. It is coordinated by the ESPAD Italian team at the National Research Council of Italy (CNR-IFC).

This is the seventh data-collection wave conducted by the ESPAD project since 1995.

A total of 99 647 pupils participated in the latest survey round, responding to an anonymous questionnaire.

The ESPAD Report 2019 features information on pupils’ experience of, and perceptions about, a variety of substances, including: tobacco, alcohol, illicit drugs, inhalants, pharmaceuticals and new psychoactive substances (NPS). Social media use, gaming and gambling are also covered.

To better describe contemporary patterns of nicotine consumption, the scope of the 2019 survey was extended to include e-cigarette smoking for the first time in all participating countries.

Alcohol use remains high among adolescents in Europe, with an average of over three-quarters (79 per cent) of school pupils having used alcohol in their lifetime and almost half (47 per cent) having used it in the last month.

But trend data show some steady decreases, with levels now lower than in 2003 when both peaked at 91 per cent and 63 per cent, respectively.

The prevalence of “heavy episodic drinking” reached its lowest level in the 2019 survey (35 per cent), following a peak in 2007 (43 per cent).

Data show that the gender gap in the prevalence of this pattern of alcohol use has narrowed over time (boys 36 per cent; girls 34 per cent). Changes in drinking regulations at national level may have contributed to the decline in alcohol use among young people, the statement said.

Positive developments are also seen with regard to teenage smoking, against a backdrop of tobacco policy measures introduced over the last two decades.

Between 1995 and 2019, ESPAD averages for cigarette use declined for lifetime use (68 per cent to 42 per cent); current use (33 per cent to 20 per cent) and daily use (20 per cent to 10 per cent).

New data reveal high prevalence of e-cigarette smoking — 40 per cent for lifetime use and 14 per cent for last-month use — with those who have never smoked cigarettes (‘never smokers’) reporting higher rates of this behaviour than ‘occasional smokers’ and ‘regular smokers’.

Although the study did not investigate the contents of e-cigarettes, it is likely that a high proportion of these devices include nicotine and that overall adolescent nicotine use could be rising again. “This issue calls for further investigation given the potential for public health consequences,” the statement said.

The latest survey shows that, on average, one in six school pupils (17 per cent) reported having used an illicit drug at least once in their life, with levels varying considerably across the ESPAD countries (range: 4.2 per cent–29 per cent).

Lifetime prevalence of illicit drug use in this group has been declining slightly since 2011, although has been generally stable over the past two decades.

Cannabis is still the illicit drug most used by school pupils in ESPAD countries.

On average, 16 per cent of respondents reported using cannabis at least once in their lifetime (11 per cent in 1995), while 7.1 per cent reported last-month use (4.1 per cent in 1995).

Lifetime use has slowly declined since 2011, while last-month use has stabilised since 2007. High-risk cannabis use, explored for the first time in all participating countries in the 2019 survey, revealed that, on average, four per cent of respondents fell into this category and are potentially at risk of developing cannabis-related problems.

The non-medical use of prescription drugs among adolescents remains a concern, the statement said.

For example, 6.6 per cent of those surveyed reported having used tranquilisers or sedatives, and four per cent having used painkillers, ‘to get high’ in their lifetime.

On average, 3.4 per cent of pupils reported having used new psychoactive substances (NPS) in their lifetime — a small decrease from four per cent in 2015 — but still representing higher levels of use than for amphetamine, ecstasy, cocaine or LSD taken individually. Almost all NPS users are polysubstance users (also consuming alcohol, cannabis and stimulants).

According to the report: “The high degree of normalisation of gambling in societies and the culture of gambling within the family environment have been recognised as important drivers of gambling onset and youth progression into problem gambling”.

The 2019 ESPAD results show that gambling for money has become a popular activity among school pupils in Europe, with 22 per cent of respondents reporting gambling on at least one game in the past 12 months (predominantly lotteries).

An estimated 7.9 per cent of pupils had gambled for money online in that period. The screening tool used in the latest survey to estimate problem gambling revealed that, on average, five per cent of pupils who had gambled in the last 12 months fell into this category.

Over the last two decades, driven mainly by the increasing popularity of smartphones and tablets, gaming has become more popular and is increasingly played on these devices.

Around 60 per cent of respondents reported having played digital games on a typical school day within the last month (69 per cent on a non-school day). In most countries, boys spend twice as much time gaming as girls.

Around 94 per cent of respondents reported use of social media in the past week. On average, users spent two to three hours on social media on a typical school day, rising to six or more hours on non-school days. In most countries, girls reported using social media on non-school days more frequently than boys.

The report concludes: “With the 2019 data collection, ESPAD brings together comparable information from over 30 European countries over a period of 24 years. This places the project in a unique position to continue to make a valuable contribution to the development of credible and effective policies and interventions to protect youth health and social wellbeing in general”.

(Photo: Romana Ferrer)

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