Alcohol is the most commonly used substance, while vaping is now more common than cigarette smoking among young people, according to a new WHO/Europe report coordinated by researchers at the University of Glasgow.

The data was collected from across Europe, Central Asia, and Canada and collated to form the ‘Health Behaviour in School-aged Children International Report from the 2021/2022 Survey’ (HBSC). The report is based on data from nearly 280,000 adolescent boys and girls.

The WHO-commissioned report found that more than half of 15-year-olds in Europe had experimented with alcohol, while one in five had recently used e-cigarettes.

The study highlighted particular risks for older girls around vaping and alcohol use, emphasising the need for targeted prevention strategies.

Hans Henri P. Kluge, WHO regional director for Europe, said, “The widespread use of harmful substances among children in many countries across the European Region – and beyond – is a serious public health threat.

“Considering that the brain continues to develop well into a person’s mid-20s, adolescents need to be protected from the effects of toxic and dangerous products. Unfortunately, children today are constantly exposed to targeted online marketing of harmful products, while popular culture, like video games, normalizes them. WHO/Europe is working with countries to ensure all young people, everywhere, get the best possible start in life. This means protecting them from toxic and addictive products that could affect their quality of life in the years ahead.”

In the UK, recent declines in smoking over the last few decades had stalled, and there was evidence of a small increase in alcohol use among 15-year-old girls in England since 2018.

The report found that alcohol is the most common substance used among adolescents. Among 15-year-olds in the UK, over half of girls and around two-fifths of boys had drunk alcohol in the past 30 days. England had the highest rates of lifetime alcohol use among 11 and 13-year-olds. Compared with other European countries, rates of drunkenness in the UK were high, particularly among girls.

While smoking rates have decreased in recent years, more than one in five 15-year-old girls have smoked cigarettes in their lifetime, and more than one in ten have done so in the last 30 days. Smoking prevalence is higher among girls than boys in England and Wales.

Vaping rates are concerning and have now overtaken rates of cigarette smoking. Almost one in ten 11-year-olds in England have used an e-cigarette at least once. By age 15, this increases to 26 per cent of boys and 40 per cent of girls. The prevalence of vaping among 15-year-old girls is above the HBSC average in England, Scotland and Wales.

Cannabis use in the UK is above the HBSC average; almost one in five 15-year-olds report having used cannabis at least once in their lifetime (the HBSC average is 12 per cent). In Scotland, lifetime use has declined over the past 20 years, but current use has remained relatively stable, suggesting little improvement among more regular users. Boys in Scotland have the highest rate of lifetime cannabis use among all HBSC countries.

Researchers suggest the transition to e-cigarettes, as a more popular choice than conventional cigarettes, highlights an urgent need for more targeted interventions to address this emerging public health concern. The report found that e-cigarettes were increasingly popular with young people, with 30 per cent of 15-year-old girls in England and Scotland, and 27 per cent in Wales, having vaped in the last 30 days. Levels were slightly lower among boys (17 per cent in England, 20 per cent in Scotland, 19 per cent in Wales).

Jo Inchley, HBSC international coordinator and a public health researcher at the University of Glasgow, said, “Steep increases in vaping among young people in the UK threaten to reverse some of the positive trends we’ve seen in substance use in recent years with overall declines in alcohol use and cigarette smoking since the 1990’s.

“Rates of vaping have doubled in the last four years among girls in Scotland. Vapes are far too readily accessible to young people and the health risks are underestimated. New legislation to ban single use vapes is an important step forward but further action is needed to address these worrying trends.”

Early onset of alcohol use in England, and high levels of alcohol use among older girls, was also particularly concerning. Researchers say the report findings highlighted how available and normalised alcohol is, showing the urgent need for better policy measures to protect children and young people from harms caused by alcohol.

Sabina Hulbert, co-principal investigator for HBSC England and a research fellow at the University of Kent, said, “English boys and girls aged 11 and 13 are the ones reporting the highest levels of lifetime alcohol consumption in all the countries surveyed. The vast majority of 15-year-olds (65 per cent of boys and 74 per cent of girls) report having had access to alcohol, a banned substance responsible for psychological and physiological long-term damages. With figures on the rise, especially for girls, we urge our policy makers to make immediate changes to the clearly ineffective measures that are currently in place to protect our young generations from harm.”

Sally Kendall, co-principal investigator for HBSC England and a professor of community nursing and public health at the University of Kent, said, “There is very little comfort to be taken from the fact that the proportions of children smoking in England are lower than the international averages in some cases. Clearly, vaping has replaced smoking as a dangerous recreational activity in our children, and those figures are amongst the highest among all other countries. Measures towards a lifetime ban on smoking are very welcome, but policymakers need to act quickly to include vaping in their legislations.”

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