Research finds concerning trends in adolescent substance use in the UK

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 latest data from across Europe, Central Asia and Canada, from the new Health Behaviour in School-aged Children (HBSC) study, paints a concerning picture of adolescent substance use in the UK and beyond. The report is based on data from 2021-22, 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 a shocking 1 in 5 had recently used e-cigarettes. 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. In addition, the study highlights particular risks for older girls around vaping and alcohol use, emphasising the need for targeted prevention strategies.

Major findings of the report include:

● Prevalence of alcohol consumption. Alcohol is the most common substance used among adolescents, with the report finding, that 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.

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

● E-cigarette use. 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% of boys and 40% of girls. Prevalence of vaping among 15 year-old girls is above the HBSC average in England, Scotland and Wales.

● Cannabis use trends. 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 (HBSC average = 12%). 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% of 15 year-old girls in England and Scotland, and 27% in Wales, having vaped in the last 30 days. Levels were slightly lower among boys (17% in England, 20% in Scotland, 19% in Wales).

Dr Jo Inchley, HBSC International Coordinator, 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 4 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.

Dr Sabina Hulbert, Co-PI for HBSC England, 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 years olds (65% of boys and 74% 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.”

Professor Sally Kendall, Co-PI for HBSC England, 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 between all other countries. Measures towards a lifetime ban on smoking are very welcome but policy makers need to act quickly to include vaping in their legislations.”

The report, ‘A focus on adolescent substance use in Europe, central Asia and Canada’, is published here