A WHO Europe report into adolescent health and well-being paints an alarming picture of substance use in Europe, with a survey of schools finding that 32% of 15-year-olds had used an e-cigarette and 20% consumed products in the last 30 days, E-cigarette use now surpasses cigarette smoking.
As habits established in adolescence often continue into adulthood, the report flags concerns that this will create growing longer-term problems for public health.
“The widespread use of harmful substances among children in many countries across the European Region – and beyond – is a serious public health threat,” said Dr Hans Henri P. Kluge, WHO Regional Director for Europe. “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.”
E-cigarettes are seen by some health authorities as a positive alternative to smoking for adults. However, the aggressive targeting of a younger market has seen a surge in use in this group, with a particularly sharp rise in consumption between the ages of 13 and 15.
Historically there has been a difference between boys and girls, with more boys smoking than girls. With e-cigarettes, girls reach the same level of use by 15 as boys and even outpace them after 15.
Concerns are now mounting that the rise in use threatens progress made in tobacco control. The report calls for e-cigarettes to be incorporated into smoke-free policies, with similar measures to restrict marketing, reduce toxicity, remove flavours and increase taxation.
WHO has already called for e-cigarettes to be made available only to those who are trying to quit smoking, where other proven cessation strategies have been exhausted. It has also called for e-cigarettes to be regulated like medicines, rather than being sold as consumer products.
The report is largely a school-based survey carried out every four years in collaboration with the Health Behaviour in School-aged Children (HSBC) and surveying alcohol use, drunkenness, and cannabis use.
Alcohol
Alcohol is still the most commonly used substance among young people, with more than half of 15-year-olds having tried alcohol at least once. Roughly 10% of adolescents have experienced drunkenness, with the figures reaching 20% for 15-year-olds. The escalating trend of alcohol abuse and its normalisation is another red flag for public health.
Cannabis
One positive note in the survey is the slight decrease in cannabis use, with 12% of 15-year-olds in the survey having used it compared to 14% in the last survey (2018).
The report is seen as an important benchmark to gain insights and to inform what further action is needed.
[Edited by Rajnish Singh]