Teenagers across Europe are in a state of “profound transition”, with traditional substance use patterns giving way to new digital-age risks, according to the results of the 2024 European School Survey Project on Alcohol and other Drugs (ESPAD).
The study, conducted in collaboration with the European Union Drugs Agency (EUDA) and coordinated by the Italian National Research Council (CNR), surveyed 15- to 16-year-olds across 37 European countries, including 25 EU member states. The report marks the eighth wave of data collection since the project began in 1995 and the first conducted after the COVID-19 pandemic.
Cannabis remains the most commonly used illicit drug among European adolescents, but usage rates have fallen markedly across nearly all Western and Northern European countries. The decline is reflected in both lifetime and current prevalence rates, as well as reduced perceptions of ease of access.
However, significant geographic disparities persist. Several Eastern European and Balkan countries reported stable or slight increases in cannabis and other illicit drug use, while Nordic countries continue to report the lowest levels of consumption.
Perhaps most notably, the traditional gender gap in cannabis use is rapidly narrowing, with girls now reporting similar – and in some cases higher – rates of consumption compared to boys. This shift reflects broader cultural changes in gender norms around substance use.
The most striking trend was the sharp rise in e-cigarette use, non-medical pharmaceutical drug use, and problematic social media, online gaming and gambling behaviours. These patterns are most pronounced among girls, where traditional gender gaps in substance use are narrowing or even reversing.
“While the continued decline in the use of established substances is welcome, it is clear that this does not necessarily correspond to a reduction in risk,” the report stated. “Indeed, the intertwining of psychoactive substance use and digital risk behaviours represents a new and complex challenge for public health.”
The findings prompted calls for three strategic interventions. The report called for broader evidence-based prevention approaches to address the full spectrum of youth risk behaviours via the roll-out of EUDA’s European Prevention Curriculum – a training programme adopted by prevention professionals.
Researchers also emphasised the need to prioritise mental health and wellbeing in schools and communities, with gender-sensitive approaches to help address emerging risks among adolescent girls.
Finally, the report called for urgent action to tackle digital environments that expose young people to early risks. This included addressing addictive design in online gaming and strengthening digital identity verification to prevent underage access to online gambling.
The 2024 survey expanded beyond traditional substance monitoring to include social media use, gaming and gambling. In response to the pandemic’s mental health impacts and ongoing conflicts in Europe and the Middle East, ESPAD strengthened its focus on adolescent mental well-being for the first time.
“Only through such a systemic perspective can risk be transformed into resilience, and environments be created that support the development of healthier and self-aware youth,” the report concluded, underlining the need for multisectoral, agile interventions that can adapt to the complex changes shaping young people’s lives.
