Kirsty Blenkins AYPH’s new Evidence and Policy Lead reflects on new substance use data from the Health Behaviour in School-aged Children (HBSC) study.

HBSC is a school-based survey carried out every four years in collaboration with the World Health Organisation (WHO). It includes 2021-22 data on 280,000 children aged 11, 13 and 15 from 44 countries and regions who were asked about alcohol, cigarettes, vaping and cannabis use 

Despite declines in substance use in recent years including alcohol and smoking, HBSC data suggests an increase in use of cannabis, vaping, and alcohol amongst young people aged 11-15. Vaping is now more common than smoking. While substance use remains generally higher among boys than girls at age 11, there is emerging evidence of increasing gender difference with girls aged 13 and 15 in Great Britain drinking, smoking, and vaping more than boys of the same age.

Key points from the HBSC report include: 

Alcohol: Alcohol is the most common substance used among adolescents. Over half of 15-year-old girls and about two-fifths of boys of the same age drank alcohol in the last month. UK girls, especially, get drunk more often than their counterparts in other European countries. 

Tobacco: Though smoking is decreasing, more than one in five 15-year-old girls have smoked, with higher rates amongst girls than boys in England and Wales. 

E-cigarettes: Vaping is now more common than smoking. Nearly one in ten 11-year-olds in England have tried e-cigarettes, rising to 26% of boys and 40% of girls by age 15. Prevalence of vaping among 15-year-old girls in England, Scotland and Wales is above the HBSC average.  

Cannabis: UK teens use cannabis more than the HBSC average, with almost one in five 15-year-olds trying it. Boys in Scotland have the highest cannabis use rate among all countries studied. 

Socioeconomic differences: Smoking is more common among teens from low-income families, while e-cigarette use, alcohol, and drunkenness are more common among wealthier teens. 

Signs of increases in drug, vaping and alcohol use amongst young people need to be monitored. It will be key to keep track of new data sets coming out later in 2024 from the Smoking, Drinking and Drug use survey in England for further indicators. What we do know is that the earlier young people use substances the more harm they might experience including increases in risky behaviours, exclusion from school and low mood. This is important for young people now and for their future adulthood as health behaviours formed in adolescence can last a lifetime.

AYPH policy and good practice recommendations: There is a clear need for evidence-based interventions in this space. Action is needed at multiple levels, targeting those most vulnerable, alongside referral pathways to specialist substance misuse services for young people. Implementation of effective school-based interventions is important; however, any measures to improve young people’s health should consider the context in which young people are living including access to drugs and inaccurate information about harms online. Alongside prevention programmes in schools there is also a need for awareness raising with young people, parents and carers and regulation.  

Young people’s involvement in this work is also important. They understand how these issues affect them and their peers, as our Young Ambassadors said. ‘Vapes have been marketed towards teens and with vapes shops popping up everywhere’.  They are also thoughtful about potential solutions ‘We need support groups for young people who might be finding it difficult to stop vaping’.  

Moving forward specific focus on how substance use is affecting young people is key so that we can support better services and a range of preventative measures specifically focused on young people. 

AYPH offers training in youth friendly health services, ethical practice and engagement and health inequalities amongst young people. We have a track record of service evaluation and development of young people’s health and wellbeing services. We are seen as experts on participation work and are regularly commissioned by other organisations to support the involvement of young people through a range of processes, from consultations about services to setting up youth governance structures. 

Author: Kirsty Blenkins

June 2024