Europe's teens ditching booze, but hooked on vapes and online gambling: ESPAD report
The latest European School Survey Project on Alcohol and Other Drugs (ESPAD) report, released on 20 May 2025, paints a complex and evolving picture of adolescent health across the continent. Whereas a long-term decline in the use of traditional substances, like alcohol and tobacco, is a public health success story that has been decades in the making, this optimistic trend is now being eclipsed by a worrying increase in new behavioural risks. These new challenges consist of the rising use of e-cigarettes, the non-medical use of prescription drugs, and a sudden surge in online gaming and gambling. This shift in the landscape of adolescent risk demands urgent attention from public health officials and policymakers across the 37 participating European countries, as it indicates a fundamental transformation in the nature of vulnerabilities facing 15-16-year-old students, the target demographic of ESPAD’s 30-year monitoring efforts.
Shifting landscape of adolescent risk
The present a dual narrative, highlighting both encouraging progress in long-standing public health battles and the rapid emergence of novel challenges.
For decades, public health initiatives across Europe have focused on reducing adolescent engagement with alcohol and tobacco. The 2024 ESPAD report confirms the sustained effectiveness of these efforts, showcasing a remarkable long-term decline in traditional substance use among 15-16-year-olds.
Alcohol consumption, once highly prevalent, has seen a significant reduction. Lifetime alcohol use among students in 32 consistently participating countries dropped from 88 percent in 1995 to 74 percent in 2024. Similarly, current use (within the last 30 days) fell from 55 percent to 43 percent over the same period. Perhaps most notably, heavy episodic drinking, defined as consuming five or more drinks on one occasion in the last 30 days, reached its lowest recorded level at 30 percent in 2024, down from 36 percent in 1995, according to the ESPAD report.
Cigarette smoking has experienced an even more dramatic reduction. Lifetime cigarette use among students more than halved, plummeting from 68 percent in 1995 to just 32 percent in 2024 across the 32-country trend. A particularly significant drop of 10 percentage points occurred between 2019 and 2024 alone. This reduction indicates the effectiveness of tobacco control measures, such as enhanced perception of health harms, age limits, and decreased social acceptability of smoking.
In addition, illicit drug use has also gone down. On average, 1 in 8 students in school (14 percent) had used an illicit drug at least once in their lifetime in 2024. This is a drop from 19 percent in 2015. Cannabis remains the most commonly used illicit drug, but its lifetime use has also fallen to 12 percent from a peak of 18 percent in 2003. The sustained decline across alcohol, cigarettes, and illicit drugs since 1995 can be equated to a public health achievement. This success provides a blueprint for addressing new risks, highlighting the importance of consistent, multi-faceted public health interventions that combine education, policy, and efforts to shift social norms.
Rise of new concerns
As established patterns of drug use fall, the ESPAD 2024 report identifies increasing concerns about emerging health and behavioural risks associated with a new generation of risks, most notably those presented by digital systems and prescription drug misuse.
E-cigarette use has experienced a major surge, becoming a prominent concern. Current e-cigarette use among 15-16-year-olds rose from 14 percent in 2019 to 22 percent in 2024 across the 32-country trend. Lifetime use also increased from 41 percent to 43 percent. Another finding in the study is that girls (46 percent) reported more lifetime e-cigarette use than boys (41 percent) in 30 countries. This fast growth indicates an apparently reduced perception of risk over conventional cigarettes, possibly driven by marketing and having attractively flavoured products available or a need to remain in step with peer norms.
Non-medical pharmaceutical drug use also has a disturbing trend. Lifetime non-medical use stands at 14 percent among students, with girls consistently reporting higher rates (16 percent compared to 11 percent for boys). Tranquillisers and sedatives are the most frequently misused, at 8.5 percent. Alarmingly, 1 in 5 students reported that tranquillisers are easy to access. The perceived ease of obtaining these substances underscores a critical regulatory and monitoring gap, potentially indicating diversion from legitimate prescriptions or illicit market supply. This calls for multi-faceted interventions in the form of public information campaigns regarding the safe storage of prescription medications, school and community education around the risks of non-medical use, and possibly heightened monitoring of prescription dispensing. It also implies a demand for strong mental health care, given that these medications are commonly used for self-medication.
Online gambling has increased alarmingly, rising almost by half from 8 percent in 2019 to 14 percent in 2024. The increase is particularly significant among girls, whose online gambling increased three-fold from 3 percent in 2019 to 9 percent in 2024. In addition, problem gambling behaviour almost doubled from 4.7 percent in 2019 to 9 percent in 2024. Notwithstanding tightened gambling controls throughout Europe, the trends stress the imperative for ongoing surveillance and focused prevention.
Gaming participation has also increased, with 80 percent of students reporting gaming in 2024, up from 47 percent in 2015. Girls’ engagement in gaming tripled from 22 percent in 2015 to 71 percent in 2024, shifting what was once predominantly a male activity to one common among both genders. A significant 22 percent of students believed they had a gaming problem.
While the continued decline in alcohol consumption, cigarette smoking, and illicit drug use among 15-16-year-olds means a major public health achievement, the progress is now challenged by a concerning surge in the use of e-cigarettes, non-medical pharmaceuticals, online gambling and problematic social media engagement.
