While substance use among 15–16-year-old students in Europe continues its long-term decline, new behavioural and health risks are on the rise. The latest findings from the European School Survey Project on Alcohol and Other Drugs (ESPAD), released today, flag growing concerns over increasing e-cigarette use, the non-medical use of pharmaceutical drugs, and a sharp uptick in online gaming and gambling among teenagers. The findings also reveal a noticeable increase in risky behaviours among girls across several areas. The study, carried out in collaboration with the European Union Drugs Agency (EUDA) and coordinated by the Italian National Research Council, is based on a 2024 survey in 37 European countries, including 25 EU Member States (¹).

This is the eighth data-collection wave conducted by the ESPAD project since 1995. A total of 113 882 students (aged 15–16-years) participated in this latest survey round, responding to an anonymous questionnaire. This edition marks 30 years of monitoring adolescent risky behaviours across Europe.

The 2024 ESPAD findings relate to students’ experience of, and perceptions about, a variety of substances, including: tobacco, alcohol, illicit drugs, inhalants, pharmaceuticals and new psychoactive substances (NPS). Social media use, gaming and gambling are also covered. In the aftermath of the COVID-19 pandemic and amid ongoing conflicts in Europe and the Middle East, has also strengthened its focus on adolescent mental well-being. This survey round included a new focus on mental well-being and prevention activities, recognising the growing importance of these factors in shaping adolescent health outcomes.

Fewer European teenagers are drinking alcohol and smoking traditional cigarettes, but e-cigarette use is rising, according to the 2024 survey.

Lifetime alcohol use among 15-16-years-olds has steadily declined over 30 years — from 88 % in 1995 to 74 % in 2024 (data referring to 32 countries included in the trend analyses). Current use (last 30 days) also fell from 55 % to 43 % in the same period (32-country trend). Despite an overall decline, alcohol remains widely used. Nearly three-quarters of the students from the 37 European countries (73 %) reported to have tried alcohol at least once in their lifetime, while almost half (42 %) reported drinking in the past month. The prevalence of ‘heavy episodic drinking’ ('binge drinking') — defined as five or more drinks on at least one occasion in the last 30 days — also fell from 36 % in 1995 to 30 % in 2024 (32-country trend), the lowest level recorded by .

Cigarette smoking is following a similar downward trend, against a backdrop of tobacco policy measures introduced over the last two decades. Lifetime cigarette use among students fell by more than half, from 68 % in 1995 to 32 % in 2024 (32-country trend). The most significant decline was between 2019 and 2024, with a 10-percentage-point drop.

In contrast e-cigarette use is on the rise. Since ESPAD first began measuring their use in 2019, e-cigarette use has increased in most countries. Data from 32 countries that collected information on e‑cigarette use for both 2019 and 2024 show that current use rose from 14 % to 22 % during this period (lifetime use increased from 41 % to 43 %). In 30 countries, girls (46 %) report more lifetime use than boys (41 %).

In 2024, on average, 1 in 8 school students aged 15-16 years (14 %) reported having used an illicit drug at least once in their life, with levels varying considerably across the countries (range: 4 %–25 %). Data show a continued decline in illicit drug use in this group, with lifetime prevalence dropping from 19 % in 2015 to 14 % in 2024 (32-country trend). Cannabis is still the most commonly used illicit drug, although lifetime use has declined to 12 % (32-country trend) from a peak of 18 % in 2003 (11 % in 1995). Early initiation and high-risk cannabis use remain concerns, yet, overall, the average current use (past 30 days) has dropped to 5 %, reflecting a long-term declining trend.

On average, around 3 % of students reported having used NPS in their lifetime (3.4 % in 2019) representing higher levels of use than for amphetamine (1.8 %), MDMA (2.1 %), cocaine (2.3 %) or LSD/hallucinogens (1.8 %) taken individually. For the first time, the survey covered nitrous oxide ('laughing gas'), which was used by an average 3.1 % of respondents. The majority (67 %) of countries now show higher prevalence of inhalant use among girls than boys.  

Non-medical use of pharmaceutical drugs is a growing concern, with lifetime use now standing at 14 %. Girls consistently report higher rates (16 % vs. 11 %). Tranquillisers and sedatives are the most frequently misused (8.5 %), followed by painkillers (6.9 %) and attention/hyperactivity medications (3.4 %). The perceived ease of obtaining these substances — 1 in 5 students say tranquillisers are easy to access — underscores the need for targeted prevention and monitoring of prescription drug misuse among teens.

While overall gambling rates have remained relatively stable since 2015, online gambling has risen sharply, with 14 % of respondents reporting this practice in 2024, nearly doubling from 8 % in 2019. The growth is especially pronounced among girls, whose online gambling tripled from 3 % in 2019 to 9 % in 2024 (32-country trend). Boys remain more active gamblers overall (29 % vs. 16 % for girls) and are twice as likely to gamble online (20 % vs. 8.7 %). Despite stricter gambling regulations across Europe, harmful gambling behaviour has nearly doubled (from 4.7 % in 2019 to 9 % in 2024 — 32-country trend), with the steepest rise seen among girls. These trends highlight the urgent need for continued monitoring and targeted prevention efforts.

Gaming has become more popular over the last two decades, largely driven by the popularity of smartphones and tablets. The latest findings show a significant increase in gaming among students, with 80 % reporting gaming in 2024 (up from 47 % in 2015, 32-country trend). Once a predominantly male activity, this practice has become increasingly common among girls, whose engagement tripled from 22 % in 2015 to 71 % in 2024 (32-country trend). Boys consistently report higher gaming rates, but the increase was more gradual (up from 71 % in 2015 to 89 % in 2024 — 32-country trend). ESPAD found that 22 % of students believed they had a gaming problem. On social media use, nearly half of the students (47 %) self-reported problematic use (38 % in 2015). Girls consistently reported higher levels of self-perceived problematic social media use across countries.

Amid ongoing social and economic challenges, the 2024 survey used the WHO-5 Well-Being Index to assess youth mental health for the first time. Overall, 59 % of students reported good well-being (a score above 50 out of 100), with boys (70 %) consistently scoring higher than girls (49 %) across all countries. Northern Europe reported the highest self-reported well-being levels, while Ukraine showed the lowest (43 %), potentially resulting from the impact of conflict on young people’s mental health and access to care.

This was the first survey to include information on youth engagement in prevention programmes, with the aim of providing new insights to support more effective prevention strategies. The study reveals that 72 % of students participated in at least one prevention programme in the two years preceding the survey. Awareness-raising initiatives, focusing solely on providing information, were more common in Eastern Europe, while skills-based programmes, which develop personal and social skills, were more prevalent in Western and Southern Europe. Alcohol was the most commonly addressed topic, with illicit substances and behavioural risks receiving less attention. These results, while not focusing on the quality of programmes provided, do lay the groundwork for future research into the evidence base of prevention efforts across Europe.