1. Smoking, drinking and drug use
by young people in England,
Scotland and Wales
HEALTH BEHAVIOUR IN SCHOOL
AGED CHILDREN

2. World Health Organisation – Health
Behaviours in School Aged Children
“The Health Behaviour of School-
aged Children (HBSC) study
provides key insights into the
health-related behaviours of
young people. Its unique
methodology has facilitated
engagement with hundreds of
thousands of young people in
many parts of the world since its
inception in 1983, building a data
base over time that describes
patterns and issues relevant to
their health and well-being.”
http://www.euro.who.int/__data/assets/pdf_file/0003/1
63857/Social-determinants-of-health-and-well-being-
among-young-people.pdf

3. Tobacco is the leading cause of preventable death in the world, imposing
a large burden on societies. Previous HBSC research has shown that
tobacco use is related to other risk behaviours and negative health
outcomes in young people, including unhealthy dieting patterns, high
levels of alcohol consumption, bullying, early sexual initiation, poor self-
rated health and low life satisfaction, frequent multiple health
complaints and injuries.
TOBACCO USE

4. 15-year-olds who report first
smoking at age 13 or younger
25
20
15
Girls
10 Boys
5
0
Scotland England Wales

5. How we compare to Europe
15-year-old girls who report first 15-year-old boys who report first
smoking at age or younger smoking at age or younger

6. Risky drinking, including frequent drinking and drunkenness, is associated
with adverse psychological, social and physical health
consequences, including academic failure, violence, accidents, injury and
unprotected sexual intercourse. Alcohol can disrupt brain development in
childhood and adolescence, particularly in the cortical region, which
influences cognitive, emotional and social development.
ALCOHOL USE

7. Weekly drinking
Boys Girls
40 35
35 30
30 25
25
20
20 Wales Wales
15
15 England England
10 Scotland 10 Scotland
5 5
0 0
11 year 13 year 15 year 11 year 13 year 15 year
olds olds olds olds olds olds

8. How we compare to Europe
15-year-old girls who drink 15-year-old boys who drink
alcohol at least once a week alcohol at least once a week

9. 15-year-olds who report first
drunkenness at age or younger
25
20
15
Girls
10 Boys
5
0
Scotland Wales England

10. Been drunk at least twice
Boys Girls
50 60
45
40 50
35 40
30
25 Wales 30 Wales
20 England England
15 20
Scotland Scotland
10 10
5
0 0
11 year 13 year 15 year 11 year 13 year 15 year
olds olds olds olds olds olds

11. How we compare to Europe
15 -year-old girls who have been 15 -year-old boys who have been
drunk at least twice drunk at least twice

12. Policy Reflections
• School-based intervention programmes focusing specifically
on alcohol use and targeting adolescents and their parents
have considerable effects. Generic, psychosocial and
developmental, school-based prevention programmes
focusing on life skills and a healthy lifestyle in general are
also effective and could be considered as policy and
practice options.
• Family interventions are effective in delaying alcohol
initiation and reducing frequency of consumption among
adolescents. Family treatments focused on change in
maladaptive behaviours, multidimensional family therapy
and group-administered cognitive behavioural therapies
have received considerable empirical support.

13. Early-onset, heavy and accelerating cannabis use is related to a range of
problems, including cognitive impairment, deteriorating school
performance and dropout, externalizing problems such as risk
taking, aggression and delinquency and internalizing problems such as
depression and anxiety.
CANNABIS USE

14. Young people were asked how often they had used cannabis in
their lifetimes, during the last 12 months and during the last 30
days.
Girls Boys
30 25
25 20
20
15
15 Ever used Ever used
10
10
Last 30 Last 30
5 5
days days
0 0

15. How we compare to Europe
15-year-old girls who have used 15-year-old boys who have used
cannabis in the last days cannabis in the last days

16. Cannabis User Groups
25 Young people (15-year-olds only) were asked
whether they had used cannabis: in their life;
20 in the last 12 months; and in the last 30 days.
Response options ranged from “never” to “40
times or more”. Based on the frequency of
15
use, four user groups were defined as follows:
• discontinued users: those who have used
10
cannabis at least once in their lifetime but
not in last 12 months;
5
• experimenters: those who have used
cannabis 1–2 times in the last 12 months;
0
• regular users: those who have used
England Wales Scotland HBSC cannabis 3–39 times in the past 12
average months;
• heavy users: those who have used
Discontinued Experimenters cannabis 40 times or more in the past 12
Regular users Heavy users months.

17. Policy Reflections
• Interventions in schools that focus on
increasing drug knowledge, decision-making
skills, self-esteem and resistance to peer
pressure effectively reduce cannabis use, and
family-based treatments concentrating on
cannabis or substance use are similarly
effective; indeed, family-based and
multisystem approaches have a large effect.
Motivational interviewing is also effective.