Prevalence, attitudes and trends


Excluding tobacco and caffeine, alcohol is the psychoactive substance used most by young people across the EU. The proportion of 15- to 16-year-old students who have been drunk at some time in their lives ranges from 36 % in Portugal to 89 % in Denmark (90) (Figure 19 and Figure 42 OL). The majority of young people in the EU have never used illicit drugs but, among those who have, cannabis is the most commonly used drug, followed by inhalants/solvents (91). According to the 1999 ESPAD survey in Greece and Sweden, lifetime experience of inhalants/solvent use is as high as or higher than lifetime experience of cannabis use among 15- to 16-year-old students (92).

National school surveys do not measure problem substance use among young people, but they are a very useful source for assessing experimental drug use and attitudes among young people. On the basis of Reitox reports and 1999 ESPAD data, lifetime prevalence of cannabis use was lowest in Portugal (8 %), Sweden (8 %), Greece (9 %) and Finland (10 %). Lifetime prevalence was highest in France (35 %), the United Kingdom (35 %) and Ireland (32 %), followed by Spain (30 %). School survey sample sizes may be found in Statistical Table 3. Strict comparability of data in this table is limited as not all Member States used the same school survey methods.

Among 15- to 16-year-old students, in general, lifetime prevalence of use of cannabis, inhalants, tranquillisers and sedatives (without a doctor’s prescription) is higher than use of stimulant and hallucinogenic drugs. School students experimenting with cocaine and heroin are relatively rare throughout the EU, with lifetime use of these drugs ranging from 0 % to 4 % (Statistical Table 3).

Most young people who have tried cannabis will have some experience of alcohol and tobacco. Young people who use ecstasy, amphetamines, cocaine and hallucinogens tend to form a separate cluster and belong to specific social groups. Relationships in consumption of different drugs are shown in Table 15 OL based on Spanish school survey data (Observatorio Español sobre Drogas, 2002) (Table 15 OL). A major challenge is to respond to the complexities and idiosyncrasies of different patterns of drug use (Calafat et al., 1999; Parker and Eggington, 2002; Smit et al., 2002).

A higher level of drug use among males than among females is more marked in adult populations than in school students. However, among school students, gender differences are greatest in Greece, France, Italy and Portugal. One exception is that the use of tranquillisers and sedatives without a doctor’s prescription and of alcohol together with ‘pills’ is generally higher among girls.

Variations in prevalence also occur between regions within Member States. In Germany, the gap between east and west is closing faster in students than in adults. Other aspects of drug prevalence, such as the spread of cannabis into rural areas, are the same as those observed in older populations.


Attitudes towards different drugs can help predict future prevalence of drug use. In 1999, disapproval of getting drunk once a week varied widely, from relatively low in Denmark (32 %) to high in Italy (80 %). Disapproval of cannabis experimentation was less variable and was lowest in France (42 %) and highest in Portugal (79 %) and Sweden (78 %) (Figure 43 OL). Attitudes help to predict trends, but other factors are also involved. In all Member States, disapproval and perceptions about ‘great risks’ attached to experimenting with drugs such as ecstasy, cocaine and heroin were generally very high among 15- to 16-year-old school students. Disapproval of trying ecstasy ranged from 71 % in Greece to 90 % in Denmark.


Figure 20

Lifetime prevalence of (A) being drunk, (B) taking cannabis and (C) taking ecstasy (15- to 16-year-old students)

item Denmark | item Greece | item France | item Ireland | item Italy | item Portugal | item Finland | item Sweden | item UK | item Norway | 

Source: ESPAD school survey project (1995 and 1999). The data for France and Greece for 1995 are based on surveys in 1993.


Concern is growing about increased levels of drunkenness and ‘binge’ use of alcohol for recreational purposes (Figure 44 OL). Between 1995 and 1999, marked increases in lifetime experience of being drunk occurred in Greece and Norway (Figure 20). Strictly comparable data for alcohol use are not available for Member States that do not participate in the ESPAD surveys, but trend data from both Germany (1973–2001) and Spain (1994–2000) show recent decreases in alcohol consumption by young people (Bundeszentrale für Gesundheitliche Aufklärung, 2002; Observatorio Español sobre Drogas, 2002). However, it is possible for overall consumption to decrease while patterns of ‘binge’ drinking increase.

During the 1990s, lifetime prevalence of cannabis use increased to such a level that it could be described as widespread in a number of Member States. However, by 1999, the use of cannabis among young people in Ireland, the Netherlands and the United Kingdom had decreased. This may indicate that prevalence has reached saturation in these countries, with a trend towards stabilisation at levels of around 30 %.

There are also indications of stabilisation of lifetime use of ecstasy at very much lower levels than for cannabis. In the case of the United Kingdom, decreased lifetime prevalence of both cannabis and ecstasy was accompanied by a decrease in perceived availability (93) (Figure 45 OL) and an increase in disapproval (Figure 46 OL). In 1999, the proportion of students who perceived that the risk associated with trying ecstasy once or twice was great was highest in the two Member States (Ireland and the United Kingdom) in which lifetime prevalence of ecstasy was also highest (Figure 47 OL) and where much media coverage was given to a relatively small number of ecstasy-related deaths. Media coverage, together with an increasingly negative image, appears to have influenced the downward prevalence of ecstasy use in these two Member States.

Young people judge each other on the basis of image, style and possession of status symbols. Such symbols, which may include drugs, change constantly. Currently held negative images of heroin users and the ready accessibility of other drugs are important factors in current drug choices (FitzGerald et al., 2003). A recent analysis of drug lyrics in English-language popular music since the 1960s has shown that musicians today are more likely than in the past to decry the harm that cannabis does (Figure 48 OL) (Markert, 2001).

The results of a recent survey of 878 young people up to the age of 19 conducted in 10 EU cities signal a possible tendency in urban mainstream culture towards decreasing amphetamine and ecstasy use and increasing cocaine use. This sample was not sufficiently representative or large enough to draw definitive conclusions. This study also found that respondents spend more money on alcohol than on drugs or any other single category of recreational consumption, such as admission to discos, clubs or cinemas, mobile phones and tobacco (Calafat et al., 2003) (Figure 49 OL).

Almost all of the EU Member States (Belgium, Denmark, Germany, Spain, France, Luxembourg, Italy, the Netherlands, Austria, Portugal and the United Kingdom) report rising concerns about a possible increased cocaine and base/crack market for young problem drug users. See ‘Trends in availability’ for further information.

(90) Based on responses to having been ‘drunk from drinking alcoholic beverages’.

(91) Based on responses to ‘sniffed a substance (glue, aerosols, etc.) to get high’.

(92Statistical Table 3: School surveys – lifetime prevalence among students, 15–16 years of age.

(93) Based on responses that the drug would be ‘very easy’ or ‘fairly easy’ to obtain if wanted.