Key findings from the 2024 European School Survey Project on Alcohol and Other Drugs (ESPAD)

Overview of results

The 2024 European School Survey Project on Alcohol and Other Drugs (ESPAD) marks 30 years of monitoring adolescent risky behaviours across Europe, with 37 participating countries. While the focus remains on substance use behaviours and trends, this edition introduces a new focus on mental well-being and prevention activities, recognising the growing importance of these aspects in shaping adolescent health outcomes. As adolescent behaviours evolve, ESPAD’s long-term monitoring continues to provide crucial insights to guide prevention and policy efforts, ensuring responses remain effective and relevant.

Despite long-term declines in substance use, emerging trends raise new concerns. Cigarette smoking has decreased markedly over the past decades, with lifetime prevalence halving over the period 1995–2024. Early initiation persists, however, particularly among girls, whose daily smoking rates at age 13 or younger have increased in recent years. Meanwhile, e‑cigarette use has risen sharply among adolescents, with rising rates of early initiation and daily consumption, fuelling concerns over the dual use of traditional and electronic cigarettes and reflecting a broader shift toward alternative nicotine products.

Alcohol consumption has also declined over time, with overall use and binge drinking decreasing. However, this reduction is more pronounced among boys, with girls showing a more stable trend. Despite this progress, alcohol remains widely accessible, and early initiation and heavy episodic drinking remain significant concerns in some regions.

Cannabis is still the most commonly used illicit drug, although lifetime prevalence has declined to its lowest level since 1995. While boys generally report higher use, gender gaps are narrowing, with some exceptions where girls surpass boys. Early initiation and high-risk use remain concerns, although overall current use (defined as within the past 30 days) has dropped to 5%, reflecting a long-term declining trend. Perceived availability varies widely, but cannabis remains the most easily obtainable illicit substance among students.

The use of other illicit drugs has declined among ESPAD students, with gender gaps narrowing, although boys still generally report higher use and perceived availability. Meanwhile, inhalant use is rising among girls, while non-medical pharmaceutical use is also increasing.

Beyond substances, behavioural risks are shifting. Gaming has surged among ESPAD students, especially among girls, and it is no longer a predominantly male activity, reflecting broader shifts in digital behaviours. Despite increased participation, perceived problematic gaming remains stable. On the other hand, concerns about problematic social media use have grown, particularly among boys, while rates among girls remain high.

Gambling remains stable, but online participation has grown sharply, and harmful gambling behaviour has nearly doubled, with a more pronounced increase among girls.

A good state of mental well-being is reported by 59% of students on average. The findings highlight notable regional differences, as well as gender disparities, with girls consistently reporting lower well-being than boys. The lowest well-being scores are recorded in countries experiencing conflict and instability.

Prevention efforts are widespread, with most students having taken part in at least one intervention. Alcohol is the most frequently addressed topic, while illicit substances and behavioural risks receive less attention. Skills-based prevention programmes, which emphasise interactive approaches, are more common in western and southern Europe. A focus for future survey rounds might be the extent to which the prevention interventions being provided can be considered evidence-based or otherwise.

Data explorer

Highlights

Cigarette use

Cigarette use continues to be widespread among adolescents in ESPAD countries, with nearly one in three students having smoked cigarettes at least once in their lives (32% on average). The highest prevalence rates are observed in Hungary (51%) and Slovakia (46%), while the lowest are in Iceland (13%) and Malta (16%). Gender differences show a slightly higher prevalence among girls (32% versus 31% among boys). This trend is evident in more than two-thirds of the countries, with the largest differences in Romania (47% versus 36%) and Bulgaria (46% versus 36%). However, in some countries, this trend is reversed, notably in Kosovo (¹) (47% among boys versus 36% among girls) and Georgia (35% versus 24%).

On average, 15% of ESPAD students report first smoking cigarettes at age 13 or younger. The highest proportions are recorded in Slovakia (24%) and Kosovo (23%), while the lowest are in Iceland (6.4%) and Malta (7.1%). In just over half the countries, early smoking initiation is more common among girls, particularly in Bulgaria (23% versus 17%). Among the countries where boys are more likely to start at an early age, Kosovo shows the widest gap (31% versus 16%).

More than half of ESPAD students (55%) consider cigarettes fairly or very easy to obtain. This perception is highest in Denmark (76%), followed by Germany and Norway (70%). In contrast, the lowest proportions are reported in Kosovo (32%) and Moldova (23%). Overall, boys are more likely than girls to perceive cigarettes as easily accessible (61% versus 50%).

Current cigarette use, defined as smoking in the past 30 days, is reported by 18% of students. The highest prevalence is observed in Croatia and Hungary (32%), while the lowest is in Iceland (4.2%) and Sweden (8.2%). Current smoking is more prevalent among girls in more than half of the ESPAD countries, with the widest gender gap reported in Bulgaria (34% versus 25%) and Romania (30% versus 22%). However, the pattern is reversed in Kosovo (33% versus 23%) and Georgia (18% versus 9.5%), where boys have higher current smoking rates.

Daily consumption of cigarettes is reported by 7.9% of ESPAD students, with similar percentages across genders. The highest rates are observed in Bulgaria and Croatia (20%), while the lowest is in Iceland (0.8%).

Another key figure is the daily use reported by students who started smoking at an early age (13 years or younger). On average, 3.6% of students fall into this category, with the highest proportion observed in Bulgaria (8.7%).

Tracking the trends: how things have changed from 1995 to 2024

Between the first and last ESPAD surveys, the lifetime prevalence of cigarette use steadily declined, halving from 68% to 32%, with the most notable decrease occurring between 2019 and 2024 (a drop of 10 percentage points). Over the 30-year period, the drop in prevalence was greater among boys, from 70% to 30%. The countries with the greatest reductions are the Faroe Islands, Ireland, Iceland and Sweden.

The trend in the past 30-day use also shows a constant decline, dropping from 33% to 18%, with nearly overlapping trends between boys and girls. A similar pattern is observed in daily smoking, which decreased from 20% to 8%.

Finally, while the proportion of daily smokers aged 13 years or younger has also declined over the three decades (from 10% in 1995 to 3.6% in 2024), a comparison between 2019 and 2024 data reveals a slight increase (plus 0.6%). As the prevalence among boys remains unchanged in the last two surveys, this increase is driven by girls, whose rate rises from 2.5% to 3.6%, confirming their increased involvement in almost all the observed smoking patterns.

Dual use

Although cigarette smoking is the most common form of tobacco use, focusing solely on it underestimates nicotine consumption due to the rise of alternative products. Considering both cigarettes and e‑cigarettes, lifetime use increases from 32% to 47%, with major increases registered in Czechia and Estonia, while current use rises from 18% to 28%, with a notable rise among girls in both lifetime and current use.

When considering dual daily consumption, the prevalence rises from 7.9% to 14% (15% among girls versus 12% among boys), with higher occurrences in Bulgaria and Hungary (25%).

Daily use initiated at an early age also shows a notable increase when dual use is considered, rising from 3.9% to 6%. In this case, the largest increases are observed in Lithuania and Estonia, once again being more pronounced among girls.

e-Cigarette use

On average, 44% of the students in ESPAD countries report having used e‑cigarettes at least once in their lifetime, with national prevalence ranging from 22% in Portugal to 57% in Hungary.

In 13 out of 37 ESPAD countries, at least half of the students have tried e‑cigarettes, whereas in only six countries (Portugal, Malta, Iceland, North Macedonia, Montenegro and Ireland), fewer than one-third of students report lifetime use.

Overall, girls (46%) report a higher lifetime prevalence of e‑cigarette use than boys (41%), with exceptions in Kosovo, Georgia, Moldova, the Faroe Islands, North Macedonia, Ukraine and Portugal. The largest gender differences are found in Liechtenstein and Malta, where the prevalence among girls exceeds that of boys by 13 percentage points, and in Kosovo, where, conversely, boys report a 12-percentage-point higher prevalence than girls (51% versus 39%).

On average, 16% of students tried e‑cigarettes at the age of 13 or younger, with the highest proportions in Estonia (33%) and Lithuania (31%), and the lowest in Portugal (5.4%) and Montenegro (7.4%). Early e‑cigarette use is more common among girls than boys in the majority of countries, with the largest differences observed in Estonia (37% for girls versus 29% for boys), Latvia (34% versus 27%) and Ireland (18% versus 12%). Conversely, in Kosovo boys report a 12-percentage-point higher prevalence than girls (25% versus 13%).

A high percentage of students (60%) believe that obtaining e‑cigarettes is either fairly or very easy if they want to, with large differences between countries, ranging from 33% in Kosovo to 82% in Denmark. In 20 countries, this perception is above average, with at least 60% of students considering e‑cigarettes easily accessible. On average, boys and girls report similar levels of perceived availability.

Current e‑cigarette use, defined as the use in the past 30 days, is reported by 22% of students (19% for boys and 25% for girls). The lowest rates are observed in Portugal and the Faroe Islands (both 6.4%) and Malta (10%), while the highest rates of current e‑cigarette use are reported in Poland (36%) and Serbia (34%).

Daily e‑cigarette use varies between countries, ranging from 1.5% in the Faroe Islands to 20% in Poland. In 22 countries, daily e‑cigarette use is notable higher among girls, while in only two countries, namely Kosovo (7.7% versus 5.8%) and Georgia (4.2%versus 1.2%), it is higher among boys.

Tracking the trends: how things have changed from 2019 to 2024

The popularity and prevalence of e‑cigarette use has sharply increased in the last decade, with the majority of ESPAD countries reporting an increase since 2019.

Data from 32 countries that collected information on e‑cigarette use for both 2019 and 2024 show that lifetime use increased from 41% to 43%, while current use rose from 14% to 22% during this period. Out of these 32 countries, 11 reported a lower percentage of lifetime use, with the largest decreases observed in Monaco (from 63% to 44%), Ukraine (from 51% to 37%) and Lithuania (from 65% to 51%). The highest increases in e‑cigarette use were found in Serbia (from 18% to 51%) and Greece (from 35% to 52%).

Similar trends were observed for current e‑cigarette use, which declined particularly in Monaco and Lithuania, while major increases were recorded in Serbia (29 percentage points) and in Croatia (20 percentage points).

Alcohol use

Lifetime alcohol consumption is reported by 73% of adolescents in ESPAD countries. The highest prevalence rates are observed in Hungary (91%) and Denmark (90%), while the lowest are recorded in Kosovo (29%) and Iceland (41%). Gender differences indicate a slightly higher prevalence among girls (74%) than boys (72%), a trend observed in more than half of the countries. The most pronounced gender differences are found in Iceland (48% versus 34%), Latvia (84% versus 73%) and Lithuania, Malta and Monaco, each showing a 10-percentage-point gap. However, in some countries, the trend is reversed, most notably in Kosovo (37% among boys versus 23% among girls).

On average, 33% of ESPAD students report having had their first alcoholic drink at age 13 or younger, a measure of early drinking, while 8% say they have experienced drunkenness at the same age. The highest rates of early drinking are reported in Georgia (64%) and Moldova (49%), while the lowest are in Iceland (12%), Kosovo and Norway (14%). Similarly, early-age drunkenness is most prevalent in Georgia (25%) and Bulgaria (14%), and least common in Kosovo (3%), France and Portugal (3.6%) and the Faroe Islands (3.9%).

Boys report slightly higher rates than girls, both for drinking alcohol (34% versus 33%) and getting drunk (8.2% versus 7.8%). However, with regard to alcohol consumption at age 13 or earlier, in some countries the gap widens, showing higher rates for boys, such as in North Macedonia (35% versus 22%), Montenegro (47% versus 36%) and Serbia (49% versus 37%). Conversely, in Latvia and Lithuania, it is girls who report the highest proportions (46% versus 35% and 35% versus 26%, respectively). With regard to drunkenness at an early age, gender differences also emerge at the national level. Notably, in Georgia, boys show a higher prevalence than girls (30% versus 20%). By contrast, the pattern is reversed in Czechia (14% among girls versus 7.6% among boys) and Estonia (14% versus 9.3%).

Three out of four ESPAD students (75%) consider alcoholic beverages fairly or very easy to obtain. This perception is highest in Denmark and Germany (94%), followed by Greece (92%), while the lowest proportions are reported in Kosovo (42%) and Iceland (54%). Overall, girls tend to perceive alcohol as easier to obtain than boys (77% versus 73%), particularly in Lithuania (64% versus 51%), Cyprus (78% versus 66%) and Latvia (74% versus 62%).

Current alcohol use, defined as consumption within the past 30 days, is reported by 42% of students. The highest prevalence is observed in Denmark (68%) and Germany (62%), while the lowest is recorded in Iceland (12%) and Kosovo (14%). Current alcohol consumption is slightly higher among girls (43% versus 41%), with the widest gender gap found in Latvia (35% versus 25%), Malta (42% versus 33%) and Ukraine (45% versus 36%). However, the pattern differs in Cyprus, where boys report higher rates than girls (49% versus 35%).

Alcohol intoxication on at least one occasion in the past 30 days is reported by 13% of all ESPAD students. The highest rates are observed in Denmark (36%), Austria (24%) and Hungary (22%), while the lowest is recorded in Kosovo (4.9%). Overall, the percentages are equal between genders. However, at the national level, girls more often report higher rates of drunkenness than boys, with the widest gap observed in Cyprus (12% for girls versus 4.4% for boys).

A key measure of heavy drinking is binge drinking, defined as the intake of five or more drinks on a single occasion in the past 30 days. On average, the prevalence across ESPAD countries stands at 31%, with higher proportions reported in Denmark (55%), Germany (49%) and Austria (48%), and the lowest in Iceland (8.9%). Boys and girls show similar rates for this pattern on average. However, at the national level, notable gender differences emerge: boys report higher prevalence in Montenegro (27% versus 18%) and Liechtenstein (41% versus 35%), whereas girls have higher rates in Malta (34% versus 25%).

Tracking the trends: how things have changed from 1995 to 2024

From 1995 to 2024, lifetime alcohol consumption in ESPAD countries has shown a decreasing trend, declining from 88% to 74%, albeit with some fluctuations. Prevalence peaked at 91% in the 2003 survey before declining in subsequent years. Although these data are not consistently available for all countries since 1995, the largest decreases have occurred in Iceland (from 79% to 41%) and Sweden (from 89% to 56%). The trends for boys and girls follow a similar pattern.

Alcohol consumption in the past 30 days has also declined between the first and most recent ESPAD surveys, dropping from 55% to 43%. This trend mirrors the decrease observed in lifetime consumption, with a peak prevalence of 63% in 2003. The greatest reductions are observed in Iceland (from 56% to 12%), Ireland (from 66% to 35%) and Finland (from 57% to 27%).

With regard to heavy episodic drinking, although its prevalence has declined from 36% to 30% over the 30-year observation period, it peaked at 42% in 2007 after having risen since 1995. This trend is evident in both boys and girls. In boys, the peak occurred earlier (47% in 2003) and was sustained in 2007, whereas in girls, a peak of 38% was recorded in 2007. However, the overall decline among girls from 1995 to 2024 has amounted to just one percentage point.

Illicit drug use

On average, 13% of ESPAD students report having used any illicit drug at least once in their lifetime. Lifetime prevalence of illicit drug use varies widely between ESPAD countries, with the highest rates observed in Liechtenstein (25%) and Czechia (24%), and the lowest in Georgia and Moldova (both 3.9%).

Overall, only a small gender disparity is observed, with 14% of boys and 12% of girls reporting lifetime use of illicit drugs. A relatively large 8-percentage-point difference is observed between boys and girls in Ukraine. Malta stands out, where lifetime prevalence among girls exceeds that of boys by 6 percentage points (15% versus 9.3%).

Looking at individual substances, cannabis is the most commonly used drug (12% lifetime use), followed by cocaine (2.3%), ecstasy/MDMA (2.1%), LSD or other hallucinogens (1.8%) and amphetamine (1.8%). The average lifetime prevalence of methamphetamine, crack, heroin and GHB use remains lower, at approximately 1% for each drug. On average, boys show higher lifetime prevalence rates than girls for each substance.

At the country level, amphetamine use ranges from 0.7% in Georgia and Monaco, to 4.3% in Hungary, while methamphetamine use ranges from 0.5% in Monaco and North Macedonia to 3.1% in Poland. Cyprus records the highest lifetime prevalence among ESPAD countries for use of LSD and other hallucinogens (6.8%) and cocaine (6.2%). It also reports the highest prevalence for ecstasy/MDMA (4.7%), crack and heroin (both 4.1%) and GHB (3.4%).

Illicit drug use other than cannabis

While cannabis accounts for the greater proportion of reported illicit drug use, the average lifetime prevalence of any illicit drug use other than cannabis is considerably lower, standing at 5%. At the country level, rates vary from 1.7% in Georgia to 9.9% in Cyprus, with relatively high prevalence also reported in Iceland (7.9%) and Montenegro (7.6%). On average, prevalence is higher among boys than girls (5.4% versus 4.5%).

The rate of cocaine/crack use at age 13 or younger stands at 0.9% on average among the 17 countries that collected this information in 2024, with the highest prevalence recorded in Ukraine (4%). Overall, boys (1.2%) are more likely to start early than girls (0.5%), although the average difference remains under one percentage point. Similar patterns emerge for amphetamine/methamphetamine and ecstasy/MDMA, with Ukraine reporting the highest rates (3.3% and 3.7%, respectively) and Kosovo showing the next highest prevalence (1.4% for both).

The perceived availability of illicit drugs other than cannabis is relatively low. On average, easy access is reported by 13% of students for cocaine, 11% for ecstasy/MDMA, 9% for amphetamine and almost 8% for both crack and methamphetamine.

There are wide variations between countries in the perceived availability of substances. Norway reports a higher percentage of students perceiving substances to be easily available, with the highest rates recorded for cocaine (28%), ecstasy/MDMA (25%) and amphetamine (19%). Slovenia reports the highest perceived availability of crack (13%) among the 16 countries that collected this information. High rates of perceived availability are also found for both amphetamine (18%) and methamphetamine (15%) in Montenegro. In contrast, perceived availability of other illicit drugs remains low in Georgia, Moldova and the Faroe Islands, generally ranging between 1.8% and 3.6%.

Perceived availability of substances is generally higher among boys than girls, with the exception of cocaine, which is reported as more easily accessible by girls (13%) than boys (12%) on average. For each substance, the average gender difference remains below 1.5 percentage points. However, gender disparity patterns vary across countries and substances. In some countries, such as Liechtenstein and Monaco, boys report higher perceived availability of illicit substances, while in others, including Cyprus, Slovakia, Bulgaria and Malta, girls report a higher perceived availability than boys.

Tracking the trends: how things have changed from 1995 to 2024

Generally, between 1995 and 2003, lifetime prevalence of illicit drug use increased. Since 2003, the average prevalence remained stable at 19% until 2015, then declined to 17% in 2019 and further to 14% in 2024.

Countries showing a sustained increase across multiple ESPAD data collection waves include Norway, where rates have been rising since 2011, and Montenegro, where rates have steadily risen since 2007, when ESPAD data collection began there.

Between 1995 and 2019, girls and boys followed similar trends, with the average rate among girls consistently 5 to 6 percentage points lower than that of boys. However, between 2019 and 2024, the gap narrowed to a record-low 2-percentage-point difference. When looking at individual countries, most ESPAD countries show either parallel or converging trends between boys and girls.

Illicit drug use excluding cannabis saw its highest lifetime prevalence in 2007, followed by a slight decline until 2019, after which it has remained stable. However, this overall trend masks country-specific variations. Notably, Cyprus stands out with a considerable increase since 2003, when ESPAD data collection began there.

The trend in the percentage of students using illicit drugs other than cannabis is similar for boys and girls, with girls consistently reporting rates 1 to 2 percentage points lower across all survey years.

Cannabis use

Cannabis remains the most commonly used illicit drug across all ESPAD countries. On average, 12% of students report having used cannabis at least once in their lifetime. The highest prevalence is observed in Czechia (24%) and Liechtenstein (23%), while the lowest is in Georgia (3.3%) and Moldova (2.5%). Although the overall gender gap has decreased over time, boys continue to report higher cannabis use than girls on average (13% versus 11%). This trend is evident in most countries, particularly in Ukraine (15% versus 6.7%) and Montenegro (13% versus 6.8%). However, Malta stands out as an exception, where cannabis use is more prevalent among girls (14%) than boys (8.6%).

On average, 2.4% of ESPAD students report first using cannabis at age 13 or younger. The highest proportions are recorded in Ukraine (4.9%) and Czechia (4.1%), while the lowest is in Moldova (0.7%). Early cannabis use is generally more common among boys than girls, except in Cyprus, Czechia, Malta, Slovenia, Austria, Slovakia, Latvia, Germany and Liechtenstein.

Cannabis is perceived as the most accessible illicit substance, with around one in four ESPAD students (26%) considering it fairly or very easy to obtain. Availability perception is highest in Denmark, Germany and Slovenia (41%) and Norway (40%). In contrast, the lowest perceived availability is reported in Moldova (5.3%), Ukraine (7.1%), the Faroe Islands (11%), Kosovo and Georgia (12%). As with use patterns, boys are more likely than girls to perceive cannabis as easily accessible (28% versus 24%).

Regarding current use, all ESPAD countries report prevalence rates below 10%, with the lowest figures, below 2%, observed in Moldova, Georgia, Romania and the Faroe Islands. Meanwhile, prevalence is higher in Italy and Slovenia (8.6%) and Liechtenstein (9.6%). Once again, where a gender gap exists, boys tend to report higher current cannabis use than girls.

ESPAD also assesses high-risk cannabis use through the Cannabis Abuse Screening Test (CAST), applied to students who reported using cannabis in the past year. The prevalence of high-risk use ranges from below 1% in Moldova and Georgia, to a maximum of 5.9% in Czechia and Slovenia. Only a few ESPAD countries report sizeable gender differences in high-risk cannabis use, and in all cases, boys show higher figures, except in Malta, where the prevalence is slightly higher among girls (4.4 % versus 2.6%).

Tracking the trends: how things have changed from 1995 to 2024

Over the past three decades, cannabis use among European adolescents has shown notable fluctuations. The lifetime prevalence of cannabis use peaked at 18% in 2003 and 2011 but has since followed a declining trend, reaching 12% in 2024, the lowest level recorded since ESPAD began in 1995.

Current cannabis use has remained relatively stable over time, oscillating between 6.7% and 7.4% from 1999 to 2019. However, the 2024 data show a drop to 5%, returning to levels close to those observed in 1995 (4.1%).

Despite a steady increase in the perceived availability of cannabis until 2019, when 33% of students reported it as fairly or very easy to obtain, this figure suddenly dropped to 27% in 2024, approaching the level recorded in 1995 (26%).

Other substance use

The survey also gathered data on other substances, including new psychoactive substances (NPS), synthetic drugs designed to mimic the effects of traditional controlled substances while avoiding legal restrictions; pharmaceuticals, including tranquillisers or sedatives, used without a doctor’s prescription; painkillers, used to get high; attention/hyperactivity medication, used without a doctor’s prescription, as well as anabolic steroids; inhalants; and, for the first time, nitrous oxide.

Among ESPAD students, the average lifetime prevalence of NPS use is about 3%, with the highest rates recorded in Poland (6.4%) and Slovenia (6%), and the lowest in the Netherlands, Liechtenstein, the Faroe Islands and Moldova (below 1%).

The average lifetime prevalence of NPS use is slightly higher among boys than girls (2.8% versus 2.6%), although gender differences vary between countries. In 13 countries, girls report a higher lifetime prevalence of NPS use in 2024. The largest gaps in favour of girls are observed in Cyprus (6.6% for girls versus 2.9% for boys) and Slovakia (6.4% versus 4.3%), while in Ukraine, boys report higher lifetime use than girls (3.6% versus 2%).

Regarding specific substances, 3.5% of ESPAD students (average based on data from 23 out of 37 countries) report having used synthetic cannabinoids at least once in their lifetime, ranging from 0.7% in Georgia to 16% in Slovakia. Similarly, 1.1% of students report lifetime use of synthetic cathinones (average calculated from 14 out of 37 countries), with the highest figures found in Hungary (3.7%). The lifetime use of synthetic opioids varies between 0.6% in Georgia, Ireland and Portugal, to 2.2% in Estonia, with an average prevalence of 1.1% (based on data from 15 out of 37 countries).

On average, boys show a slightly higher prevalence of use than girls for all three of the classes of new synthetic substances included in the survey. The only exceptions are found in Cyprus, where girls (9.1%) report a higher prevalence of synthetic cannabinoid use than boys (4.3%), Malta (4.7% among girls versus 2.4% among boys), Latvia (2.9% versus 2.6%) and Portugal (2.1% versus 1.7%). In addition, in Hungary, girls report higher lifetime use of both synthetic cannabinoids (7.9% versus 5.6% among boys) and synthetic cathinones (4.3% versus 2.9%).

Lifetime prevalence of inhalant use stands at 6.4% on average, with large differences between countries. The highest rates are found in Sweden (17%) and Liechtenstein (16%), while the lowest rates are reported in Kosovo (1.3%) and North Macedonia (2.1%). In 2024, inhalant use is higher among girls on average (6.7% among boys versus 7.9% among girls), and exceeds that of boys in 25 out of 37 ESPAD countries. For the first time, nitrous oxide use has been surveyed among ESPAD students in 18 countries, with an average of 3.1% reporting lifetime use. The highest prevalence is recorded in Bulgaria (9.4%) and Liechtenstein (7.2%), with both countries showing higher figures for girls than boys.

Approximately 2.2% of ESPAD students report first using inhalants at age 13 or younger, with notable differences between countries. Early onset of inhalant use ranges from less than 1% of students in Portugal (0.3%) and Italy (0.4%), to 5% or more in Germany (5.9%) and Slovenia (5%).

The prevalence of lifetime use of pharmaceuticals for non-medical purposes averages 14% in ESPAD countries, with higher rates among girls (16%) than boys (11%). The highest prevalence is observed in Lithuania (29% overall, 36% among girls).

Among the different categories of pharmaceuticals, the most commonly used are non-prescribed tranquillisers and sedatives (8.5%), followed by painkillers to get high, reported by 6.9% of students on average. Overall, 3.4% of students report the use of attention/hyperactivity drugs, which are included in the 2024 ESPAD survey for the first time in a subsample of 18 countries. Across all categories, pharmaceutical use is generally higher among girls, except in Bulgaria, where boys report higher use across all types of medicines; the Faroe Islands and Ireland for tranquillisers and sedatives; Cyprus, Bulgaria, Greece, Italy, Ukraine, Georgia, Norway and Spain for painkillers; and Denmark and Kosovo for attention/hyperactivity drugs.

On average, 19% of students perceive non-prescribed tranquillisers and sedatives as fairly or very easy to obtain, with the highest perceived availability recorded in Poland (49%), Denmark (39%) and Czechia (38%). The lowest perceived availability of pharmaceuticals is observed in Moldova (3.4%) and Ukraine (5.9%). Girls in all countries are more likely to perceive tranquillisers and sedatives as easily available, except for Monaco, North Macedonia, Moldova and Latvia, where boys report higher perceived availability.

A relatively small number of students across ESPAD countries report the use of anabolic steroids, with an average of 1.5%. The highest proportion is recorded in Cyprus (4.2%), followed by Poland (3.3%) and Ukraine (2.8%). Overall, boys are more likely than girls to have tried anabolic steroids.

Tracking the trends: how things have changed from 1995 to 2024

The lifetime use of inhalants among European adolescents followed an increasing trend until 2011, after which it has been declining. Nowadays, the prevalence rates are similar to those observed in mid-1990s. The narrowing gender gap observed between 2011 and 2019 widened in 2024, with a majority of countries now showing higher prevalence of inhalant use among girls. However, trends vary across ESPAD countries. While some countries, such as Bulgaria, Finland, Iceland, Italy and Sweden report a sizeable increase in inhalant use since 2011, particularly between 2019 and 2024, others, including Croatia, Czechia, Estonia, Latvia and Portugal, have reported a decline.

Trends in the use of pharmaceuticals for non-medical purposes are often shaped by changes in the set of the medicines included. Overall, lifetime use of tranquillisers and sedatives has risen across Europe among both boys and girls, with notable increases reported in Austria, Germany, Iceland, Lithuania, Norway, Sweden and Ukraine. Girls have consistently reported higher rates of pharmaceutical use over time.

Gambling for money

On average, 23% of ESPAD students report having gambled for money in the past 12 months, either in person or online, through games of chance, such as slot machines, card or dice games, lotteries, or betting on sports or animal races.

Italy has the highest prevalence of gambling among students (45%), followed by Iceland (41%) and Greece (36%), while the lowest rate is observed in Georgia (9.5%).

Boys report notably higher gambling participation than girls, both on average (29% versus 16%) and in most countries. The only exception is Iceland, where the prevalence is nearly equal, with 42% of boys and 41% of girls having gambled in the past 12 months.

Among ESPAD students who report gambling for money in the past year, the vast majority (85%) chose to gamble in physical locations, such as bars and clubs. This proportion ranges from 68% in Sweden to 98% in Italy and 97% in Cyprus. Although the prevalence of land-based gambling among boys is almost double that among girls (25% versus 14%), the proportion who gambled in physical locations is slightly higher among girls (86%) than boys (84%) on average, with only modest gender differences observed in most countries.

Roughly two out of three (65%) ESPAD students who report having gambled for money in the past year did it through online platforms, either exclusively or in combination with physical locations. The highest proportions are observed in Sweden (81%), Slovenia (77%), Kosovo (76%), Iceland (75%), Montenegro (75%), Bulgaria and Slovakia (74% each), while the lowest proportions are found in Italy (28%) and Spain (44%). The prevalence of online gambling engagement among boys (20%) is more than double that among girls (8.7%). Even among students reporting gambling for money in the past year, the proportion of those choosing the online channel is higher among boys (70%) than among girls (54%). Unlike land-based gambling, great variability is observed in gender differences across countries: the highest is observed in Portugal (80% among boys versus 43% among girls), while no or very small gender differences are found in North Macedonia, Kosovo, Moldova, Iceland, Spain, Germany and Liechtenstein.

ESPAD also assesses the presence of a possible harmful gambling behaviour through the Lie/Bet screening instrument, applied to students who report gambling engagement in the past year. The proportion of student gamblers exhibiting potential harmful gambling behaviour ranges from less than 5% in Liechtenstein, Czechia, Faroe Islands and Monaco, to a maximum of 22% in Kosovo. While on average and in the vast majority of countries, the proportion of student gamblers with a possible harmful behaviour is highest among boys (11% versus 4.6% among girls), this is not the case in Malta (7.1% versus 3.7%) and Cyprus (8.3% versus 5%).

Tracking the trends: how things have changed from 2015 to 2024

Although many European countries have adopted stricter gambling regulations in recent years, with a heightened focus on protecting minors, gambling among European adolescents has remained stable since ESPAD first began investigating the issue in 2015. However, notable changes have emerged over time.

Specifically, gambling participation among boys decreased slightly, from 32% in 2015 to 30% in 2024, while it increased slightly among girls, from 14% to 16% over the same period.

Online gambling has seen considerable growth, with its prevalence rising from 7.9% in 2019 to 14% in 2024. While the gender gap in online gambling persists, participation rates grew by more than half among boys (from 13% in 2019 to 20% in 2024) and tripled among girls (from 2.7% in 2019 to 8.7% in 2024).

The percentage of student gamblers exhibiting potential harmful gambling profile has increased notably, nearly doubling from 4.7% in 2019 to 8.5% in 2024. While this proportion remains much higher among boys, the increase is more pronounced among girls.

These figures highlight the shifting landscape of adolescent gambling, particularly the increasing role of online gambling and evolving gender dynamics, that calls for ongoing monitoring and tailored interventions.

Gaming and social media

Overall, 80% of ESPAD students report having played digital games at least once in the past month. About 70% played on a typical school day within the past 30 days, while 77% played on a non-school day. Across ESPAD countries, the prevalence of gaming in the past month is lowest in Kosovo (59%) and Moldova (66%), while the highest is reported in Liechtenstein (95%) and Germany (91%). Boys are more likely to engage in gaming than girls (89% versus 71%), reflecting a consistent gender gap in gaming engagement across countries. This gap is particularly wide in Greece and Iceland, ranging from 33 to 35 percentage points, while it is minimal or absent in Cyprus, Ukraine and Bulgaria (0 to 5 percentage points).

Within the past 30 days, 17% of all ESPAD students report an average 4 or more hours of game time on a typical school day and 32% on a typical non-school day, with rates twice as high among boys compared to girls in both cases.

ESPAD also assesses the self-perceived risk associated with gaming and social media use through a three-item scale developed by Holstein and colleagues in 2014. According to the authors, a score of 2 or 3 indicates a self-perceived high risk of problems related to gaming and social media use.

In 2024, 22% of ESPAD students score 2–3 points on the perceived gaming risk scale. This measure is lowest in Czechia (12%), Denmark (13%), Austria and Finland (14%), and highest in Cyprus (37%), Lithuania and the Netherlands (both 31%).

Overall, boys (30%) are more than twice as likely as girls (13%) to score positively on the perceived gaming risk scale. The largest gender differences are observed in Portugal and Germany, where boys outscore girls by 25–26 percentage points. In contrast, the gap is minimal in Cyprus (minus 1 percentage point) and even reversed in the Netherlands, where girls score 7 percentage points higher than boys.

Regarding social media use, nearly half of the students (47%) score 2–3 points on the perceived social media use risk scale. The highest prevalence is found in Austria (58%), Liechtenstein (57%) and Germany (56%), while the lowest is recorded in Czechia (29%), Hungary and Poland (both 32%).

Girls (53%) are more likely than boys (42%) to score positively on the perceived social media use risk scale. In this case, the gender differences fall within a narrower range, from 3 to 17 percentage points, consistently in favour of girls. The largest gaps are observed in the Faroe Islands, Liechtenstein and Slovakia (17%).

Tracking the trends: how things have changed from 2015 to 2024

The latest ESPAD findings highlight a substantial increase in gaming prevalence among 16-year-old students over time, rising from 47% in 2015 to 80% in 2024. The trend is particularly pronounced among girls, whose gaming prevalence more than tripled, from 22% in 2015 to 71% in 2024. While boys consistently report higher gaming engagement, their increase is more gradual, rising from 71% in 2015 to 89% in 2024. The narrowing gender gap suggests that gaming, once a predominantly male activity, has become increasingly common among girls.

The prevalence of perceived gaming risk has remained relatively stable, with overall rates increasing slightly from 20% in 2015 to 22% in 2024. Among boys, the percentage remained consistent at around 30%, while among girls, it increased from 9.5% in 2015 to 13% in 2024, which is in line with their increasing gaming engagement.

The perceived problematic use of social media has increased from 38% in 2015 to 47% in 2024 overall. The rise was more pronounced among boys, increasing from 30% to 41%, while among girls, the rate remained consistently high, fluctuating at around 53–54%.

Mental well-being

In the aftermath of the COVID-19 pandemic and amid ongoing conflicts in Europe and the Middle East, ESPAD has strengthened its focus on adolescent mental well-being. The persistent effects of social isolation, educational disruptions and socio-economic instability have heightened concerns regarding youth mental health.

To systematically assess and monitor this issue, the 2024 ESPAD survey included for the first time the WHO-5 Well-Being Index, a validated measure of mental state based on recent life experiences. A score above 50 out of 100 is considered indicative of good mental well-being.

On average, 59% of students report having a good mental well-being. Regionally, the highest rates of well-being are found in northern Europe, with the Faroe Islands (77%), Iceland (75%) and Denmark (72%) showing the highest prevalence. The country with the lowest rate of self-reported well-being is Ukraine (43%), where, since 2022, adolescents have been exposed to traumatic events and limited access to mental health care, followed by Czechia (46%), Hungary (47%), Cyprus and Poland (49%).

Mental well-being tends to be generally higher among boys than girls, both on average (69% versus 49%) and across all ESPAD countries. The largest gender differences are observed in Italy (66% among boys versus 35% among girls), Poland (64% among boys versus 33% among girls) and Sweden (78% among boys versus 48% among girls). The smallest gender gaps are found in Cyprus (52% among boys versus 46% among girls), Ukraine (48% among boys versus 39% among girls), the Faroe Islands (83% among boys versus 72% among girls) and Georgia (75% among boys versus 62% among girls).

Prevention activities

Around 72% of ESPAD students report having participated in at least one prevention intervention in the two years preceding the survey. These interventions range from awareness events, focused solely on providing information, to skills-based programmes, which incorporate interactive activities designed to develop personal and social skills. This is the first data collection to include information on participation in prevention programmes, providing new insights into youth engagement in such initiatives. It is important to stress that not all prevention interventions are evidence-based.

More than half of the students (56%) report having attended awareness or information events on licit and illicit substances or risk behaviours. Participation rates are highest in Slovakia (77%) and Hungary (74%), while the lowest are in Kosovo (31%) and Montenegro (38%).

Alcohol is the most frequently addressed topic, with 49% of students reporting participation in related information events. At the national level, percentages are highest in Slovakia (70%) and Croatia (67%), while the lowest are recorded in Kosovo (18%).

Tobacco-related events are the second most frequently reported, attended by 38% of students. The highest attendance rates are observed in Slovakia and Hungary (59%), while the lowest are in Cyprus (22%) and Georgia (23%).

Only 31% of ESPAD students, on average, report having attended awareness or information events on illicit substances. Participation rates are highest in Slovakia (60%) and Iceland (56%), and lowest in Kosovo (10%), Georgia and Sweden (11% both).

The least frequently addressed topics are non-substance-related risk behaviours, such as gambling, gaming or internet disorders, with an average of 28% of ESPAD students reporting participation. The highest participation rate is recorded in Iceland and Slovenia (48%), while Kosovo shows the lowest (9.4%).

Participation in substance-related awareness or information events is more frequently reported by girls. However, for events related to gambling, gaming and internet disorders, boys (30%) report higher involvement than girls (24%).

Regarding interactive training activities, a key component of prevention efforts, 55% of ESPAD students report participating in interventions focused on developing social skills, personal skills or media literacy. At the national level, participation ranges from 35% in the Faroe Islands and 36% in Sweden, to 71% in Malta and Spain and 72% in Finland.

The most frequently reported type of training focuses on social skills, 41% on average, aiming to enhance interaction and communication with others (e.g. expressing feelings, empathy and dealing with peer pressure). Finland records the highest participation rate (64%), while Sweden shows the lowest (25%).

A similar proportion of students (40%) report participating in media literacy training, which focuses on critically analysing advertisements and media content to recognise intended messages and reduce susceptibility to manipulation. These training activities were most prevalent in Finland (60%) and Denmark (59%), and least common in Kosovo (20%).

The least widespread type of training focuses on improving personal skills, generally equipping students with strategies to cope with challenging life situations in a healthy way, reported by just over one-third of ESPAD students (36%). Participation rates are highest in Lithuania (56%) and Malta (55%), and lowest in the Faroe Islands (23%) and Sweden (24%).

Overall, the gender gap in reporting participation is more pronounced for these interventions, with 60% of girls reporting involvement compared to 51% of boys. This pattern remains consistent across all types of training.

While awareness or information events tend to be more concentrated in eastern Europe, skills-based prevention initiatives, deemed to have a higher potential for effectiveness compared to awareness or information events, are more prevalent in western and southern Europe.

Participating countries

The following countries participated in the 2024 edition of the ESPAD survey:
Austria, Bulgaria, Croatia, Cyprus, Czechia, Denmark, Estonia, Faroe Islands, Finland, France, Georgia, Germany, Greece, Hungary, Iceland, Ireland, Italy, Kosovo (¹), Latvia, Liechtenstein, Lithuania, Malta, Moldova, Monaco, Montenegro, Netherlands, North Macedonia, Norway, Poland, Portugal, Romania, Serbia, Slovakia, Slovenia, Spain, Sweden, Ukraine.

Source data

The data used to generate data visualisations on this page may be found below, as well as in our Data catalogue. This data set is covered by a Creative Commons Attribution 4.0 International (CC BY 4.0) licence. Note for attribution, please use 'European School Survey Project on Alcohol and Other Drugs (ESPAD)'.

Acknowledgements

Austria: Julian Strizek; Bulgaria: Anina Chileva, Yuliya Andzhekarska; Croatia: Martina Markelić; Cyprus: Ioanna Yiasemi; Czechia: Pavla Chomynová, Zuzana Dvořáková, Ladislav Csémy; Denmark: Ola Ekholm, Rikke Bjerring Plenborg; Estonia: Sigrid Vorobjov, Liina Veskimäe, Jaanika Piksööt; Faroe Islands: Maria Skaalum Petersen, Pál Weihe; Finland: Kirsimarja Raitasalo; France: Eric Janssen, Stanislas Spilka; Georgia: Ekaterine Khutsishvili, Mamuka Nadareishvili, Sofiko Alavidze; Germany: Kilian Olk; Greece: Anastasios Fotiou; Hungary: Zsuzsanna Elekes, Petra Arnold, Tamás Domokos, Ágoston Horváth, Máté Kapitány-Fövény, Tamás Felföldi, András Csanaky, Zsolt Horváth, Márk Csanaky; Iceland: Ragný Þóra Guðjohnsen; Ireland: Joan Hanafin, An t-Uasal Seán Ó Broin; Italy: Sonia Cerrai, Elisa Benedetti, Rodolfo Cotichini, Marco Scalese, Alice Berti, Giada Anastasi, Sabrina Molinaro; Kosovo: Mytaher Haskuka; Latvia: Diāna Vanaga-Arāja, Oksana Žabko, Inese Šūpule; Liechtenstein: Martin Birnbaumer-Onder; Lithuania: Liudmila Rupšienė, Laura Šaltytė-Vaisiauskė, Aelita Bredelytė, Egidijus Laucevičius, Rūta Gedminienė, Brigita Rašimaitė; Malta: Trischia Falzon; Moldova: Nicolae Jelamschi, Valeriu Pleșca, Sergiu Otgon, Liliana Buzdugan; Monaco: Julie Marty; Montenegro: Tatijana Đurišić; Netherlands: Karin Monshouwer; North Macedonia: Elena Kjosevska, Sanja Prosheva; Norway: Elin K. Bye; Poland: Janusz Sierosławski; Portugal: Elsa Lavado, Vasco Calado, Nuno Rodrigues, Rui Lima, Pedro Fins, Nelson Carvalho; Romania: Ruxanda Iliescu; Serbia: Kilibarda Biljana, Jelena Gudelj; Slovakia: Alena Kopányiová, Robert Tomšik; Slovenia: Tanja Urdih Lazar; Spain: Begoña Brime, Luisa María López Sánchez; Sweden: Siri Thor, Ulf Guttormsson; Ukraine: Tetiana Bondar.

The 2024 ESPAD studies in Albania, Bosnia and Herzegovina, Georgia, Kosovo (¹), Montenegro, North Macedonia, Republic of Moldova, Serbia and Ukraine were co-funded by the European Union in the framework of EU funded technical cooperation projects implemented by EUDA.

About ESPAD

The European School Survey Project on Alcohol and Other Drugs (ESPAD) is a collaborative effort of independent research teams in more than 40 European countries and the largest cross-national research project on adolescent substance use in the world. The overall aim of the project is to repeatedly collect comparable data on substance use among 15-16 year old students in as many European countries as possible. The EUDA is a key partner in the ESPAD project. The ESPAD study is coordinated by the Institute of Clinical Physiology of the Italian National Research Council.

More information can be found on the ESPAD website.

About this publication

Recommended citation: ESPAD Group (2025), Key findings from the 2024 European School Survey Project on Alcohol and Other Drugs (ESPAD), European Union Drugs Agency, Lisbon, https://www.euda.europa.eu/publications/data-factsheets/espad-2024-key-findings_en

Identifiers

HTML: TD-01-25-003-EN-Q
ISBN: 978-92-9408-039-4
DOI: 10.2810/5746644

Related resources

• ESPAD-EUDA cooperation information page and outputs
• ESPAD website [external website]
• ESPAD data portal [external website]

(¹) This designation is without prejudice to positions on status, and is in line with UNSCR 1244/1999 and the ICJ Opinion on the Kosovo declaration of independence.