The changing attitudes of Generation Z towards substance use and risky behaviours

For approximately 30 years, the Italian National Research Council has partnered with the European Union Drugs Agency (EUDA) to survey more than 113,800 students aged 15–16 across Europe to monitor adolescent risk behaviours. The latest findings reveal that, although cannabis, alcohol, and traditional cigarettes use among European teenagers has steadily declined, new behavioural and health risks are emerging.

These include, among others, e-cigarettes, non-medical pharmaceutical drug use, and a noticeable increase in online gaming and gambling. This changing landscape highlights the need to adapt traditional prevention methods to tackle new challenges. So, the question is: how can we protect young Europeans’ well-being while staying ahead of risks that already affect them?

The 2024 edition of the ESPAD survey reveals that, over the past three decades, there has been a steady decline in traditional substance use among European teenagers, including alcohol, cigarettes, and cannabis. Since 1995, lifetime alcohol consumption in 15–16-year-olds has decreased by 14%, and cigarette smoking has more than halved from 68% to 32%. Illicit drug use has also declined, with cannabis remaining the most common illicit drug, and its lifetime use dropping to 12% from a peak of 18% in 2003.

According to Dr Sabrina Molinaro, the Coordinator of the ESPAD Survey, one of the reasons for this shift, particularly regarding cannabis use, is how COVID-19 shaped the social interaction dynamics among teenagers. “The lockdown has significantly impacted how they spend time together. In 2024, they probably went out less than they did in 2019. Furthermore, the fact that the decrease is associated with occasional use suggests that these young individuals likely consumed cannabis mainly during parties or social outings with friends. Consequently, now that they spend more time at home, they are probably less likely to use cannabis in those environments,” explains Dr Molinaro.

Another explanation is how alcohol and tobacco policies have also influenced societal behaviour towards these substances in recent years.

According to Dr Margreet de Looze, Assistant Professor in the Department of Interdisciplinary Social Science (Youth Studies) at Utrecht University: “Strong tobacco control measures, especially those targeting norms around smoking, such as smoke-free laws, were implemented, which helped transform smoking from something socially acceptable to something increasingly stigmatised. For alcohol, policy changes vary a bit more across countries, but norms have also shifted dramatically. Non-drinking, for example, is now perceived a more ‘normal’ by many teenagers.” – Read the full interview with Margreet de Looze

This decline in ‘more traditional’ substance use doesn’t necessarily mean that adolescents are less at risk now compared to the past. Instead, it indicates that their behavioural risks are simply changing. For instance, there is increasing concern about new psychoactive substances (NPS), with about 3% of adolescents having tried them at some point in their life, and non-medical use of pharmaceutical drugs- particularly tranquillisers and sedatives- that has risen across Europe, with lifetime use reaching 14%. Additionally, online gambling has grown significantly, with its prevalence almost doubling between 2019 and 2024 in our continent. Finally, perceived problematic social media use has increased by 9% since 2015, reaching 47% in 2024.

Gender gap?

One crucial aspect to notice from this changing landscape is that, as Dr Molinaro highlighted, “it seems that 16-year-old girls are more inclined to problematic behaviours than in the past.” Based on ESPAD data, girls have shown increased involvement in activities previously more common among boys, such as online gambling and gaming. They also report higher rates of problematic social media use, along with increased consumption of substances and e-cigarettes.

Dr Sabrina Molinaro, the Coordinator of the ESPAD Survey: “Our findings show a complete change in alcohol consumption patterns among females. Since 2019, the prevalence of intoxication among females 16 years old, has surpassed that of the male population. This is an unusual trend; previously, only some northern European countries showed higher female intoxication rates, while southern and central European countries typically saw higher male prevalence. Recently, many countries have reported higher intoxication rates among females.” – Read the full interview with Sabrina Molinaro

Dr Margreet de Looze: “The industries that sell alcohol and tobacco have aggressively gender-targeted girls and young women. Marketing strategies link substance use with empowerment, confidence, body image and modern femininity—whether through fashion-driven social-media campaigns, women-only promotions or products designed specifically for girls, such as menthol cigarettes or fruit-flavoured drinks. These commercial pressures interact with growing gender equality to produce a rise in girls’ engagement in traditionally ‘masculine’ risk behaviours. Thus, while increased gender equality has brought many positive outcomes, it may have also unintentionally widened girls’ exposure to harmful health behaviours. This highlights the need for prevention strategies that account for changing gender norms, as well as the specific ways industries target girls.”

Mental health and problematic social media use

Gender differences are also present in the level of mental well-being of European adolescents. Despite the pandemic and the difficult economic and political stability in Europe and beyond, more than half of European teenagers surveyed in the ESPAD report experience good mental well-being. Nevertheless, boys generally report higher mental well-being than girls, with averages of 69% versus 49%, overall and across Europe.

“Our research shows that schoolwork pressure has increased in recent years, especially among girls. This may partly explain why mental health problems increased more sharply among girls. Furthermore, we are currently looking into two other hypotheses, namely that girls were more strongly affected by the social restrictions during the COVID-19 pandemic and that girls are disproportionately impacted by social media use, particularly through mechanisms such as social comparison, body-image pressure, and disrupted sleep,” comments Dr de Looze.

Dr Kamran Niaz, Epidemiologist, UNODC Research, United Nations Office on Drugs and Crime (UNODC): “There is an overlap between mental well-being, substance use, and exposure to harmful content online, especially on social media and gaming platforms. […] Adolescents in Europe, as in other regions, have a high use of and exposure to a range of social media and gaming platforms where they are likely to be exposed, among other contents, to drug-related content where drug-related behaviours may be promoted and normalised, that may then influence the adolescents to experiment with drugs.” – Read the full interview with Kamran Niaz

The constant flow of updates can be overwhelming for users. As Dr Molinaro explains, young people often turn to the online world to escape real-life issues, immersing themselves in this virtual environment and being bombarded by different stimuli. “I think it’s impressive how digital everything is these days. This generation has greater access to information than ever before, which makes them more aware of the world around them. I guess this means they’re feeling more pressure to perform better than ever before. It’s like they’re feeling more anxious because they need to perform,” adds Dr Molinaro.

Adapting prevention to the new landscape

As suggested by the UNODC report, starting harmful behaviours like drug use in adolescence can be especially damaging, as it can disrupt education, brain development, and the transition to adulthood. “Although the causal pathways are complex, in addition to somatic harms to the brain and to the respiratory and other systems, early intensive cannabis use, as an example, brings with it a range of social and educational issues, including limited academic achievement and subsequent economic problems,” says Dr Niaz.

Therefore, it is crucial to implement effective policies, ensure access to evidence-based care, and combat stigma to reduce the health impacts of substance use and risky behaviours. To do so, Dr Molinaro suggests adapting traditional prevention programmes to address the new needs of Generation Z.

“Previously, peer influence was a significant risk factor for many risky behaviours. Because they spend less time in person and more time online, this younger generation likely requires a different approach to prevention. They need to stay connected, develop practical skills, and enhance their ability to focus on specific activities. This is challenging in an age of multitasking, with numerous inputs such as screens and notifications,” comments Dr Molinaro.

Finally, besides modernising outdated prevention programmes, we need to prioritise their long-term sustainability. As explained by Dr de Looze, prevention funding generally rises when youth substance use increases and decreases when rates go down, creating a vicious cycle.

“What we need to remember is that every year, a new group of 11-, 12-, and 13-year-olds enters adolescence. If we don’t consistently equip each new cohort with the skills and support they need to make healthy choices, we risk repeating the same pattern. Sustainable, long-term investment in prevention is crucial; otherwise, we will keep rediscovering the same problem every few years,” concludes Dr de Looze.