ESPAD average
Early onset of substance use (%) a
  Average Min. Max.
Cigarettes 23 9 46
Daily smoking 4 1 8
Alcohol 47 14 72
Intoxication 8 2 22
Cannabis 3 1 8
Ecstasy 1 0 2
Amphetamine / methamphetamine 1 0 3
Cocaine / crack 1 0 2
a Percentage of students using a substance at the age of 13 or younger

Cigarettes

More than one in five ESPAD students (23 %) had smoked cigarettes at the age of 13 or younger (Table 4a). The proportions vary considerably across countries, from 46 % in Estonia and 45 % in Lithuania to 9-13 % in the former Yugoslav Republic of Macedonia, Iceland, Malta and Norway. Both on average and in most individual countries, more boys than girls have smoked cigarettes at the age of 13 or younger. The largest difference between boys and girls was found in Moldova (33 % versus 8 %). The highest rates among boys (50-51 %) were found in Estonia and Lithuania. The Czech Republic and the three Baltic countries of Estonia, Latvia and Lithuania had the highest rates among girls (40-41 %).

The ESPAD average for students who began smoking cigarettes on a daily basis at the age of 13 or younger is 4 %. The rates were highest in Estonia and Slovakia (8 %) and lowest in Norway (1 %). Due to the small proportion of students reporting onset of daily smoking at an early age, gender differences were generally less than 3 percentage points (ESPAD average: boys 5 %, girls 3 %), even though in the majority of countries more boys than girls reported early onset of daily smoking. The countries with the highest prevalence estimates for boys were Estonia, Lithuania and Slovakia (9 %). Among girls, Bulgaria and Estonia (7 %) were the countries with the highest rates.

Alcohol

Nearly half of the students (47 %) reported alcohol use at the age of 13 or younger (Table 4a). The highest proportions of students reporting alcohol use at an early age were found in Georgia (72 %), the Czech Republic (68 %) and Cyprus (66 %). The countries with the lowest rates were Iceland (14 %) and Norway (19 %). Boys were more likely than girls to have used alcohol at the age of 13 or younger, with the highest gender difference found in Albania (61 % for boys versus 37 % for girls) and Montenegro (58 % versus 36 %).

One in twelve students experienced intoxication at the age of 13 or younger. The proportion of students reporting intoxication at an early age varied across countries: Georgia (22 %) and Estonia (15 %) were at the high end and Iceland (2 %) and Belgium (Flanders) (3 %) were at the low end of the scale. Higher rates were more likely to be found in the eastern part of Europe. In general, more boys than girls reported intoxication at an early age (ESPAD average: 9 % versus 6 %, respectively).

Illicit drugs

On average, 3 % of the students reported that they had first used cannabis at the age of 13 or younger (Table 4b). The highest proportions were found in Monaco (8 %), France and Liechtenstein (6 % each). Rates of early onset of amphetamine/methamphetamine use were lower (ESPAD average: 1 %), with the highest proportions in Bulgaria (3 %) and Cyprus (2 %). Boys were more likely than girls to have used cannabis or amphetamine/methamphetamine at the age of 13 or younger. Similar results were found for early onset of ecstasy and cocaine/crack use.

Table 4a. Early onset of substance use: prevalence of students experiencing substance use (cigarettes, daily smoking, alcohol, intoxication) at the age of 13 or younger (percentage)

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a Official name former Yugoslav Republic of Macedonia.

Table 4b. Early onset of substance use: prevalence of students experiencing substance use (cannabis, ecstasy, amphetamine/methamphetamine, cocaine/crack) at the age of 13 or younger (percentage)

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a Used by end of 8th grade, approximate age is 13 (amphetamines only, cocaine only, tranquillisers only).

b Official name former Yugoslav Republic of Macedonia.