In this section, overall trends measured across countryspecific means of 25 countries are reported between 1995 and 2015. The 25 countries included are Bulgaria, Croatia, Cyprus, the Czech Republic, Denmark, Estonia,

Figure 10. Countries included in the 25-country average (marked in blue)

Figure 10. Countries included in the 25-country average (marked in blue)

Table 13. Overview of ESPAD surveys conducted between 1995 and 2015 by country: sample size and participation rate

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Country 1995 1999 2003 2007 2011 2015
n % a n % a n % a n % a n % n a % a
Albania . . . . . . . . 3189 100 2553 100
Austria . . . . 2402 73 2571 63 . . 3684 17 b
Belgium (Flanders) . . . . 2320 c 88 1889 d 54 e 1798 f 58 e 1771 f 56 e
Bosnia and Herzegovina (FBiH) . . . . . . 2973 g 100 3813 d 99 . .
Bosnia and Herzegovina (RS) . . . . . . 2609 g 97 3132 98 . .
Bulgaria . . 5391 100 2740 100 2353 100 2217 100 2922 98
Croatia 2815 100 3602 100 2884 99 3008 99 3002 90 2558 98
Cyprus 632 100 2095 100 2152 98 e 6340 100 4243 76 2098 85
Czech Republic 2962 100 3579 99 3195 100 3901 100 3913 98 2738 96 e
Denmark 2439 78 1790 56 2978 65 877 46 2181 42 e 1670 26 e
Estonia 3118 94 3254 89 2463 80 2372 90 2460 95 2452 90
Faroes 543 100 463 100 640 97 552 100 557 100 511 100
Finland 2300 100 3286 99 e 3543 97 4988 99 3744 81 4049 85
FYR Macedonia k . . 5199 100 . . 2452 g 97 . . 2428 98
France . . 2284 97 2199 86 2916 98 2572 95 2714 93
Germany h . . . . 5110 91 5011 90 2796 40 . .
Greece . . 2259 94 1906 97 3060 88 5908 87 3202 95
Greenland . . 421 76 e 555 n.a. . . . . . .
Hungary 2571 99 6421 92 2677 98 2817 94 3063 85 2735 93
Iceland 3814 90 3524 99 e 3348 98 3510 97 3333 95 2663 79
Ireland 1849 81 2277 100 2407 91 2221 76 2207 72 1470 18 b
Isle of Man . . . . 721 100 e 740 100 . i . . .
Italy 1555 99 4106 100 4871 97 9981 99 4837 88 4059 85
Latvia 2179 49 2284 90 2841 97 2275 93 2622 95 1119 42
Liechtenstein . . . . . . . . 366 100 316 100
Lithuania 3196 100 5039 100 5036 100 2411 99 2476 99 2573 99
Malta 2832 100 4321 100 3500 99 3668 99 3377 100 3326 98
Moldova . . . . . . 3176 g 99 2162 100 2586 100
Monaco . . . . . . 393 100 401 100 397 100
Montenegro . . . . . . 5823 g 100 3387 100 3844 100
Netherlands . . 2615 n.a. 2095 97 2091 98 2044 d 50 e 1684 d 43 e
Norway 3910 90 3918 86 3833 77 3482 58 e 2938 28 2584 53
Poland 8940 96 3330 n.a. 5964 98 2120 93 5933 94 11822 94
Portugal 2033 100 3609 100 2946 98 3141 95 1965 90 3456 96
Romania . . 2393 94 4371 100 2289 98 2770 100 3500 100
Russia (Moscow) . . 2937 95 1925 92 3939 j 96 e 1757 77 . .
Serbia . . . . . . 6156 g 94 e 6084 97 . .
Slovakia 2376 99 2442 100 2276 98 2468 100 2009 100 2208 100
Slovenia 3306 100 3184 100 2785 100 3085 100 3186 100 3484 99
Sweden 3472 94 3445 89 3232 87 3179 87 2569 80 2551 83
Switzerland . . . . 2613 86 2499 88 . . . .
Ukraine 7193 99 2994 97 e 4173 98 2447 98 2210 99 2350 98
United Kingdom 7722 46 e 2641 74 e 2068 55 e 2179 40 1712 5 . .
a Class participation rate: proportion of selected classes participating in the survey.
b Estimated from the maximum number of classes that could participate.
c Flanders and Wallonia.
d Data collected in autumn.
e School participation rate (class participation rates not available).
f Data collected in previous autumn.
g Data collected in spring 2008.
h Five federal states: Bavaria, Berlin, Brandenburg, Mecklenburg-Western Pomerania and Thuringia.
i Data collected but not delivered.
j Russia.
k Official name former Yugoslav Republic of Macedonia.
Red typeface: countries included in the 25-country average.
n.a. = not available.

Table 14. ESPAD average for selected indicators based on 25 countries: 1995-2015

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Measure 1995 1999 2003 2007 2011 2015
Perceived availability of cannabis 22 30 33 33 32 32
Early onset of daily cigarette use a 10 9 10 7 7 4
Early onset of daily cannabis use a 2 2 3 3 3 3
Lifetime use of cigarettes 67 68 66 59 56 47
Current cigarette use b 32 36 33 29 29 22
Daily cigarette use b 20 24 23 18 18 13
Lifetime alcohol use 89 90 90 88 86 81
Current alcohol use b 56 61 63 60 58 47
Heavy episodic drinking c 36 39 40 42 41 35
Lifetime illicit drug use 11 17 20 18 19 18
Lifetime cannabis use 11 16 19 17 18 17
Lifetime use of illicit drugs other than cannabis 3 6 5 7 6 5
Current cannabis use b 4 6 8 7 7 7
Lifetime inhalant use 8 9 9 9 9 8
Lifetime use of tranquillisers or sedatives without a doctor’s prescription 8 7 7 7 7 6
a At age 13 or younger.
b Last 30 days.
c More than five drinks on one occasion at least once in the last 30 days.

Availability of cannabis

The average proportion of students who answered that they would find it easy (combined positive responses on ‘very easy’ and ‘fairly easy’) to obtain cannabis, if they wanted to, increased from 1995 to 2003 in both genders and levelled off thereafter (Figure 11). Rates among boys are slightly higher than among girls. Overall, the perceived availability of cannabis among boys increased from 23 % to 33 % and among girls from 21 % to 30 %.

Early onset of substance use

Daily smoking

On average, between 1995 and 2003 rates of early onset of daily smoking (that is, at the age of 13 or younger) were rather stable at about 10 %, but rates dropped thereafter to 4 % in 2015, indicating a strong decrease in early onset daily smoking over the last 10 years (Table 14). Genderspecific trends are almost parallel, with slightly lower rates in girls than boys (1-2 percentage points difference in recent surveys; Figure 12).

Cannabis use

Rates of cannabis use at the age of 13 years or younger increased slightly until 2003 among girls and until 2007 among boys and stabilised thereafter (Figure 13). Trends by gender are almost parallel, with girls’ rates being slightly lower than boys’ rates.

Cigarette use

On average, lifetime prevalence rates of smoking showed a stable trend between 1995 and 2003 and decreased thereafter (Table 14). Rates of lifetime smoking among boys and girls follow this general trend. However, the gender gap in lifetime smoking rates, still visible in 1995, closed in 2015 (Figure 14). Similar trends can be observed for current smoking and daily smoking (Table 14). Rates of current (last- 30-day) use decreased by 10 percentage points between 1995 and 2015 (Table 14; Figure 15); reductions in daily use amounted to 7 percentage points (Figure 16).

Alcohol use

The prevalence of lifetime as well as current (last-30-day) use of alcohol decreased between 2003 and 2015 (Table 14; Figures 17 and 18). No gender differences in trends can be observed, with the exception of constantly higher rates among boys.

The prevalence of heavy episodic drinking, although showing the same level in 2015 as 20 years before, peaked in the middle of the 2000s and has decreased since then. However, as shown in Figure 19, rates of heavy episodic drinking generally increased among girls, resulting in a narrowing of the gender differences over time.

Illicit drug use

Generally, between 1995 and 2003, an increase can be seen in the prevalence of illicit drug use, most of which occurred between the first two surveys. Since then, the prevalence has remained largely unchanged. Trends in illicit drug use experience among boys and girls follow the general trend, with girls’ rates being about 6 percentage points lower than boys’ rates (Figure 20). Trends for lifetime cannabis use are similar to the trends for any illicit drug use, with rates being only slightly lower (Table 14 and Figure 21). Prevalence rates of lifetime cannabis use as well as current (last-30-day) use for both genders peaked in 2003 and stabilised thereafter (Figures 21 and 22).

Lifetime use of illicit drugs other than cannabis rose to a peak in 2007 (Table 14; Figure 23). Since 2007, the rates appear to have slightly decreased. This trend is also seen for boys and girls, with a consistent gender gap of 1-2 percentage points.

Inhalant use

The use of other psychoactive substances such as inhalants shows generally stable lifetime prevalence rates over the observed period. The gender-specific curves reveal a narrowing and, by the end, closure of the gender gap, with rates among boys slightly decreasing but rather unchanged rates among girls (Figure 24).

Pharmaceutical use

The lifetime prevalence rates for the use of tranquillisers or sedatives without a doctor’s prescription show a slightly downward trend, with similar trends for boys and girls. Tranquillisers or sedatives are the only psychoactive substances that were taken more frequently by girls than boys (Figure 25).

Figure 11. Perceived availability of cannabis by gender; students responding cannabis ‘fairly easy’ or ‘very easy’ to obtain: 25-country trend 1995- 2015 (percentage)

Figure 11. Perceived availability of cannabis by gender; students responding cannabis ‘fairly easy’ or ‘very easy’ to obtain: 25-country trend 1995- 2015 (percentage)

Figure 12. Daily cigarette use at the age of 13 or younger by gender: 25-country trend 1995-2015 (percentage)

Figure 12. Daily cigarette use at the age of 13 or younger by gender: 25-country trend 1995-2015 (percentage)

Figure 13. Cannabis use at the age of 13 or younger by gender: 25-country trend 1995-2015 (percentage)

Figure 13. Cannabis use at the age of 13 or younger by gender: 25-country trend 1995-2015 (percentage)

Figure 14. Lifetime use of cigarettes by gender: 25-country trend 1995-2015 (percentage)

Figure 14. Lifetime use of cigarettes by gender: 25-country trend 1995-2015 (percentage)

Figure 15. Cigarette use in the last 30 days by gender: 25-country trend 1995-2015 (percentage)

Figure 15. Cigarette use in the last 30 days by gender: 25-country trend 1995-2015 (percentage)

Figure 16. Daily cigarette use by gender: 25-country trend 1995-2015 (percentage)

Figure 16. Daily cigarette use by gender: 25-country trend 1995-2015 (percentage)

Figure 17. Lifetime alcohol use by gender: 25-country trend 1995-2015 (percentage)

Figure 17. Lifetime alcohol use by gender: 25-country trend 1995-2015 (percentage)

Figure 18. Alcohol use in the last 30 days by gender: 25-country trend 1995-2015 (percentage)

Figure 18. Alcohol use in the last 30 days by gender: 25-country trend 1995-2015 (percentage)

Figure 19. Heavy episodic drinking (five or more drinks on one occasion) during the last 30 days by gender: 25-country trend 1995-2015 (percentage)

Figure 19. Heavy episodic drinking (five or more drinks on one occasion) during the last 30 days by gender: 25-country trend 1995-2015 (percentage)

Figure 20. Lifetime use of illicit drugs by gender: 25-country trend 1995-2015 (percentage)

Figure 20. Lifetime use of illicit drugs by gender: 25-country trend 1995-2015 (percentage)

Figure 21. Lifetime use of cannabis by gender: 25-country trend 1995-2015 (percentage)

Figure 21. Lifetime use of cannabis by gender: 25-country trend 1995-2015 (percentage)

Figure 22. Cannabis use in the last 30 days by gender: 25-country trend 1995-2015 (percentage)

Figure 22. Cannabis use in the last 30 days by gender: 25-country trend 1995-2015 (percentage)

Figure 23. Lifetime use of illicit drugs other than cannabis by gender: 25-country trend 1995-2015 (percentage)

Figure 23. Lifetime use of illicit drugs other than cannabis by gender: 25-country trend 1995-2015 (percentage)

Figure 24. Lifetime use of inhalants by gender: 25-country trend 1995-2015 (percentage)

Figure 24. Lifetime use of inhalants by gender: 25-country trend 1995-2015 (percentage)

Figure 25. Lifetime use of tranquillisers or sedatives without a doctor’s prescription by gender: 25-country trend 1995-2015 (percentage)

Figure 25. Lifetime use of tranquillisers or sedatives without a doctor’s prescription by gender: 25-country trend 1995-2015 (percentage)