Adolescence is a period of experimentation, sometimes linked to participation in behaviours detrimental to health, including tobacco consumption and the use of illicit drugs. Tobacco smoking in childhood and adolescence has both immediate and long-term health consequences, increasing the risks of respiratory diseases like asthma in the short term and the long-term risks of cardiovascular diseases, respiratory illnesses, and cancer.
While tobacco smoking among adolescents has continued to decline in most EU countries in the last decade, too many adolescents still smoke. On average in EU countries, more than one in six (17%) 15‑year‑olds reported smoking cigarettes at least once in the past month in 2022 (Figure 4.1). This proportion reached a high of more than one in four in Bulgaria, Hungary, Italy and Croatia, whereas less than one in ten reported to have smoked cigarettes in the past month in Ireland, Portugal and Malta. The gender gap in tobacco smoking between 15‑year‑old boys and girls is fairly small in most countries. On average, a slightly greater proportion of 15‑year‑old girls reported smoking in 2022 (18% compared with 16% for boys) (Charrier et al., 2024[1]).
The smoking rate among 15‑year‑olds has decreased since 2014 in nearly all EU countries, except in Bulgaria, where it slightly increased, and Romania and Spain, where the rates were stable. However, the decrease was generally more pronounced between 2014 and 2018 than between 2018 and 2022.
EU countries have used a mix of policies to reduce smoking rates among adolescents and the rest of the population, including taxes to increase prices, smoking bans in indoor public places, restrictions on youth purchase of tobacco, advertising restrictions, plain packaging of tobacco products, and greater education. In 2014, the EU adopted a directive that came into force in 2016, banning flavoured cigarettes, imposing rules on novel tobacco products, and tightening regulations on the production and sales of e‑cigarettes, such as setting maximum nicotine concentration and requiring compulsory health warnings to inform consumers that e‑cigarettes contain nicotine. Despite these efforts, about one in five (22%) 15‑year‑olds across EU countries reported using e‑cigarettes in the last month in 2022.
Cannabis smoking is by far the most used drug among adolescents. Frequent and heavy cannabis use during adolescence is linked to long-term increased risk of dependence and cognitive functioning problems, including memory losses and attention deficits.
On average in EU countries, 1 in 14 (7%) 15‑year‑olds reported smoking cannabis at least once in the past month in 2022 (Figure 4.2). This proportion ranged from over one in ten in Bulgaria, Poland and Italy to less than 1 in 20 in Romania, Portugal, Denmark, Estonia, Ireland and Cyprus. Examining trends since 2014 reveals that past-month cannabis use among 15‑year‑olds decreased in more than one‑third of EU countries, while it increased in the remaining two‑thirds. France and Denmark experienced the most substantial decreases, although this finding may be attributable to a delay in the age of initiation for cannabis use in these countries. The 2022 data also highlights a gender disparity, with 15‑year‑old boys (8%) being more likely to report past-month cannabis use compared to their female counterparts (6%) across EU countries on average.
EU countries use a mix of approaches to reduce cannabis consumption among adolescents, combining legal controls of drug dealers and users, education and public awareness programmes of the health risks of drug use, and treatments for young people who have developed addictions.
