Tobacco, alcohol, and cannabis use have fallen among French adolescents in the last decade, particularly between 2018 and 2021 following the COVID-19 outbreak.
In France, as across the WHO European Region, measures taken to control the COVID-19 pandemic have disrupted the lives of adolescents. School closures between 2020 and 2021 affected their schooling and learning and their sociability, distancing them from their peers and their primary social setting at this age.
In the first quarter of 2021, 1,972 ninth-grade students from public and private schools responded to the French national adolescent health and substance use survey (EnCLASS), a project linked to the HBSC survey in France, supported by the Ministry of Education, the French Monitoring Centre for Drugs and Drug Addiction (OFDT) and conducted in partnership with the National Institute of Health and Medical Research (Inserm) and the National School of Public Health (EHESP).
The survey investigates various health behaviours, including the use of tobacco, alcohol and cannabis, and has found that the pandemic has had a significant effect on this behaviour among young teens in France.
State of tobacco, alcohol and cannabis use among adolescents
The study has found that alcohol remains the most frequently used substance by French adolescents, with two-thirds of 9th-grade students having consumed alcohol at some point in 2021. At the same time, this figure is the lowest recorded since 2010, with 60% of the total decrease occurring between 2018 and 2021.
Most strikingly, the percentage of 9th-grade students who had never consumed alcohol doubled in the last decade.
“These positive trends show how young people’s social interactions can affect harmful substance abuse, as well as the power of targeted policies and campaigns,” said Emmanuelle Godeau, one of the lead investigators in the EnCLASS survey, a member of the EHESP National School of Public Health in France, and the PI for HBSC in France: “The continuous decline in the use of tobacco and alcohol among adolescents in France is also the result of successful public policies and strategies, including the denormalization of smoking.”
It is with smoking that the results are most significant. The use of tobacco and cigarettes has gone down considerably. In 2021, the proportion of adolescents who had ever smoked tobacco cigarettes (at least once in their lifetime) was a little over 29.1%, compared to 37.5% in 2018 and nearly 52% in 2010. Similarly, the current use of cigarettes (at least 1 cigarette in the past 30 days) has dropped from 13.6% in 2018 to 10.2% in 2021.
Unlike tobacco cigarette smoking, the new research shows that e-cigarette use remained stable between 2018 and 2021. Worryingly, the use of e-cigarettes is becoming increasingly popular among French teenagers, with a proportion of lifetime use of e-cigarette now higher than lifetime tobacco use.
Like tobacco and alcohol, cannabis use is declining rapidly. In 2021, 9.1% of students in 9th grade experimented with it, almost three times less than in 2010 (23.9%).
Targeted policies improve behaviour
The results of this latest survey conducted in France are in part attributable to the wider effects of the COVID-19 pandemic, especially the restrictive social measures that most of the WHO European Region saw during 2020 and most of 2021.
“The limitation of opportunities for meetings and festive moments with peers has resulted in lost opportunities for initiation and the use of substances, hence the lower levels of use, even alcohol, which is rarely drunk alone at this age,” explained Stanislas Spilka of the French Monitoring Centre for Drugs and Drug Addiction (OFDT), the other lead investigator in the EnCLASS survey.
At the same time, smart policies, taken at the local and national level, can go a long way in ensuring that any gains made in the promotion of wellbeing and healthier behaviours continue over time.
“These results raise the crucial question of until what point in their lifetime will the conditions imposed on young people during the pandemic actually affect them,” said Dr Martin Weber, Team Lead, Quality of Care, at WHO/Europe.
“The studies show that measures such as no access to substances, no in-person interactions, among others may have affected overall substance use, and could be seen as a ‘natural experiment’” concludes Emmanuelle Godeau.