European schools, health agencies and youth bodies have been advised to prioritise mental well-being and prevention activities to help teenagers avoid or overcome negative addiction outcomes.

The recommendations form part of the Eighth European School Survey Project on Alcohol and Other Drugs (ESPAD), undertaken by EUDA, the European Union Drug Agency.

A one-of-a-kind study, the ESPAD Report was conducted on 113,800 students aged 15- to 16-years-old, across 37 European countries (excluding the UK). The age range of 15-to-16 is viewed as vital by researchers, as students are surveyed at a formative point of their teenage experience prior to entering adulthood.

EUDA underscores the relevance of the ESPAD Report, which “marks 30 years of monitoring adolescent risky behaviours across Europe, with 37 participating countries”.

An overview details “long-term declines in substance use, emerging trends raise new concerns,” as smoking prevalence has decreased across all countries, but researchers view new trends.

The ESPAD Report tracks the prevalence of cigarette smoking, alcohol consumption, e-cigarettes, cannabis, hard drugs, gambling with money, gaming and social media, and other substance abuses. While long-term declines in smoking and alcohol consumption are encouraging, the rise in behavioural addictions is a growing concern.

EU Teens’ mixed experience of gambling 

Gambling, both offline and increasingly online, remains prevalent across the continent. According to the findings, 23% of European students reported gambling for money in the past year, whether through slot machines, betting shops, or online platforms.

Italy leads the board with the highest gambling prevalence at 45%, followed by Iceland at 41%  and Greece at 36%. Georgia reported the lowest figure at 9.5%. Italian teenage boys are significantly more likely to gamble than girls, 29% vs 16%, though Iceland is an outlier, where the rates are nearly identical at 40%.

The survey reveals that traditional gambling remains popular, with 85% of student gamblers preferring physical venues like bars and clubs. That figure rises to 98% in Italy. However, the shift towards digital gambling cannot be ignored. Around two-thirds of those who gambled in the past year did so online, either exclusively or in combination with offline methods.

Online gambling has seen a sharp rise since 2019, growing from 7.9% to 14%. Among boys, the rate jumped to 20%; among girls, it more than tripled to 8.7%. Sweden, Slovenia and Kosovo report the highest levels of online activity, while Italy and Spain remain more anchored to traditional gambling formats.

Notably, in countries like Portugal, the gender gap is pronounced, with 80% of boys gambling online, compared to just 43% of girls.

Using the Lie/Bet screening tool, ESPAD found that the number of students exhibiting potentially harmful gambling behaviours has almost doubled, from 4.7% in 2019 to 8.5% in 2024.

“While this proportion remains much higher among boys, the increase is more pronounced among girls,” the report warns.

Digital Addiction is the greatest concern 

The shift in behavioural risk isn’t confined to gambling. ESPAD notes that digital gaming and social media are now deeply embedded in teenage life. 

Four out of five students played digital games in the past month, and 70% did so on school days. Boys remain the dominant gamers (89%), but the gender gap is narrowing fast — girls’ gaming participation has more than tripled since 2015.

Problematic gaming, though, remains largely a male issue as 30% of boys report self-perceived risk related to gaming, compared to 13% of girls. Conversely, girls are more affected by social media. Nearly half of all students (47%) scored high on the perceived social media risk scale, with the figure climbing to 53% for girls.

“This is no longer a conversation about just smoking or drinking,” the report suggests. “Digital behaviours now rival substances in terms of potential for harm.”

Poor mental well-being

Mental health has taken centre stage in the 2024 survey, with the WHO-5 Well-Being Index introduced for the first time. Only 59% of students reported good mental health, with wide disparities across regions and between genders.

The Faroe Islands, Iceland and Denmark scored highest, while war-affected Ukraine and parts of Eastern Europe reported the lowest levels.

A troubling gender gap emerges here, too. On average, 69% of boys reported good mental well-being, compared to just 49% of girls. In countries like Italy and Poland, the difference exceeds 30 percentage points.

ESPAD has further highlighted the significance of preventive actions to avoid bad outcomes. 72% of students had participated in at least one prevention activity in the previous two years, although engagement varies greatly by region.

Awareness campaigns were more prevalent in Eastern Europe, while skills-based interventions, which are considered more effective, were common in the West and South. Girls were more likely to attend sessions focused on substance abuse, while boys were more engaged in topics like gaming and gambling.

EUDA makes it clear that schools, youth services and governments must adapt rapidly to the changing landscape of adolescent risk. “Mental well-being and prevention must become core pillars of youth support systems,” the report states. “We are seeing new behaviours with significant potential for harm, and they demand equally modern, evidence-based responses.”

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