Excerpts from the 2003

European School Survey Project on Alcohol and Other Drugs

(ESPAD) Many ESPAD questions were modeled after Monitoring the Future, making U.S. comparisons possible. Therefore, U.S. data are entered into the tables and figures of the report only when there is total or close comparability. What follows are excerpts from the full report, reprinted with permission, showing tables and figures that allow comparison with MTF data.

Summary of the 2003 findings

Data on young people’s alcohol and drug habitshave been collected in three waves of the EuropeanSchool Survey Project on Alcohol and Other Drugs,ESPAD. The first study was conducted in 26 coun-tries in 1995. The second survey was done in 1999and reached 30 participating countries.

The focus of this chapter is on the findings fromthe surveys that were performed in 35 countries in2003.

The participating countries include Austria, Bel-gium, Bulgaria, Croatia, Cyprus, the Czech Repub-lic, Denmark, Estonia, the Faroe Islands, Finland,France, Germany (6 Bundesländer), Greece, Green-land, Hungary, Iceland, Ireland, Isle of Man, Italy,Latvia, Lithuania, Malta, the Netherlands, Norway,Poland, Portugal, Romania, Russia (Moscow), theSlovak Republic, Slovenia, Sweden, Switzerland,Turkey (6 cities), Ukraine and the United Kingdom.The project is a collaborative project between inde-pendent research teams in the participating coun-tries. More than 100,000 students participated in the2003 data collection.

In this chapter a short version of the 2003 find-ings is presented. Key data on important variablesare presented in summary tables 1–3. The behav-iours included are cigarette smoking, alcohol con-sumption, drunkenness and use of illicit drugs.

MethodologyAs in earlier studies, the surveys were conductedwith a standardised methodology and a commonquestionnaire to provide as comparable data aspossible. Data were mainly collected during Spring2003 and the target population was students born in1987. Thus, the age group studied turned 16 duringthe year of data collection. At the time of the datacollections the average age was 15.8 years. Datawere collected by group-administered question-naires in schools on nationally representative sam-ples of classes. Exceptions include Russia, wherethe study was restricted to Moscow only, Germany,where the study was performed in six Bundeslän-der and Turkey, where the study was restricted tosix major cities in the six main regions in Turkey.

Teachers or research assistants collected the data.

The students answered the questionnaires anony-mously in the classroom under conditions similar toa written test. The sample sizes in participating coun-tries ranges between 555 in Greenland to almost6,000 in Poland. However, small study groups areonly found in small countries where no sampling wasdone. In all remaining countries, the sample size wasclose to or above the recommended number of 2,400.

The results of the survey were reported in astandardised format. These country reports formthe basis of the content of this report.

Data qualityEvery effort was made to standardise the method-ology of the ESPAD project across countries. Nev-ertheless, some methodological issues inevitablyarise in a comparative survey of 35 countries.

The validity is deemed to be high in most ES-PAD countries. The cultural context in which thestudents have answered the questions has mostprobably differed between countries. However, thisdoes not necessarily indicate large differences inthe willingness to give honest answers. A few coun-tries have experienced modest validity problems,but such problems are not of the magnitude neces-sary to seriously threaten the comparability of re-sults.

For various reasons it was not possible to giveprecise levels of statistical significance in this re-port. Small differences in point estimates betweencountries or over time should therefore be inter-preted with caution. However, given the size of thenational samples and the sampling methods em-ployed, differences of more than a few percentagepoints can with considerable confidence be consid-ered significant.

Tobaccohe use of cigarettes 40 times or more in lifetime andthe 30 days prevalence rates are presented in thesummary tables. In nearly all ESPAD countries50–80% of the students had smoked cigarettes atleast once in their lifetime, and those who hadsmoked 40 times or more are mainly found incountries where the lifetime prevalence is high. In

Summary of the 2003 findings 19

Austria, the Czech Republic, the Faroe Islands,Greenland, Germany, Lithuania and Russia (Mos-cow) about 40% had smoked 40 times or more intheir lifetime. The lowest prevalence rates arefound in Turkey (13%), Malta (16%), Iceland andPortugal (18% each).

In eight of the 35 ESPAD countries more boysthan girls had smoked 40 times or more in theirlifetime. These countries are mainly found in theeastern parts of Europe such as Estonia, Latvia,Lithuania, Poland, Romania and Ukraine, but alsoin Cyprus and Turkey. Large differences in theother direction with more girls reporting this be-haviour are mainly found in two northern islands,Greenland and the Isle of Man.

The highest percentage of students, which re-ported smoking during the last 30 days is found inGreenland, which stands apart from other countrieson this variable (60%). High rates are also found inAustria, Bulgaria, Germany, Russia (Moscow) andthe Czech Republic (43–49%). Particularly lowproportions are found in Cyprus, Iceland, Swedenand Turkey with figures ranging between 18 and25%.

Countries with substantially higher rates of lastmonth smoking among boys include Cyprus, Lat-via, Lithuania, Turkey and Ukraine. Considerablyhigher rates among girls are found in Greenland,Ireland, Isle of Man and the United Kingdom.

Alcohol consumptionPrevalence of alcohol consumption 40 times ormore in lifetime is presented in the summary ta-bles. They also contain the 30 days prevalence ofalcohol consumption 10 times or more, as well asthe 30 days prevalence of consuming beer, wineand spirits 3 times or more.

In two thirds of the ESPAD countries the vastmajority (90% or more) of the students have drankalcohol at least once in their lifetime. However,these students do not all drink on a regular basis. Astudent who has been drinking at least 40 times canbe labelled as more of a regular consumer. Theprevalence rates of this frequency of drinking aremuch lower than the total lifetime prevalence.

The highest rates reporting use of alcohol 40times or more in lifetime are primarily found in thesame countries as reported the highest lifetime fig-ures. They include Denmark, Austria, the CzechRepublic, Isle of Man, the Netherlands and theUnited Kingdom (43–50%). The lowest proportionis reported from Turkey (7%) followed by Green-land, Iceland, Norway and Portugal (13–15%).

More boys than girls report this level of alcoholconsumption. In a few countries, Isle of Man, Fin -land and Norway, the gender distribution is aboutequal. However, no country reports prevalencerates among girls that exceed those of the boys.

A higher frequency of alcohol use is revealedamong students who had consumed alcohol 10times or more during the last 30 days, i.e. at leastevery third day on average. About one quarter ofthe students in the Netherlands (25%) and aboutone fifth of the respondents in Austria, Belgium,Malta and the United Kingdom (17–21%) reportedthis frequency of alcohol use. In some countries,this drinking frequency is hardly reported at all.Proportions of 3% or less were found in Finland,Greenland, Iceland, Norway and Sweden. Thus,the very low prevalence rates are mainly concen-trated to the Nordic countries.

Many students report rather frequent beer con-sumption. The percentages of students who hadconsumed beer 3 times or more during the last 30days varies between 10 and 44%. The highest fig-ures are found in Denmark, Bulgaria, the Nether-lands and Poland (40–44%). The smallest propor-tions were reported from Norway and Turkey (10and 14% respectively). Other countries where lessthan 20% had consumed beer that often includeFinland, Hungary, Iceland and Portugal.

Drinking beer is a predominantly male behav-iour in most ESPAD countries. The only excep-tions are two countries in the North Atlantic,Greenland and Iceland, where almost equal propor-tions of girls and boys report frequent beer drink-ing.

A smaller number of students had been drinkingwine than beer during the last 30 days. The propor-tions of students reporting a wine consumptionfrequency of 3 times or more during last 30 daysare in most cases lower than 20%. However, onecountry stands out in this respect, as one third(35%) of the students in Malta reported this fre-quency of wine drinking. Other high prevalencecountries include Austria, the Czech Republic,Greece, Italy and Slovenia (21–23%). The lowestproportions that reported this frequency of wineconsumption are found in Finland, Iceland, Nor-way and Turkey (5% or less).

The number of students who had been drinkingspirits during the last 30 days vary considerablybetween the ESPAD countries. This also holds truealso when looking at the number of students whohad been drinking 3 times or more during lastmonth. The British Isles are at the top but also two

20 Summary of the 2003 findings

Mediterranean countries. The highest proportion isfound in Malta, where 43% of the students reportedthis frequency of spirits consumption. The coun-tries that come next include the Faroe Islands,Greece, Ireland, Isle of Man and the United King-dom (37–39%).

In about half of the countries, more boys thangirls report such frequent consumption of spirits.However, almost the same number of countriesreport prevalence rates that are equal or almostequal between the sexes. Only three countries re-port proportions among the girls that exceed thoseof the boys. These countries are all high frequencycountries and they are all parts of the British Isles,i.e. Ireland, Isle of Man and the United Kingdom.

DrunkennessLifetime prevalence of having been drunk 20 timesor more and the 30 days prevalence of being drunk3 times or more are presented in the summarytables.

Some students have a rather limited experienceof getting drunk, while others get intoxicated morefrequently. However, in 30 of the 35 countries stud-ied a majority of the students have been drunk atleast once. The countries with the highest percent-ages indicating that they had been drunk 20 timesor more in lifetime include Denmark, Ireland, Isleof Man, the United Kingdom, Estonia and Finland(26–36%). In other countries only a few report thisfrequency of drunkenness. In Turkey only 1% hadbeen drunk 20 times or more and in Cyprus,France, Greece and Portugal this was reported byabout 3% of the students.

In a majority of the countries there are moreboys than girls that report this frequency of intoxi-cation. In no country are the girls in majority. How-ever, in relatively many countries the gender distri-bution is rather even. These countries include boththe British Isles and most of the Nordic countries(Finland, the Faroe Islands, Iceland, Ireland, Isle ofMan, Norway, Sweden and the United Kingdom).

The number of students who have been drunk 3times or more during the last 30 days is of coursemuch smaller, but the highest ranked countries arein most cases the same. Thus, in Denmark andIreland about one fourth of the students had beendrunk that often. Other countries with high preva-lence rates include Isle of Man and the UnitedKingdom.

However, in about half of the ESPAD countriesthe number of students reporting this frequency ofintoxication is 10% or less. The lowest figures are

reported from Cyprus, France, Greece, Portugaland Turkey (1–4%).

Binge drinkingThe frequency of having 5 or more drinks in a row,sometimes referred to as “binge drinking”, providesan alternative measure of heavy alcohol use. Theproportion indicating such consumption 3 times ormore during the last 30 days vary considerablyover the ESPAD countries. This is reported by onefifth to one third of the students in about half of theESPAD countries.

The highest number of students reporting this be-haviour is found in Denmark, Ireland, Isle of Man,Malta, the Netherlands, Norway, Poland and the United Kingdom (24–32%). Thus, there is aconcentration of countries to the northern and west-ern parts of Europe with Malta as the only exception.Countries with the lowest binge drinking figures areCyprus, France, Greece, Hungary, Iceland, Romaniaand Turkey (5–11%).

Illicit drugsLifetime use of various illicit drugs are presentedin the summary tables, including cannabis, am-phetamines, LSD, Ecstasy, tranquillisers or seda-tives without a doctor’s prescription and the use ofinhalants. In addition the 30 days prevalence ofcannabis is included.

The vast majority of students in all ESPADcountries that have tried any illicit drug have usedmarijuana or hashish. Thus, the number of studentsreporting cannabis use is almost identical with thetotal illicit drug prevalence.

The top country in this respect is the CzechRepublic where 44% of the students have usedmarijuana or hashish. High prevalence rates arealso reported in France, Ireland, Isle of Man, Swit-zerland and the United Kingdom (38–40%). Othercountries where more than one fourth have usedcannabis include Belgium, Germany, Greenland,Italy, the Netherlands, the Slovak Republic andSlovenia (27–32%).

The lowest levels are reported in Cyprus, Greece,Sweden, Romania and Turkey (3–7%), but also in theFaroe Islands, Finland and Norway (around 10%).

The use of cannabis during the last 30 days mayindicate regular use. In some countries about onefifth of the students report this, in others muchlower prevalence rates are noted. The countrieswith the highest 30 days prevalence include theCzech Republic, France, Isle of Man, Switzerlandand the United Kingdom (19–22%).

Summary of the 2003 findings 21

In most ESPAD countries there are more boysthan girls who have used cannabis. However, thegender differences are small in Bulgaria, Croatia,Greenland, Hungary, Iceland, Ireland, Russia(Moscow) the Slovak Republic and Slovenia.

The countries with the highest percentages ofstudents reporting use of amphetamines are Esto-nia, Germany, Iceland, Lithuania and Poland (5–7%). In 13 countries 1% or less reported use ofamphetamines.

The ESPAD students do not use LSD very fre-quently. The highest percentages are found in theCzech Republic and Isle of Man where 5–6% re-ported such use.

Ecstasy is the most used drug of those includedin the questionnaire apart from cannabis. In theCzech Republic 8% had used it, followed by Croa-tia, Estonia, Ireland, Isle of Man, the Netherlandsand the United Kingdom (5–7%).

Tranquillisers or sedatives can be used both as alegally prescribed medicine and as an illicit drug.The use of such substances without prescription ismost common in Poland (17%) followed by Lithu-ania (14%), France and the Czech Republic (11–13%). The lowest prevalence rates are found inAustria, Bulgaria, Germany, Ireland, Ukraine andthe United Kingdom (2% each).

The highest prevalence of inhalants is reportedin Greenland, where 22% had ever used them.Other countries with high levels of inhalant useinclude Cyprus, Greece, Ireland, Isle of Man, Maltaand Slovenia (15–19%).

Very small gender differences are found in rela-tion to the use of inhalants. In a majority of thecountries there are no gender differences, but inBelgium, Cyprus, Greece, Portugal and Ukrainemore boys than girls reported this behaviour. Girls

only reported more use than boys in one country,Ireland.

ConclusionsIn summary, the pattern of alcohol consumptionreveals that frequent drinking is most prevalentamong students in the western parts of Europe,such as the British Isles, the Netherlands, Belgiumbut also in Austria, the Czech Republic and Malta.Very few students in the northern parts of Europedrink that often.

Beer consumption is most prevalent in Bulgaria,Denmark, the Netherlands and Poland, while wineconsumption is most prevalent in typical wine pro-ducing countries such as Austria, the Czech Repub-lic, Greece, Italy, Malta and Slovenia. The con-sumption of spirits is less uniform, with high preva-lence rates in as disparate countries as the FaroeIslands, Greece, Ireland, Isle of Man, Malta and theUnited Kingdom.

The prevalence of drunkenness seem to be mostconcentrated to countries in the western parts ofEurope, such as Denmark, Ireland, Isle of Man andthe United Kingdom. Very few students report fre-quent drunkenness in Mediterranean countries suchas Cyprus, France, Greece, Portugal, Romania andTurkey.

The illicit drug use is dominated by use of mari-juana or hashish. Frequent use is mainly reportedfrom countries in the central and western parts ofEurope, where more than one third of the studentshave used it. The high prevalence countries includethe Czech Republic, France, Ireland, Isle of Man,Switzerland and the United Kingdom. The lowprevalence countries are found in the north as wellas the south of Europe.

22 Summary of the 2003 findings