Arja Rimpelä, Susanna Rainio, Heini Huhtala, Hanna Lavikainen, Lasse Pere ja Matti Rimpelä. The Adolescent Health and Lifestyle Survey 2007. Adolescent smoking, alcohol and substance use in 1977-2007. Helsinki 2007. 99 pp. (Reports of the Ministry of Social Affairs and Health, Finland, ISSN 1236-2115, 2007:63) ISBN 978-952-00-2486-4 (pb.) ISBN 978-952-00-2487-1 (PDF)

Based on the Adolescent Health and Lifestyle Survey data accumulated over the last 30 years, this report examines changes in the use of tobacco products and alcohol, exposure to tobacco smoke, tobacco addiction, use of nicotine replacement products and social exposure to drugs among 12-18-year-old adolescents. Health behaviours in the adolescent population have been monitored by comparable methods biennially since 1977 via national postal surveys. The latest survey was conducted in the spring of 2007, to which a total of 5,840 adolescents responded (61%).

Favourable development in smoking and alcohol and substance use seems to have continued during the past two years. However, there are signs that a turn towards less favourable development may be taking place. The overall picture is still mainly positive, indicating that the efforts in the beginning of the 2000s aimed at supporting a shift toward the positive direction for adolescent health and health behaviours continue to have good outcomes.

Smoking experiments as well as daily smoking are now started at a later age than ever. Experimenting with smoking is much less popular than before: in 18-year-olds about one-quarter has never tried and in 12-year-olds only about one-eighth has tried. Smoking among 18-year-olds, who are in transition into adulthood, may begin to decline. Although we are approaching the target set in Health 2015, the national public health programme, (to reduce the number of 16-18-year-old smokers to 15%), there is still a long way to go to reach a smoke-free society. Given that one-fourth (25%) of 16-18-year-old adolescents still smoke cigarettes, it is highly important that smoking prevention efforts are continued.

The decrease seen in snus use has stopped and, among girls, snus use may be increasing. In Finland, efforts should be taken to prevent the similar increase in snus use of girls and women as has happened in Sweden. Not only needs the control of domestic illegal sales be intensified, but also the snus delivery routes from Sweden should be blocked, e.g. by means of restricting import of large quantities of snus (for so called “personal use").

Nicotine replacement therapy (NRT) products were used by 2% of 14-year and 6% of 16-year-olds. The most common of the retail outlets where the underage youths acquired nicotine replacements were pharmacies. Other locations included food stores and other retail outlets but more rarely. Friends were the most popular channel for acquisition. Although the retail sale of NRT products to minors is forbidden by law, they can purchase these products at pharmacies with a prescription. However, NRTs can easily be acquired in self-service pharmacies even by underage persons who thus have access to a non-prescription product that strengthens or even creates nicotine addiction. Those reporting use of NRT products include minors who, based on their reported smoking status, are misusing the product. Efforts should be made to intensify the supervision of NRT product sales in both retail outlets and pharmacies.

Exposure to environmental tobacco smoke (ETS) has significantly decreased from the 1990s. Approximately 5%, or one in every 20 children aged 14, and 1-2% of 12-year-olds continue nonetheless to spend at least one hour daily in smoky rooms. Over the past two years, the decline in exposure has stopped in some age groups. At least in the younger age groups, home smoking can be regarded as the most important factor related to ETS exposure, and more effective means are needed to disseminate information to parents regarding its influence on smoking initiation and direct health effects of smoke.

The proportion of adolescents abstaining from alcohol continued to increase between 2005 and 2007. Of 14-year-olds 60% and of 16-year-olds about one-fourth abstain from alcohol. Recurring use of alcohol and drunkenness-oriented drinking also continue to decrease, except in 18-year-old boys of whom 12% still drink weekly until really drunk. The lowering of alcohol taxes and removal of alcohol import quota in 2004 contributed to the increase of drunkenness-oriented drinking among 18-year-old boys, which has remained on a high level. If this trend cannot be stopped e.g. by means of raising alcohol taxes, the social and health-related harms from alcohol will continue to increase among the older adolescents and young adults, and the objectives of the Health 2015 programme to decrease the adverse health effects of alcohol and drug use cannot be realized.

The decreasing trend in social exposure to drugs has levelled-off during the past two years, which means that the positive development seen at the turn of the millennium has stopped. The situation calls for careful surveillance of drug use to enable prompt action should the exposure to drugs begin to rise again.

Key words: alcohol, drugs, exposure, tobacco, young people