Smoking, Drinking and Drug Use among Young People in England 2018 [NS]

In 2009, the Chief Medical Officer of England published the first official guidance on alcohol aimed specifically at children and young people.

It recommended that the healthiest and safest option was for children to remain alcohol free up to age 18. If they did drink alcohol it should not be at least until the age of 15. For young people aged 15 to 17, it was suggested they should only drink in a supervised environment, and no more than once a week.

The guidance was based on a body of evidence that drinking at a young age, and particularly heavy or regular drinking, can result in physical or mental health problems, impair brain development, and put children at risk of alcohol-related accident or injury. More broadly it is also associated with missing or falling behind at school, violent and antisocial behaviour, and unsafe sexual behaviour¹.

The 2012 Alcohol Strategy had a particular focus on excessive drinking by adults, but also included the ambition to achieve ‘a sustained reduction in both the numbers of 11 to 15 year olds drinking alcohol and the amounts consumed’.

Attempting to accurately measure alcohol consumption among young people presents similar challenges to surveys of adults. Recall of their drinking can be erroneous and the majority of pupils’ drinking is in informal settings where the quantities they drink are not necessarily standard measures. They are also not very knowledgeable about the alcoholic strength of different drinks. See appendix B for more background on the methods that were used to measure alcohol consumption.

This part includes information on drinking prevalence, frequency, and alcohol consumption levels including drunkenness.

Changes to question to establish whether a pupil had drunk alcohol (2016)

Prior to 2016, the question used to establish whether a pupil had drunk alcohol was:

‘Have you ever had a proper alcoholic drink – a whole drink, not just a sip?  Please don’t count drinks labelled low alcohol’.

Before the 2016 survey took place the questionnaire was tested with a group of pupils and this question caused confusion. In general, pupils thought the use of the word ‘proper’ meant the question referred to spirits only.  They were also unaware of what would be considered a ‘low alcohol’ drink and some assumed low alcohol would include beer, cider, cocktails and alcopops.

In light of this feedback, the question was changed in the 2016 survey to:

“Have you ever had an alcoholic drink – a whole drink, not just a sip?”

Whilst this means the survey now gives an improved picture of the proportion of young people who have drunk alcohol, comparisons with years prior to 2016 are not possible.  However, large directional changes such as whether prevalence has decreased over a long period of time can be made as the impact of the new wording is small in comparison, (although the exact size of the change cannot be calculated).

This change to the initial alcohol question may also have had an impact on the more detailed questions which follow.  This is because some of these were only asked of those pupils who answered ‘yes’ to the initial question on drinking alcohol, so the change to this question may lead to a slightly different group of pupils answering the more detailed questions than in earlier years.

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^{1. Viner R, and Taylor B, (2007) Adult outcomes of binge drinking in adolescence: findings from a UK national birth cohort. Journal of Epidemiology and Community Health, 61: 902-907.}

Ever had an alcoholic drink, by year

Between 2003 and 2014 there was a decline in the proportion of pupils who had ever had an alcoholic drink.

In 2018, 44% (confidence interval 41-46%) of pupils said they had ever had an alcoholic drink, the same as in 2016. 

Data prior to 2016 is not comparable due to a change in the survey question.

Ever had an alcoholic drink, by sex and age

Prevalence of having ever had an alcoholic drink was the same for boys and girls.

It varied with age, increasing from 14% of 11 year olds to 70% of 15 year olds.

Usual frequency of drinking, by age

6% of all pupils said they usually drank alcohol at least once per week. A further 11% of pupils said they usually drank between once a fortnight and once a month; meaning a total of 17% who said they usually drank alcohol at least once a month.

The proportion usually drinking once a week increased with age, from 1% of 11 year olds to 14% of 15 year olds. 

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For more data relating to this section:

Had an alcoholic drink in the last week, by year

Between 2003 and 2014 there was a decline in the proportion of pupils who had drunk in the last week.

In 2018, 10% (confidence interval 9-11%) of pupils said they had drunk in the last week, the same as in 2016. 

Data prior to 2016 is not comparable due to a change in the survey question.

Had an alcoholic drink in the last week, by sex and age

11% of girls and 9% of boys had drunk in the last week. This is not a statistically significant difference. 

The proportion increased after the age of 12; 2% of 11 year olds and 3% of 12 year olds drank in the last week, compared to 23% of 15 year olds.

Had an alcoholic drink in the last week, by ethnicity

White pupils were most likely to have had an alcoholic drink in the last week, with 13% having done so . This compares to 7% of Mixed ethnicity pupils, 3% of Black pupils and only 1% of Asian pupils.

Had an alcoholic drink in the last week, by region

The prevalance of having had a drink in the last week was significantly lower in London (5%) than any other region. Prevalance in other regions ranged from 9% to 14%.

When pupils drank in the last week

For this question, pupils were able to give more than one answer.

Pupils who drank in the last week were most likely to have done so on Saturday (67%). 38% drank on Friday, and 30% drank on Sunday. The proportion was 10% or less for weekdays.

The proportion drinking on Saturday increases with age, unlike for other days of the week where there was little variation (see table 5.11).

Factors associated with drinking in the last week

A logistic regression model was used to explore which characteristics might be associated with drinking in the last week. This identifies associations, not causes; in other words, factors which identify pupils with an increased or decreased likelihood of having drunk alcohol in the last week. See Appendix B for more information on the regression model used.

The 7 factors (explanatory variables) shown below had a significant association with having drunk alcohol in the last week. The size of the circles represents an estimate of the relative contribution to the model (table 5.26 shows the odds ratios for each possible value of each variable in the model).

It was estimated that having parents who don't discourage drinking had the strongest association, followed by age (being older), and recent drug use. 

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For more data relating to this section:

This section is based only on pupils who said they had a drink in the last week (10% of all pupils).

Quantities of alcohol were converted into units of alcohol, using a standard method described in Appendix B.

How much pupils drink (units), by age

Pupils who drank alcohol in the last week consumed an average (mean) of 10.3 units that week. This is an estimate and subject to a margin of error: the proportion in the population is likely to be somewhere between 9.1 and 11.6. 

21% of pupils who drank in the last week were estimated to have drunk more than 15 units. Younger pupils who drank in the last week were more likely to have drunk fewer units than older pupils.

What pupils drink

For this question, pupils were able to give more than one answer.

Pupils who drank in the last week were most likely to have drunk beer, lager or cider, with boys more likely than girls (87% of boys, 65% of girls). Girls were more likely than boys to have drunk spirits (67% of girls, 52% of boys), alcopops (39% and 27%) or wine, martini or sherry (55% and 27%). 

What pupils drink as a proportion of total units

Beer, lager and cider accounted for 60% of the alcohol units consumed by pupils in the last week. Beer, lager and cider made up 73% of boys’ consumption, compared with just under half (46%) of girls’ consumption. 

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For more data relating to this section:

Pupils who were drunk in the last four weeks, by sex

9% of pupils said they had been drunk in the last four weeks, including 6% of pupils who had been drunk once or twice, and 2% more often.

Girls (11%) were more likely to have been drunk in the last four weeks than boys (7%).

Pupils who were drunk in the last four weeks, by age

The proportion of pupils who reported having been drunk in the last four weeks increased with age.

22% of 15 year olds reported having been drunk in the last four weeks, compared with 1% of 11 and 12 year olds.

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^{2. This covers prevalence of drunkenness among all pupils. Drunkenness as a proportion of pupils who drank in the last 4 weeks is reported in the part 6 tables (6.14 to 6.17).} 

For more data relating to this section:

The results from this survey can be compared with estimates for children from the Health Survey for England (HSE) which is carried out in the respondent’s home. 

We would expect the estimates from HSE to be lower than SDD as children seem to be less likely to admit to risky behaviours such as smoking, drinking and drug taking when completing surveys at home.  This is evident in the 2017 HSE results which are much lower than those from SDD surveys.

In HSE 2017, 6% of 11-12 year olds and 32% of 13-15 year olds had ever had an alcoholic drink.  This compares to 44% of all pupils in this 2018 SDD survey, although this uses a different question to establish drinking prevalence than HSE, so is not directly comparable.  SDD 2014 used the same question as HSE and found that 38% of pupils had ever drunk alcohol.

Estimates for Scotland are available from the Scottish Schools Adolescent Lifestyle and Substance Use Survey (SALSUS). 

SALSUS is also carried out in schools under exam conditions but it only covers 13 and 15 year olds.  In 2015, SALSUS reported that 28% of 13 year old pupils and 66% of 15 year olds in Scotland had ever had an alcoholic drink.  This compares to 38% and 73% respectively from 2016 SDD in England.   SALSUS also reported that 4% of 13 year olds and 17% of 15 year olds had drunk alcohol 7 days prior to being surveyed, which compares to 6% and 24% in SDD. SALSUS was run again in 2018 but the results were not available at the time of this publication.

Estimates from Wales are available from the Welsh government Student Health and Well-being Survey:

The survey is also carried out in schools under exam conditions, and like SDD covers children in years 7 to 11.  In 2017/18 the survey showed that 8% of pupils had drunk alcohol at least once a week, and was 17% for those in year 11.  The equivalent figures from SDD in 2018 were 10% (all pupils) and 23% (15 year olds).