The widespread use of alcohol and e-cigarettes among adolescents is "alarming", according to a report released on Thursday by the World Health Organization's (WHO) European branch, which recommended measures to limit access.
Based on survey data from 280,000 young people aged 11, 13 and 15 in Europe, Central Asia and Canada, the WHO said it showed a "concerning picture" of substance use among young people.
"The long-term consequences of these trends are significant, and policy-makers cannot afford to ignore these alarming findings," the health body said.
The report found that 57 percent of 15-year-olds had drunk alcohol at least once, for girls the figure was 59 percent, compared to 56 percent of boys.
The WHO noted that overall drinking had decreased for boys, while it had increased for girls.
When it came to current use -- defined as having drunk at least once in the last 30 days -- eight percent of 11-year-old boys reported having done so, compared to five percent of girls.
But by age 15, girls had overtaken boys, with 38 percent of girls saying they had drunk at least once in the last 30 days, while only 36 percent of boys had.
"These findings highlight how available and normalised alcohol is, showing the urgent need for better policy measures to protect children and young people from harms caused by alcohol," said WHO Europe -- which gathers 53 countries including several in Central Asia.
In addition, nine percent of teenagers reported having experienced "significant drunkenness" -- having been drunk at least twice.
The WHO said this rate climbed from five percent among 13-year-olds to 20 percent for 15-year-olds, "demonstrating an escalating trend in alcohol abuse among youth".
- Costly consequences -
The report also highlighted the increased use of e-cigarettes -- often called vapes -- among teenagers.
While smoking is declining, with 13 percent of 11-15 year-olds having smoked in 2022, two percentage points less than four years earlier, the report noted that many of them have instead adopted e-cigarettes -- which have overtaken cigarettes among adolescents.
Around 32 percent of 15-year-olds have used an e-cigarette, and 20 percent reported having used one in the last 30 days.
"The widespread use of harmful substances among children in many countries across the European Region -– and beyond -– is a serious public health threat," WHO Regional Director for Europe Hans Kluge said in a statement.
Kluge called for higher taxes, restrictions in availability and advertising, as well as a ban on flavouring agents.
"Engaging in high-risk behaviours during the adolescent years can shape adult behaviour, with substance use at an early age being linked to a higher risk of addiction," the report said.
"The consequences are costly for them and society," it added.
Cannabis use, meanwhile, was down slightly with 12 percent of 15-year-olds having ever used it, down four percentage points in as many years.
Conducted every four years by the WHO, the HBSC (Health Behaviour in School-aged Children) survey examines the health behaviour of 11, 13 and 15-year-olds, and includes a section on substance use.