Smoking, Drinking and Drug Use among Young People in England, 2023

Extensive research has demonstrated the harmful effects that smoking has on health. Smoking contributes to a variety of health conditions, including cancers and respiratory, digestive and circulatory diseases, whilst also impairing the development of teenage lungs. Moreover, smoking causes more preventable deaths than any other single cause; in 2019, 74,600 preventable deaths in England were estimated to be attributed to smoking:

NHS England: Statistics on Public Health, England – 2023

Tobacco use remains one of the most significant public health challenges in the UK.

In 2022, the government launched an independent review into tobacco control policies, led by Dr Javed Khan OBE. Following extensive consultation, the review made recommendations to support the government’s target to be smokefree by 2030 (adult prevalence of 5% or less). 

The great majority of smokers start as teenagers - two-thirds before the age of 18. 

One of the national ambitions in the government’s tobacco control plan published in 2017, was to reduce the number of 15 year olds who regularly smoke to 3% or less by 2022.  Progress against this target is discussed in the “Pupils who are regular smokers” section in this chapter.

Tobacco control plan for England

All pupils were asked about their cigarette smoking behaviour. Pupils were categorised in three ways based on the responses given:

• Regular smokers (defined as usually smoking at least one cigarette per week).
• Occasional smokers (defined as usually smoking less than one cigarette per week).
• Non-smokers.

The term ‘current smoker’ used in this report includes regular and occasional smokers.

‘Ever smoked’ includes ‘current smokers” plus ‘ex-smokers” and those who have ‘tried smoking once’.

This part includes information on smoking prevalence, patterns of cigarette consumption and factors associated with regular smoking.

Pupils who have ever smoked, by year

In 2023, 11% (confidence interval 10-13%) of 11-15 year old pupils had ever smoked which is the lowest level ever recorded by this survey. 

The rate has remained stable from the last survey, with 12% of pupils saying that they had ever smoked in 2021.

There has been a steady decline since 1996, when 49% of pupils had smoked at least once.

For more data relating to this section:

Tables 1.1, 1.2 and 1.14 Smoking, drinking and drug use among young people, 2023

Pupils who are current smokers, by year

In 2023, 3% (confidence interval 3-4%) of pupils were classified as current smokers which is the same as in 2021. There has been a general decline in this percentage since 1996, when 22% of pupils were classed as current smokers.

Factors associated with current smoking

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

The 6 factors (explanatory variables) shown below had a significant association with current smoking. The size of the circles represents an estimate of the relative contribution to the model. See Appendix B3.4 for details of how this has been determined (additionally data table 1.10 shows the odds ratios for each possible value of each variable in the model).

It was estimated that e-cigarette use had the strongest association, followed by drug use and having friends who smoke.

For more data relating to this section:

Tables 1.1, 1.2, 1.10, 1.12 and 1.15 Smoking, drinking and drug use among young people, 2023

Pupils who are regular smokers, by year

In 2023, the proportion of pupils who were classified as regular smokers has stayed the same at 1% (confidence interval 0.9 - 1.5%), which was the same proportion as in 2021.

The government's tobacco control plan aims to reduce the number of 15 year olds who regularly smoke to 3% or less. In 2023, 2% of 15 year olds were regular smokers which is similar to the proportion in 2021 (3%). In the long term, the proportion of 15 years olds who regularly smoke has fallen significantly, having been 30% in 1996.

For more data relating to this section:

Tables 1.1 to 1.3, Smoking, drinking and drug use among young people, 2023

Smoked cigarettes in the last week, by gender and age

This measure differs from regular smoking as it may include some occasional smokers who had smoked in the last week, and may exclude some regular smokers who did not smoke in the last week.

2% of pupils said they had smoked in the last week in the 2023 survey, which is the same as the percentage in the 2021 survey. 

2% of boys and 1% of girls smoked in the last week, which is not a statistically significant difference.

The proportion generally increased with age. 15 year olds had the highest percentage that smoked in the last week (4%) which was statistically different from all the other ages.

For more data relating to this section:

Tables 1.4, 1.5 and 1.6 Smoking, drinking and drug use among young people, 2023

The Health Survey for England (HSE) is an annual survey 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 2022 HSE results which are much lower than those from SDD, with 8% of 13-15 year olds saying they had ever smoked.

Health Survey for England 2022

In Scotland, the Health and Wellbeing Census also questions pupils in a classroom setting but only surveys pupils in S2 and S4 (roughly equivalent to Year 9 and Year 11 in England). 3% of these pupils were classed as regular smokers (using the same definition used in SDD), which compares to 1% in England, although different age groups are surveyed.

Health and Wellbeing Census Scotland 2021- 2022

Estimates from Wales are available from the Student Health and Wellbeing In Wales report, which like SDD covers children in years 7 to 11. In 2021/22 the survey showed that 3% of young people were current smokers, which is the same as recorded in England from SDD 2023.

Student Health and Well-being Survey