The purpose of this paper is to introduce the five papers comprising this special issue on post‐millennium trends in young people's substance use in the UK. The positions taken by the authors of each of the papers in the issue are compared with respect to their conclusions on how best to reduce harmful outcomes for young people in relation to their substance use, and what role exists for health education in this process.
The approach takes the form of a narrative review of the papers in the issue.
Across substances (alcohol, tobacco and illicit drugs), the authors identify slight downward trends in population prevalence of use by adolescents and young adults since 2000. This downward trend follows some fairly steep rises during the 1990s, resulting in levels of use remaining historically relatively high. The importance of global and demographic changes is identified as being important in understanding the (arguably somewhat limited) scope for changing youthful behaviour. The different recommendations for how to reduce harmful outcomes for young people are discussed: modifying the context/environment of use (for alcohol and tobacco), drugs treatment (for drug‐using offenders), tackling inequality and disadvantage (for heroin and crack cocaine).
Two key roles for health educators are identified: first, supporting mechanisms already known to be effective in reducing use/harmful use such as smoke‐free environments; second, providing an “expert” source of information used by the vast majority of young people who both want and require this on their lifelong health and drug “journeys”. Health education should have a harm reduction role; measuring success in terms of reducing population prevalence of substance use may be inappropriate and unrealistic.
Important insights are gained into substance use trends by young people when UK trends are set alongside international trends, and when all the psychoactive substances consumed are considered together.
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