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Reports on a unique five‐year longitudinal study of several hundred English 1990s adolescents, exploring how they make decisions about whether to try or use illicit drugs. Shows how young people make and re‐make decisions and journey down distinctive drugs pathways as abstainers, former triers, those in transition and those who are current, regular drug users. Discusses how official interventions (particularly drugs education) have only marginal impact on a generation of drugwise youth, because they fail to understand the complexities of these decisions.

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.

The purpose of this paper is to describe trends since 2000 in young people's use of illegal/illicit drugs in Britain, and to place these into a longer‐term context alongside recent theorising on youthful drug taking. The implications for health educators are to be examined.

A selective narrative review of published data and theory forms the approach.

A steady rise in the prevalence of youthful drug taking in Britain from the 1960s was followed by a sharper rise from 1990 to an all‐time peak in the middle of that decade. Rates have not quite returned to this peak since, and from 2000 onwards have declined steadily, though from a historically high level. By 2006/2007, roughly one in five younger adolescents, and one in four older adolescents and young adults, has taken an illegal/illicit drug in the past year. In spite of changes over the past two decades, youthful drug taking in Britain over this period is characterised by considerable continuity. Gender and socio‐economic differences in drug taking over this period have remained roughly stable, but changes may be under way in relation to differences by ethnic background.

In Britain, levels of youthful drug taking remain at historically relatively high levels, with recent decreases at least in part probably due to a cohort effect of the drug‐involved generation who were teenagers in the 1990s moving into their 30s. Drugs education is not the likely cause of the post‐2000 downward trend. Drug “journeys” and the pursuit of pleasure are important considerations for health educators who aim their messages at the majority of young people whose drug use is not seriously problematic, and who are proactive when they do experience problems.

This paper calls for health educators also to focus on the majority of youthful drug use that is relatively unproblematic for young people. These young people require information as they make adjustments in their behaviour, and their needs may sometimes be ignored in favour of those with problematic drug use.

The purpose of this paper is to examine trends in smoking prevalence among adolescents and young adults in the UK and to identify any developments in health education theory and practice relating to adolescent tobacco use since 2000. The implications of such research are discussed.

A literature search was conducted focusing on UK studies covering the period 2000‐2007.

Since the start of the new millennium a slight downward shift in smoking prevalence has been recorded among 11‐15 year olds after at least two decades of little change. International studies suggest that smoking rates among British adolescents are below the average of other European nations. Greater declines in smoking have been evident in young adult smokers. Smoking uptake occurs in response to a range of factors. Recent research has provided further insight into the psychology of young people although young people's attitudes towards smoking do not necessarily predict smoking uptake. Although there is a correlation between smoking uptake and other substance use, the evidence to support the gateway theory is inconclusive. Youth smoking prevention programmes devised by the tobacco industry may do more harm than good and the motives for providing such schemes are questionable. Despite extensive research, there is little evidence that school‐based smoking education programmes have a lasting impact on youth smoking prevalence. By contrast, population‐wide measures are more likely to result in the de‐normalisation of smoking and have a stronger influence on youth smoking. Health educators should support government and other agency initiatives to reduce smoking across the population as a whole rather than focusing on purely youth‐oriented campaigns.

This paper examines trends in youth smoking in the UK since the millennium. In addition it provides a comparison with international trends and points to the value of population‐wide tobacco control measures. It will be of interest to those involved with health and education.

The purpose of this paper is to identify the health problems and treatment needs of drug‐misusing offenders and to draw out the implications of the findings for health education and prevention.

This analysis is based on data collected as part of the New English and Welsh Arrestee Drug Abuse Monitoring (NEW‐ADAM) programme. The survey was based on interviews and urine sample collection with over 3,000 arrestees.

The research found that young arrestees experienced a wide range of drug‐related and general health problems. The implications of this are discussed in the context of programmes implemented as part of the government's drug strategy.

The NEW‐ADAM surveys provide an original source of information on the drug and general health needs of young people at the first point of entry in the criminal justice system.

The purpose of this paper is to provide an overview of recent changes in young people's consumption of alcohol in Britain before then charting emerging academic perspectives and some of the recent regulatory and legislative changes.

The approach takes the form of a selective narrative review of young people's alcohol consumption in the last ten years through an analysis of key British and European secondary schools surveys, alongside select qualitative studies of relevance.

There has been increased heavy drinking per session by some young people in the UK from the early 1990s, with a perceived growing public tolerance of drunkenness by many more. In recent years there is evidence that this heavy sessional consumption by youth and young adults is starting to level off. However, there are also growing numbers of occasional drinkers and abstainers, suggesting a polarisation of drinking patterns amongst young people since 2000.

Early indications that alcohol consumption has levelled off by youth, as well as young adults, since the turn of the century suggests that some of the most highly publicised excesses of 1990s alcohol‐frenzied leisure may have run their course. Possible reasons for both the 1990s increase and the 2000s levelling‐off are explored, including shifts in reporting patterns and tastes, interventions to address underage drinking and binge drinking, alongside broader legislative, socio‐economic and cultural changes in the drinks industry, the night time economy and the regulation and policing of public space.

The purpose of this paper is to review the research evidence on recent British trends in the use of heroin and/or crack‐cocaine by young people in order to appraise the scale and nature of the contemporary health problem they pose.

The approach consists of a narrative review of the main current data sources on young people's drug use.

Use of heroin or crack‐cocaine is rare in Britain in the general population of young people and is concentrated more amongst young adults than adolescents. There is some evidence for associations between use of these drugs and socio‐economic disadvantages, although the links are complex. There may be fruitful connections to be made between drug policy and public health strategies for tackling health inequalities.

Embedding responses to young people's heroin/crack use within mainstream strategies to tackle health inequalities may be mutually beneficial to both policy agendas.

Situating in its proper evidential context the emotive issue of young people's use of what are believed to be the most dangerous illicit drugs, and appraising these data from a public health perspective, may lead to a more realistic and appropriate research and policy response.