Many unhealthy behaviors often begin during adolescence and represent major public health challenges. Substance abuse has a major impact on individuals, families, and communities, as its effects are cumulative, contributing to costly social, physical, and mental health problems.

This report presents the results of the sixth data-collection wave of the European School Survey Project on Alcohol and Other Drugs (ESPAD) and marks the 20th anniversary of ESPAD data collection (1995-2015).