Girls now surpass boys in substance use
Young girls in 9th grade are now more likely to use e-cigarettes and more frequently engage in heavy episodic drinking than their male peers. This is shown in a new survey on young people's substance use habits.
For many years, boys were at the top when it came to substance use among Danish school pupils. But now, that picture is changing significantly.
A new report from the National Institute of Public Health shows that girls in 9th grade are now more likely than boys to use e-cigarettes and to drink large quantities of alcohol on a single occasion – what researchers refer to as binge drinking.
“The previous sex difference has almost disappeared – and in some areas, it has completely reversed. For example, we now see a marked increase in the proportion of girls using e-cigarettes, to the point where they have surpassed boys,” explains Senior Advisor Ola Ekholm, one of the researchers behind the report.
The report is based on data from the Danish part of the international ESPAD survey (The European School Survey on Alcohol and Other Drugs), which has monitored substance use among European – including Danish – school pupils since 1995.
Nearly 5,500 Danish 9th-grade pupils answered questions about their use of various substances.
Sharp rise among girls
One of the clearest changes is seen in the use of e-cigarettes, such as vapes and puff bars.
In 2019, 19 percent of boys and 10 percent of girls in 9th grade had used e-cigarettes in the past 30 days. Five years later, the pattern has reversed: Now, 26 percent of girls and 19 percent of boys report using e-cigarettes.
“There has been a dramatic increase in the use of so-called vapes in recent years. These products often appeal to girls through their eye-catching colors and sweet flavors,” says Ola Ekholm.
A similar shift applies to binge drinking – defined as drinking five or more units of alcohol on a single occasion.
While the proportion of boys who reported binge drinking in the past 30 days has dropped from 59 to 52 percent since 2019, the level among girls remains unchanged at 59 percent. This means that girls now top the statistics.
“Twenty-five years ago, the picture looked very different. Back then, 72 percent of boys and 56 percent of girls in 9th grade had engaged in binge drinking within the past month. So what we are seeing now is a significant shift. It would be interesting to explore more closely what’s behind this development – why boys today drink less, while the consumption among girls has not declined,” says Ola Ekholm.
Trend seen across Europe
The development is not unique to Denmark. The trend in e-cigarette and alcohol use is mirrored in many European countries.
“It’s not just in Denmark that we’re seeing this change. In many other European countries, girls are increasingly matching or even surpassing boys when it comes to the use of e-cigarettes and alcohol,” says Ola Ekholm.
He also emphasizes that even though binge drinking among Danish boys has declined, it still remains at a very high level compared to other European adolescents. The same goes for the level among Danish girls.
Use of smokeless products is also changing
The survey also shows that the gap between boys and girls is narrowing when it comes to the use of smokeless tobacco and nicotine products.
A larger share of boys still uses these products, but the gap between the sexes has become smaller.
In 2019, 17 percent of boys and 8 percent of girls had used smokeless tobacco and nicotine products in the past 30 days. In 2024, the figures are 14 percent for boys and 11 percent for girls. This means that while there has been a decrease among boys, there has been a corresponding increase among girls.
The report is funded by the Ministry of the Interior and Health through its framework agreement with the National Institute of Public Health, University of Southern Denmark (SDU). It also presents other results from the Danish part of the international study, including data on Danish adolescents' use of illicit drugs and the combined use of multiple substances.
The figure shows the percentage of 15–16-year-old boys and girls in 9th grade in Denmark who have used different types of substances in the past 30 days in 2019 and 2024.
Contact: Senior Advisor Ola Ekholm, phone: +45 6550 7772, email: oek@sdu.dk, Postdoc Heidi Rosendahl, phone: +45 6550 7792, email: harj@sdu.dk, Scientific Assistant Rikke Bjerring Plenborg, phone: +45 6550 2627, email: rikp@sdu.dk, National Institute of Public Health, University of Southern Denmark (SDU)