Drug use: patterns of drug use among young people (alcohol, tobacco, e-cigarettes, illicit drugs), factors contributing to drug use, consequences of drug use, harm minimisation

Young Australians' patterns of drug use have shifted substantially over the last decade. Smoking is down sharply, alcohol use has fallen modestly, vaping has risen sharply, and illicit drug use is roughly stable. This dot point covers the current pattern, the factors driving it, the consequences, and the policy framework Australia uses to respond.

Patterns of drug use

The AIHW National Drug Strategy Household Survey 2022-23 is the canonical Australian source. The relevant figures for young Australians:

Alcohol

• Roughly 70-80% of 18-24 year olds drink alcohol at least occasionally.
• Around 28% of 14-17 year olds abstain entirely, up from around 20% a decade earlier (so abstention is rising).
• Around 16% of 18-24 year olds drink at "risky" levels (more than 10 standard drinks per week or more than 4 in any session).
• Alcohol-related hospital admissions in the 15-24 age group remain substantial.

Tobacco smoking

• Daily smoking among 18-24 year olds is around 5%, down from around 15% two decades ago.
• Tobacco initiation (first regular use) has shifted to later ages on average.
• Smoking is now disproportionately concentrated in lower-SES groups, including young people from lower-SES backgrounds.

E-cigarettes (vapes)

• Roughly 1 in 5 18-24 year olds report current vape use (some daily, some occasional).
• Vape use is highest in this age group and the rise has been rapid (from very low levels pre-2018).
• Concerning patterns: significant numbers of young vapers had never smoked tobacco before vaping, contradicting the harm-reduction narrative that vaping replaces smoking.
• Federal vape reforms (2024): prescription-only retail sale, pharmacy-only access, plain packaging, flavour restrictions.

Cannabis

• The most-used illicit drug. Around 20% of 18-24 year olds report use in the past 12 months.
• Most use is occasional rather than regular.
• Heavy and early-onset use (under 18) is associated with worse mental health outcomes and lower educational attainment.

Other illicit drugs

• Ecstasy/MDMA. Around 5-7% of 18-24 year olds report past-year use. Festival contexts.
• Cocaine. Has risen substantially over the last decade. Around 5% past-year use in 18-24.
• Methamphetamine. Used by a smaller proportion but with substantial individual and community harms.
• Pharmaceutical drug misuse (opioids, benzodiazepines). Often under-recognised. Misuse rates in young Australians are growing.

Factors contributing to drug use

The syllabus expects you to apply the layered-determinants framework.

Individual factors

• Risk-taking propensity that peaks in adolescence/early adulthood.
• Curiosity and "first-time" experimentation.
• Coping for stress, depression, anxiety, trauma. The strongest single individual driver of problematic use.
• Genetic predisposition to dependence (well-documented for alcohol and tobacco).

Sociocultural factors

• Family modelling and supply. Parental drinking patterns predict adolescent drinking patterns. Parental supply of alcohol to under-18s is illegal in NSW (since 2007) and most other states.
• Peer norms. Drug use is concentrated in friendship groups; what your friends do shapes what you do.
• Cultural and religious context. Some cultural and religious communities have strong norms against alcohol use, with measurable effects on rates.
• Media and entertainment. Music, film, and social media depictions of drug use.

Socioeconomic factors

• Income. Both ends - alcohol and cannabis use are highest in middle income groups, severe substance use disorders disproportionately concentrate in lower-SES groups.
• Employment and education. Unemployment, low engagement with education, and time without structure are risk factors.

Environmental factors

• Access to alcohol. Density of liquor outlets correlates with consumption.
• Festival and nightlife environments. Concentrate drug use opportunities.
• Rural and remote. Different drug-use patterns than urban - higher alcohol use, lower ecstasy/MDMA, more chronic-substance-use disorders.

Consequences of drug use

The syllabus expects you to discuss short-term and long-term consequences across multiple domains.

Health consequences

• Acute. Overdose, poisoning, road and other injury, sexual assault facilitated by alcohol, contagious disease exposure (injecting drug use).
• Chronic. Liver disease (alcohol), cardiovascular disease (tobacco, methamphetamine), cancer (alcohol, tobacco), mental illness exacerbation (cannabis, methamphetamine, alcohol), dependence.

Social consequences

• Relationship damage. Family conflict, friendship loss, breakdown of partnerships.
• Educational impact. Reduced concentration, attendance, attainment.
• Employment impact. Reduced productivity, loss of jobs.
• Legal consequences. Criminal records for possession, supply, driving offences.

Financial consequences

• Direct cost of the substances.
• Indirect cost. Lost wages, healthcare costs, legal costs, property loss.

Community consequences

• Crime and antisocial behaviour related to acquisition or intoxication.
• Health system cost. Alcohol alone costs the Australian health system roughly $7 billion a year (AIHW estimates).
• Lost productivity.

Harm minimisation

Australia's National Drug Strategy is built on the harm minimisation framework, in place since 1985. It has three pillars.

Demand reduction

Strategies that aim to reduce overall use. Examples:

• Public education campaigns. Anti-smoking, drink-driving (drink driving campaigns reduced fatal crashes substantially), responsible drinking.
• School-based education. Health curriculum, programs like Triple P, FRIENDS.
• Tax and pricing. Tobacco excise is the highest-evidence example, with each price rise producing measurable reduction in smoking initiation and prevalence.
• Restrictions on availability. Liquor licensing, age restrictions on tobacco and alcohol.

Supply reduction

Strategies that aim to reduce availability of drugs.

• Border control for illicit drug importation.
• Law enforcement against supply, manufacture, and trafficking.
• Regulation of legal drugs. Pharmaceutical regulation, vape sale restrictions.

Harm reduction

Strategies that aim to reduce the harm to people who use drugs, without necessarily requiring them to stop.

• Needle and syringe programs that reduce HIV and hepatitis C transmission among injecting drug users.
• Naloxone distribution for opioid overdose reversal.
• Pill testing services at music festivals (introduced in the ACT first, expanded to NSW in 2024 and Victoria in 2025 trial form). Pill testing identifies dangerous substances and is associated with reduced consumption when warnings are issued.
• Designated driver programs and rideshare to reduce drink driving.
• Safe injecting rooms (Sydney's Medically Supervised Injecting Centre at Kings Cross, Melbourne's North Richmond facility).

Harm reduction is the most politically contested pillar because critics frame it as "enabling" drug use. The evidence consistently shows harm reduction saves lives and reduces secondary disease without increasing overall use.

How this applies to extended responses

A typical HSC question asks about specific drugs (alcohol, vapes), drug use generally, or harm minimisation as a framework. Strong responses:

1. Cite specific Australian data with sources.
2. Apply the determinants framework to drug use as the issue.
3. Discuss consequences across multiple domains.
4. Name specific harm-minimisation strategies (pill testing, needle exchanges, vape reforms) rather than describing pillars in the abstract.
5. Make an explicit judgment about effectiveness when the question requires it.