Students in their early teenage years are on the cusp of making choices that could have a significant impact on their health and well-being in the long term. While the majority of first year students (13-year-olds) will not have experimented with alcohol, tobacco or other drugs at this stage, their view and understanding of substance use will already be influenced by the adult world around them. It is beneficial to equip students with the knowledge, attitudes, and skills they need prior to the situation arising where they may decide to experiment, or may feel curiosity or pressure to try tobacco, alcohol or other drugs. Engaging in discussions about substance use in school can have a valuable influence when it takes place before the peer group starts to experiment.

Activities 1, 2 and 3 in this unit relate to tobacco use. While tobacco use in Ireland is declining among adults and young people, it is still the leading cause of preventable disease and death among adults. Nicotine exposure is associated with cognitive deficits, impaired memory and executive function and may lead to nicotine addiction and tobacco use. Attitudes to smoking have changed dramatically to the extent that people who smoke may feel judged or stigmatised by our society. While it is vital that young people are educated about the risks of nicotine and tobacco and are discouraged from using it, it is also important that we talk about smokers with respect and empathy. In all discussions about substance use, it is important to focus on the act or behaviour, and avoid moralising about the person. The increasing use of e cigarettes and vapes among adolescents is a cause for concern, and is addressed in Unit 2 of Healthy Choices.

Activities 4, 5 and 6 relate to alcohol. Alcohol is the most widely used mood-altering substance/drug in Ireland and while rates are high, it is nonetheless encouraging to know that more young people are making healthy choices about alcohol use. For example, the Health Behaviour of School Children reports found that in 2018 81% of 12-14 year olds and 37% of 15-17 year olds had never had an alcoholic drink, up from rates of 75% and 32% respectively in 2014 (HBSC study, Kolto et al., 2020). Alcohol is thought to be more harmful to the well-being of teenagers, as it disrupts normal emotional, cognitive, and social development.

Activity 7 is about substance use in the general sense, exploring all drugs in society, including medication, legal and illegal substances. Activity 8 is a lifeskills activity, focusing on managing pressure to conform to group behaviours.