A new study has found girls in the UK are drinking, smoking and vaping more than boys, while England is "top of the charts" globally for child alcohol use.
A professor at the University of Kent in Canterbury helped carry out one of the largest studies of its kind, using data from 280,000 children aged 11, 13 and 15 from 44 countries who were asked about their use of cigarettes, vapes and alcohol.
The World Health Organisation (WHO) examined the findings, which show girls aged 13 and 15 in the UK tend to be drinking, smoking and vaping more than boys across a broad pattern of behaviour.
University of Kent professor Sally Kendall, who worked on the study, said that "clearly vaping has replaced smoking as a dangerous recreational activity in our children".
The study also found that two-fifths of girls in England and Scotland have vaped by the age of 15 - higher than in other countries such as France, Austria, Germany, Albania, Spain, Canada and Norway.
Some 30% of girls aged 15 and 17% of boys aged 15 in England said they had vaped in the previous 30 days. This is higher than children in several other countries, including Ireland, Canada, Iceland, Spain, Denmark, Norway and Portugal.
The UK seems to have more of an issue with underage vaping than many other countries, with girls in the UK more likely to have used a vape by the age of 15 than the average for all 44 countries in the study.
The study also found children aged 11 and 13 in England are the most likely to have ever drunk alcohol compared with youngsters in all the other countries surveyed. Compared with other European countries, rates of drunkenness in the UK were high, particularly among girls.
At the age of 11, England tops the global chart, with 34% of girls and 35% of boys saying they have drunk alcohol.
Dr Jo Inchley from the University of Glasgow, who is international co-ordinator for the study called Health Behaviour In School-Aged Children, said some of the UK data is concerning.
She told the PA news agency: "Vaping in the UK is higher than the average across all the countries that took part in the survey as a whole.
“I guess that's a little bit concerning, and we've certainly seen quite marked increases in vaping in Scotland over the last four years... lifetime use of e-cigarettes has more than doubled in Scotland since 2018.
“So there's two areas for concern. One is that our levels are higher than elsewhere in Europe and, secondly, it looks like the trends are worsening quite substantially over a relatively short period of time in the UK."
By 13, some 57% of girls and 50% of boys in England said they had drunk alcohol - again topping the global chart.
Some 55% of girls and 56% of boys in England from higher-income families say they have drunk alcohol in their lifetime. The figures for lower-income households are 50% of girls and 39% of boys.
It comes after the UK Government said it would be creating the UK’s first “smoke-free generation”.
A Government spokesman said: "The health advice is clear - smoking, vaping and underage drinking can be damaging for young people and their development. That is why there are age restrictions on the sale of these products.
"As a government, we are creating the UK's first smoke-free generation.
“Our landmark Tobacco and Vapes Bill will make it an offence to sell tobacco products to anyone born after 1 January 2009 and includes powers to limit flavours, packaging and displays of vapes to reduce the appeal to children."
Dr Inchley believes one driver of increasing vape use may be their availability and low cost.
"Disposable vapes seem to be fairly readily accessible to young people and schools are reporting that that's a major issue that they're having to deal with on a day-to-day basis. Young people are telling us that too,” she added.
"Having ready access to any kind of substance like that obviously makes it more attractive and available, so that is a big issue.
"Some of the policy responses we're seeing now from Governments across the UK is really positive in that respect, because we do need to address the issue of availability and accessibility."
Dr Inchley said it is also "really quite worrying" that "England is at the top of the charts for 11 and 13-year-olds when it comes to alcohol use".
"So we're seeing really high levels of early initiation into drinking amongst boys and girls in England," she said.
"Why that's much higher than other countries, I don't really know, but it's certainly something we need to look at and address."
Dr Hans Kluge, WHO regional director for Europe, said the widespread use of harmful substances among children "is a serious public health threat".
He added: "Considering that the brain continues to develop well into a person's mid-20s, adolescents need to be protected from the effects of toxic and dangerous products.
"Unfortunately, children today are constantly exposed to targeted online marketing of harmful products, while popular culture, like video games, normalises them."
