Teenagers and NPS in Poland – attitudes and behaviors Tomasz Białas Agnieszka Batko Chief Sanitary Inspectorate, Poland Lisbon, 23-10-2017

General Information The survey : - conducted in September 2016 by a self-administered questionnaire - on a representative sample of 5,500 students in randomly selected schools in Poland - estimation error does not exceed 1.23% with a confidence level of 95% - covered two age groups Sample lower-secondary school (age 14 -15) upper-secondary school (age 17 -18) - general upper-secondary school (G) - technical upper-secondary school (T) - basic vocational school (BV)

NPS and other stimulants NPS – 10,3 % Female 8 % Male 12,1 %

NPS prevalence according to types of school   Lifetime prevalence Past 12 months Past 30 days age 14-15 6,5 % 2,6 % 1,3 % 17-18 G 5 % 1,8 % 0,6 % T 11,3 % 3,9 % 1,1 % BV 24 % 10,6 % 4,3 % average 10,5 % 4 % 1,4 %

NPS lifetime prevalence according to age and regions Min. 1 Max. 11,4 Min. 4,99 Max. 18,87

NPS prevalence according to regions and types of schools (age 17-18 life prevalence) Min. 1,6 Min. 3,7 Min. 3,6 Max. 11,3 Max. 24.6 Max. 39,6

NPS users in Poland according to type of area Haw many time did you buy NPS ? Rural areas Urban areas Big cities Total % N 10,5 267 11,8 % 165 8,8 137 567 How many times did you buy NPS ? Rural areas Urban areas Big cities 1 56,1 % 52,2 % 48,8 % 2 - 5 times 21,7 % 24,2 % 25,6 % 6 Times or more 22,1 % 23,6 %

When did you first try NPS (age 11-19 in %)?

How did you use NPS ? age 14-15 age 17-18 % N smoking 78,3 % 112 85,4%   78,3 % 112 85,4% 321 taking orally  22,4 % 32 16,8 % 63 snorting 27,3 % 39 20,7% 78 injecting 11,9 % 17 7,7 % 29 other 6,3 % 9 1,9 % 7

How did you get NPS in %

How much did you spend on NPS a month? Euro per month age 14 -15   age 17 -18 % N 0 – 7 € 52,9 % 36 53,8 % 86 8 – 25 € 13,2 % 9 19,4 % 31 26 – 50 € 7,4 % 5 11,3 % 18 More than 50 € 26,5 % 15,6 % 25

How many times did you buy NPS ? age 14 -15   age 17 -18 G T BV 1 58,9% 58,0 % 51,4 % 49,3 % 2 - 5 times 15,9% 16,0% 30,6 % 26,2 % 6 times or more 25,2% 26,0 % 18,0 % 24,5 % € €

Why do you think young people take NPS?

Negative consequences of using NPS Have you ever had any negative consequences due to taking NPS? % N Yes 17,1 % 98 No 65,3 % 374 Hard to say 16,9 % 97

Negative consequences of using NPS € €

Have you heard about the harmful effects of using NPS? age 14 -15   age 17 -18 G T BV No 4,1% 1,9 % 3,0 % 7,2 % Yes 95,8% 97,9% 96,6 % 92,4 % No answer 0,1% 0,2 % 0,4 % € €

Do you think the occasional use of NPS is harmless ? age 14 -15   age 17 -18 G T BV Yes 10,2% 4,3 % 5,6 % 12,6 % Rather yes 8,1% 6,8 % 10,4 % 12,8 % Rather no 14,6% 16,7 % 15,5 % 17,7 % No 41,4 % 55,5% 45,0 % 31,4 % Hard to say 25,7 % 16,8 % 23,6 % 25,6 % € €

Conclusions Students at the age 17-18 have more experience with NPS (10.5%) than students at the age of 14-15 (6.5%); the age of NPS initiation is indicated at about 14-16; There are significant regional differences in the percentage of NPS users: age 14-15 (1 - 11%), 17-18 (5 - 19%); The strongest diversity in the use of NPS seems to be the level of education and professional aspirations, in the 17-18 group (5% in general upper secondary school – 24% in basic vocational school); Half of the respondents claim that they have not bought NPS at all. The most important distribution channel are dealers (friends: 36.8% and unknown dealers: 23.5%); 17.9% of respondents buy NPS in the store and 8.5% on the web; The dominant way of using it is smoking - 75.8% - which may be a confirmation of popularity of synthetic cannabinoids; every 5-th respondent pointed to snorting, and every 6-th to taking NPS orally; Most users spend monthly up to 7 € (52%), 17% spend up to 25 €, and 18% more than 50 €. This shows relatively low costs of using NPS; Most students (58.1%) are convinced of the potential health risks associated with taking NPS, even occasionally, are high. The vast majority (96%) obtained information on the harmful effects of the NPS; Young Poles take NPS for pleasure and because of group conformism (low level assertiveness), issues of addiction and problems are less important.

Thank you for your attention more information: t.bialas@gis.gov.pl