Conclusions
In conclusion, our study shows that health risk behaviours in 2009 1) are lower than in 2005 but still prevalent among young Dutch students (aged 13–16) , 2) are higher at higher age (for all substances), 3) are higher among males (for excessive drinking and cannabis use) and 4) are higher among students with lower educational level (for all substances). Similar risk groups were described in another study among Dutch adolescents, except for the relationship between educational level and cannabis use. In the Netherlands, political and social attention for harmful alcohol, smoking and drug use among young people is strong. Future challenges are to further reduce (multiple) risk behaviours and to further postpone the onset of unhealthy habits. A recent European report showed that with respect to the present alcohol use Dutch adolescents are just above the European mean, with respect to cannabis use (last month and age of starting) they are in the top of European countries and with respect to smoking behaviour they have an average position. Recent national policies aim at further postponing the starting age and limiting the availability of substances. Special attention should be given to the youngest age groups and lower educated groups.