Pause before a decision
Give yourself time to think rather than allowing pressure, advertising or a stressful moment to make the decision for you.
HEALTHY LIVING · SUBJECT 4
Substance Use
& Prevention
Explore tobacco, nicotine, vaping, alcohol and other psychoactive substances—and discover how choices, relationships, environments, commercial forces and public policies shape health.
SELF
→
FAMILY & PEERS
→
COMMUNITY
→
COUNTRY
→
WORLD
GHE PRINCIPLE
Healthy choices. Healthier conditions.
WHY THIS MATTERS
Health choices happen in real-world environments.
Substance use is not simply a question of individual willpower. What people experience is influenced by biology, age, relationships, stress, social norms, advertising, availability, prices, laws, culture and opportunities for support.
Global Health Explorers looks at the whole picture. We learn how to make informed decisions while also asking a bigger question: What can communities and societies do to create healthier conditions?
PERSONAL HINTS
Start with what you can control.
You do not have to solve the whole problem at once. Small decisions, supportive relationships and good information can strengthen your ability to protect your health.
Know your influences
Notice how friends, media, algorithms, products, prices and social expectations can influence what seems normal.
Protect your future self
Learning about risks early can help you make decisions that support your health, learning, relationships and future goals.
Ask for help early
Reaching out to a trusted adult or qualified professional is a strength—not a failure.
GLOBAL HEALTH AT A GLANCE
Substance use affects people and societies worldwide.
7M+
deaths each year are attributed to tobacco use.
2.6M
deaths were attributed to alcohol in 2019.
200+
diseases, injuries and health conditions have
causal links with alcohol.
1.2B
people worldwide use tobacco, according to WHO.
These numbers describe population-level impacts. They do not define any individual person, and they do not tell the whole story about why substance use occurs.
EXPLORE
What is a psychoactive substance?
Psychoactive substances are substances that can affect the brain and influence mood, perception, thinking or behaviour.
Tobacco & nicotine
Tobacco products contain nicotine, a highly addictive substance. Tobacco smoke also contains many harmful chemicals.
Alcohol
Alcohol contains ethanol, a psychoactive and toxic substance that can contribute to many health and social harms.
Other psychoactive substances
Different substances can affect the brain and body in different ways. Their risks depend on the substance, the person, the context and patterns of use.
Context matters
Public health therefore examines more than the substance itself. It also considers age, environment, social conditions, policies, access to support and commercial influences.
GHE Safety Note
This page is for health education and prevention. It does not provide instructions for obtaining, using or experimenting with substances.
LEARN · 01
Tobacco & smoking
Tobacco harms nearly every organ of the body and is a major preventable cause of disease and premature death.
Health effects
Tobacco use is associated with cancer, cardiovascular disease, stroke, lung disease and other serious health problems.
Second-hand smoke
People who do not smoke can still be harmed by exposure to tobacco smoke.
Addiction
Nicotine can produce dependence, making stopping difficult for some people. Prevention and accessible support both matter.
Evidence:
WHO identifies tobacco as a major cause of preventable
death and disease and states that all forms of tobacco
are harmful.
LEARN · 02
Nicotine & vaping
New technologies can change how nicotine is delivered, but changing the delivery system does not make nicotine harmless.
Why adolescence matters
The brain continues developing during adolescence and young adulthood. WHO notes that nicotine exposure during this period can affect brain development, including attention and learning, and early use can increase the likelihood of longer-term dependence.
Prevention therefore means protecting young people from unnecessary exposure while ensuring that those who need support can receive it.
LEARN · 03
Alcohol
Alcohol is a psychoactive and toxic substance associated with a wide range of health and social consequences.
More than one pathway
Alcohol contributes to injuries, noncommunicable diseases, some infectious diseases and mental health and behavioural conditions.
Risk is contextual
Risk varies with factors including amount, frequency, age, health status and circumstances.
Prevention matters
Healthy environments, good information, supportive relationships and effective policies can reduce alcohol-related harm.
LEARN · 04
Other psychoactive substances
Different substances have different effects and risks. Public health education focuses on accurate information, prevention, harm reduction where appropriate, treatment and respect.
Avoid the “good substance / bad substance” shortcut.
A Global Health Explorer asks better questions: What are the health effects? Who is most vulnerable? What social conditions shape exposure? What policies protect people? What evidence supports prevention and treatment?
LEARN · 05
Why adolescence matters
Brain development
Adolescence is a period of important biological, social and cognitive development.
Identity & belonging
Young people are developing identities, relationships and a sense of belonging.
Experimentation & pressure
Social environments can influence what feels acceptable or expected.
Prevention opportunity
Early, accurate education can strengthen health literacy and protective environments.
HEALTHY CHOICES
What does a healthy choice look like?
Healthy choices are not about perfection. They are about having information, support, opportunities and environments that make healthier decisions possible.
Protect your health
Learn about risks and avoid unnecessary exposure to harmful substances.
Protect your relationships
Build relationships where people can say no, ask questions and support one another.
Protect your future
Think about how decisions today can influence learning, health and future opportunities.
Protect your environment
Support homes, schools, communities and policies that make healthy choices easier.
Healthy choice ≠ individual blame.
Public health asks how we can improve both choices
and the conditions surrounding those choices.
THINK
Peers, belonging & social norms
People are social. What we believe others are doing can influence our own perceptions and decisions.
What seems “normal”?
Is your perception based on direct experience, social media, advertising or assumptions?
Who benefits?
When a product becomes popular, who gains financially from that popularity?
Who is missing?
Which young people may have fewer opportunities for support or healthier environments?
CONNECT
Stress, mental health & supportive environments
Stress and difficult life circumstances can affect health behaviours. Prevention therefore includes strengthening supportive environments—not blaming individuals for experiencing difficulties.
Supportive relationships
Trusted friends, family members, teachers and other supportive adults can provide connection and help-seeking pathways.
Healthy coping
Sleep, physical activity, meaningful activities, connection and constructive problem-solving can support wellbeing.
Professional support
When concerns become difficult to manage, qualified health professionals can provide appropriate assessment and support.
Respect
People experiencing substance-related problems deserve dignity, evidence-based care and freedom from stigma.
THINK · SYSTEMS
Commercial determinants of health
Health is influenced by how products are designed, promoted, priced, distributed and regulated.
Product design
Product characteristics can influence attractiveness, use and patterns of consumption.
Marketing
Advertising and promotional strategies can shape perceptions, preferences and social norms.
Price & availability
Economic and physical availability can influence population exposure.
Policy influence
Regulation, lobbying and political processes can shape the environments in which health decisions occur.
Global Health Explorer question:
If a product is profitable, does that automatically
mean it is good for health?
THINK · DIGITAL ENVIRONMENTS
Marketing, media & algorithms
Digital environments can make marketing more personal, persistent and difficult to recognize.
Sponsored content
Promotional messages can sometimes resemble ordinary entertainment or social content.
Personalisation
Digital advertising can use information about online behaviour to target audiences.
Influencers
Popular personalities can influence perceptions of what is attractive, acceptable or normal.
Media literacy
Ask: Who created this? Who paid for it? What do they want me to think, feel or do?
CONNECT · SOCIAL DETERMINANTS OF HEALTH
Look beyond the individual.
Substance-related health outcomes can be shaped by the conditions in which people grow, learn, work and live.
Family & relationships
Support, communication and connection can influence resilience and wellbeing.
Education
Health literacy and safe learning environments can strengthen prevention.
Income & opportunity
Economic conditions influence exposure, stress and access to support.
Housing & neighbourhood
Living conditions can affect safety, stress and access to healthy opportunities.
Culture & belonging
Identity, community connection and social inclusion can shape health and wellbeing.
Policies & systems
Laws, regulation, health services and public policy shape the wider environment.
SDH question:
Would every young person have the same choices if
their living conditions were different?
PREVENTION
Prevention is not blame.
Effective prevention combines individual skills, supportive relationships, healthy environments, evidence-based services and public policy.
Build knowledge
Give young people accurate, understandable health information.
Strengthen protective factors
Support belonging, education, positive relationships and meaningful opportunities.
Improve environments
Make schools, communities and public spaces safer and more supportive.
Provide help
Ensure people can access appropriate, respectful and evidence-based support.
Use policy
Regulation can reduce exposure to harmful products and commercial influence.
Reduce stigma
Respectful language and compassionate care can make it easier for people to seek help.
GLOBAL POLICY
WHO MPOWER
Tobacco control shows how population health can combine evidence, policy and implementation.
Monitor
Monitor tobacco use and prevention policies.
Protect
Protect people from tobacco smoke.
Offer help
Offer support for quitting tobacco use.
Warn
Warn people about tobacco's dangers.
Enforce
Enforce restrictions on tobacco advertising.
Raise
Raise tobacco taxes to reduce consumption.
CONNECT
From SELF to WORLD
Global health thinking moves outward. Start with your own decisions, then examine the systems and environments around you.
SELF
What information and habits can protect my health?
→
FAMILY & PEERS
How do relationships and social norms influence us?
→
COMMUNITY
What can schools and communities do differently?
→
COUNTRY
What laws and health policies protect people?
→
WORLD
How can countries cooperate to improve health?
THINK LIKE A GLOBAL HEALTH EXPLORER
Ask better questions.
A Global Health Explorer does not stop at “Is this good or bad?” We investigate causes, evidence, equity and possible solutions.
What is the evidence?
Separate strong evidence from claims, opinions and advertising.
Who is affected?
Look at age, geography, income and other dimensions of health equity.
Why does it happen?
Investigate biological, social, commercial and policy causes.
What could change?
Move from describing a problem to identifying realistic actions.
SUSTAINABLE DEVELOPMENT GOALS
Substance use is connected to wider global goals.
Good Health & Well-Being
Prevent disease, reduce avoidable harm and strengthen access to health and support.
Quality Education
Health literacy and education can help young people make informed decisions.
Reduced Inequalities
Prevention should address unequal exposure, unequal opportunities and unequal access to support.
Peace, Justice & Strong Institutions
Effective regulation, accountability and trustworthy institutions are important for health protection.
Partnerships for the Goals
Global health challenges require cooperation among governments, communities, researchers and civil society.
GLOBAL HEALTH & EVIDENCE
Evidence helps us move from opinion to action.
Global Health Explorers uses authoritative sources and encourages young people to ask where evidence comes from and how reliable it is.
WHO
Global evidence and guidance on tobacco, alcohol, adolescent health, commercial determinants and tobacco control.
Explore WHO tobacco evidence →WHO Alcohol
Evidence on alcohol-related health consequences, disease burden and prevention.
Explore WHO alcohol evidence →WHO Commercial Determinants
Learn how commercial activities and strategies can influence population health.
Explore the evidence →ONE STEP YOU CAN TAKE
Learn to recognize influence.
The next time you see a health-related claim, product promotion or social-media message, pause and ask: Who created this message, who benefits from it, and what evidence supports it?
REFLECT → ACT
Turn learning into responsible action.
What surprised you?
Identify one idea that changed or challenged your understanding.
Check one claim.
Find an authoritative source and compare its evidence with what you have seen online.
Discuss respectfully.
Share what you learned with a trusted person without judging people who may need help.
Improve one condition.
Suggest one realistic way your school, family or community could strengthen prevention or health literacy.
CHECK YOUR LEARNING
12 Global Health Explorer MCQs
Choose the best answer. Open the explanation only after you have made your choice.
01 Which statement best describes a psychoactive substance?
Correct answer: B
Psychoactive substances can affect the central nervous system and influence mental or behavioural processes.
02 Why is nicotine exposure particularly important during adolescence?
Correct answer: C
WHO notes that nicotine exposure during adolescence can affect brain development, including attention and learning.
03 Which statement about tobacco is most accurate?
Correct answer: C
Tobacco use is associated with multiple diseases affecting many organs, and second-hand smoke can also harm people who do not smoke.
04 Which is an example of a commercial determinant of health?
Correct answer: A
Commercial determinants include activities such as marketing, pricing, product design, availability and political influence.
05 What is the best response to a persuasive health-related advertisement?
Correct answer: C
Media literacy involves examining the source, purpose, incentives and evidence behind a message.
06 Which statement best describes prevention?
Correct answer: B
Effective prevention works at multiple levels: individual, interpersonal, community, health-system and policy levels.
07 Which question best reflects a Social Determinants of Health perspective?
Correct answer: B
An SDH lens examines how living conditions, education, income, relationships, environments and systems shape health.
08 Which WHO MPOWER action focuses on helping people stop using tobacco?
Correct answer: B
MPOWER includes offering help to quit alongside monitoring, protecting people, warning, enforcing advertising restrictions and raising taxes.
09 Which SDG is most directly connected to substance-use prevention and health?
Correct answer: A
SDG 3 focuses on Good Health and Well-Being and includes important substance-related health targets.
10 Why should prevention avoid stigma?
Correct answer: B
Respectful, non-judgmental approaches can make it easier for people to discuss concerns and seek appropriate support.
11 Which sequence best represents the GHE spatial pathway?
Correct answer: B
GHE moves from the individual outward, connecting personal health with relationships, communities, countries and the world.
12 Which question best demonstrates global-health thinking?
Correct answer: C
Global health combines evidence, systems thinking, equity, context and action rather than relying on blame or one-size-fits-all solutions.
GLOBAL HEALTH LEADERSHIP
Prevention needs leaders who understand both people and systems.
A future global health leader combines scientific evidence with empathy, equity, communication and responsible action.
Evidence
Ask what is known and how confidently we know it.
Equity
Ask who benefits, who is exposed and who may be left behind.
Empathy
Understand people without reducing them to labels or statistics.
Action
Turn knowledge into realistic, responsible improvements.
EVIDENCE & REVIEW
Built from public-health evidence.
This learning page draws primarily on authoritative evidence and guidance from the World Health Organization and related public-health sources.