 It's 5 past 12, and we can start this webinar today about knowing youth. And I will give immediately the floor to our director, Alexis Gousdil, for his opening remarks. Thank you very much, Alexis. The floor is yours. Thank you, Marika. Good morning, everybody. Or good afternoon for those who are not in the same time zone than Portugal. I'm very delighted to open this 19th EMCDD webinar. I cannot believe that in less than two years we already had the 19 webinars. And thank you, all of you, of course, for following us and joining us both as speakers or participants, and also more broadly for your participation and your questions. For me, this topic today is a very important and very timely topic. Because knowing youth and making or building digital platforms for decision making is at the heart of the current but also the future new business model of the EMCDDA that has been adopted by our management board last December. And that we are now going to implement over the next three to five years. I think first we have fantastic speakers that have been invited today. I'm always delighted to see that we managed to get fantastic and very good speakers. And that it illustrates once more one of the characteristics of EMCDDA webinars is that it's not EMCDDA a pretendent to speak to everybody. On the contrary, we invite, we give the floor to the experts, to the partners, and we invite them through giving them more and better visibility. I think it's an indirect but very useful way to give more visibility to what we try to achieve together. And today we have very interesting speakers. The first of them, of course, is very special and dear to us. This is Sabrina Modinaro. She's the ESPAD coordinator. You know how important ESPAD school surveys are for us in the European Union. It illustrates also a special but very good and fruitful partnership that we have with ESPAD and that we are going to further develop in the coming years. And I think the move that was initiated by Sabrina and her colleagues with the support of the National Research Center can see in Italy to make available more easily the ESPAD data is extremely useful and important. And of course, we fully support this initiative. Sabrina also has another specific objective is to make better use of the data, the goldmine of information that is contained by ESPAD. And she certainly knows that she has a very strong ally for that purpose with the MCDD, with me as the director. Margarida Gaspar de Matus from the University, from the Faculty of Medicine, the University of Lisbon is well known to us. She's also a member of a scientific committee. And we were together attending another conference and another presentation a few weeks ago. I think she has a very good and very dynamic way to present the data, but also the questions around the data. And I would like to add that something we sometimes forget in the drug field, at least we forgot sometimes in the past, is that the statistics are supposed to help us to answer to questions. And there is sometimes a tendency to start first collecting data and then trying to find what are the questions. Luckily, we have Margarida with us to show us and share with us what is the right way to do the things. And I think the same, we can say the same about Stefanie and Christian. I think the public health education, but also the question of evaluation are very important to us. So why is it so relevant and so timely? It's also because we are going to launch in two weeks time the next edition of the European Drug Report and that the overall trend can be summarized in three words, which is everywhere, everything and everyone. Drugs are everywhere. They have never been so potent, so pure and so cheap in Europe. Everything can be a drug, which means it goes much beyond the distinction between licit or illicit drugs and drugs of vegetal origin or synthetic or chemical origin. Drugs are products that have been produced with a purpose or without specific purpose leading to human consumption, use or abuse. But that can be the object of an addiction or an addictive behavior. And why is this important? Because this shows that there is an urgent need to update the image, the vision that we have. What are people who are using, who are the people who are using drugs today? Basically people who can have an addictive, present an addictive behavior. There are much more people than just the profile, the classical profile of people injecting heroin. So if we don't update this profile, this image we have, there is no way we can conduct or adapt prevention strategies and prevention programs. So this is why it's important. And the youth, of course, is even more important in that context, first because they are even more exposed, even their age and the adolescence. There are in some cases more exposed to the possibility to develop some of those behaviors. Again, a lot of people can be in contact or ever show an addictive behavior that does not correspond to the more classic image of the junkie injecting heroin, which means you can have people who are having or ready to present an addictive behavior without being conscious of it. And certainly some of the consequences of this huge availability and also the huge potency. If you look at the potency of cannabis, the potency in THC has doubled over the last 10 years, which means that the potential risk for us are even more important than before. But it's not only about cannabis or about heroin, so we need to update the vision and the programs for prevention. And therefore this is why we need school surveys, we need good school surveys, we need repeated, periodically repeated good school surveys. And I think the work of SBAT in that context is extremely important. That's an important tool. It's also very important. I already mentioned that we really support and welcome the aim of SBAT to make those data more available to everybody who may be able to make use of those data. And then we need also to make sure that the decision makers are using those information. So it's one more reason for me to extremely supportive and proud that the MCDDA is organizing such a webinar with those so good speakers. There are two additional points I would like to mention. Because when we speak about digital platforms for decision making, of course it's the new digital world and the digital transformation. It offers also new ways and new paths for communication for entering into contact and in relation with people, especially with the youth. Except small detail is that if you are 25 years old, you are already looking very old for the young people who are exposed to any kind of substance use. Which means that we need to be aware that we need to involve and to associate young and new. We need more co-production, but we first of all need to make better use and implement more frequently those surveys. And then there is a last point that for me is both potential but can be a risk. It's the fact that more and more people talk about evidence-based and scientific-based evaluation. But honestly, there is a lot of fantasy around that. And the last time I heard a comment that was not looking scientific at all. Even if it was using many times the terms scientific evidence, it's about the evaluation of those programs. And this is why I was making reference to the work of Christian Stoker and Stefanie Helmer and the colleagues. And all the people working on the evaluation of prevention programs in Europe. I think there is a broad kind of a fantasy about what are the results we can reasonably expect from prevention programs. And certainly a comment that I hear sometimes is that there is sometimes a negative opinion about some programs or some innovative programs. Because we cannot prove that people have changed dramatically their behavior after a first contact or first preventive action. And I think this is exactly opposite to what is a scientific or evidence-based work. Nobody can pretend to be a prophet, which means that nobody can pretend that when we speak once to someone, she or he is going to change her or his behavior completely forever for the entire life. It just doesn't exist. That's not the objective of prevention. So to have a better knowledge of the behaviors of the perceptions and of the attitudes of the youth through the SPAT survey or the school surveys. It's extremely important that we use this information. We try to better understand what it means to be a teenager, an adolescent in today's world, in today's European youth. And then to try to build a preventive action that try to build on this knowledge, that try to address some of the challenges, but not limiting themselves with some pseudo performance indicators that are not appropriate, that are not realistic and that ultimately are not scientific. So having said that, I wish you a very good webinar. I'm staying with you until the end of this meeting and I'm looking forward to listen to our speakers and to listen to your questions. Alexis, thank you very much for your always inspiring words and for your dedication to our work. The chair of this session is João Matias. I would give the floor to João and then switch off my camera. Thank you very much. Have an excellent webinar. I will be behind the scenes to support. Thank you, Matica and Alexis for the introduction and good morning and good afternoon. I think Alexis made my life much easier with the very good introduction and also introducing the speakers, who I want to really thank for accepting the challenge to present on this topic. I also would like to thank my colleague Alessandra Bo for the help of setting up and organizing this webinar. Our objective with this webinar is mostly to explore and to understand what the potential we have with the data from youth surveys and all the studies around the young people and how they can better inform drug policies and public health policies. So I think the four speakers we have today will provide a good input around this topic. Alexis already mentioned briefly, we have Sabrina Molinado, that is the SPAP coordinator, a long-term collaborator, working for the National Research Council in Italy. We have Margarita Gesparmach, part of the EMCDA scientific committee and professor in the Facultabend Siena from the University of Lisbon in Portugal. Stephanie Helmer, researcher on evidence-based public health in the University of Bremen, Germany and Christian Stock, professor in public health and health education in Charity in Berlin, Germany. So we would go straight to the questions we would ask our speakers to talk to us and try to answer. So we will start with a question to Margarita Gesparmach. So what do we know about young people today and how data can inform decision-making? So Margarita please, the floor is yours. Okay, so good morning everybody. It's a pleasure to be here. Thanks for the invitation. Especially Alexis and João for the close work together. I will not present that today. I will reflect upon how is it to be young and then I will just pitch some of our research to track to make a link from research to action to inspire action and then public policies. It's perhaps too quick but I will be available if by email whenever you need. So that's me. Easy and already down and then talking about Generation Z. Okay, we will, but be careful because it's not so clear what a generation really is. And that will be the first question. What is a generation? You have a way of looking to generation which is periods of times where people are supposed to share common events, life events, historical events and we can be baby boomers, Generation X and so forth. That's a way of looking to generations and you have a lot of Google thinks about the evolution of generation now. We have already the generation alpha, which are the younger adolescents. You have also another way to look to generation which is how is it to be 18 or 80 or 60 or whatever. And note that everybody who is older than 18 has already been 18 before. And so that's a status that we acquire and we keep for a lifetime. And so that is how is it to be 18, but in the 40s in the 70s and the millennials and they were once all 18, not any longer. So into what part of the world are we talking about? Is it Europe? Because it's not. And when we talk about Generation Z, we see this. Can you see my mouse moving? And you see this. But in other parts of the world, right now, other kind of Generation Z are possible and be careful with that. And question three, are we all male, young, attractive, white, middle class, educated, sophisticated and healthy? I mean, from the other picture, only the men, white men, educated white men are Generation Z. Be careful. They are all immersed in bias visions and whatever I say from now on, keep this in mind. We are all biased. It's Generation Z. And of course, they have the war at the corner, an economical recession, COVID and lockdowns and all kinds of things, and I will just pitch you a little bit and link you to the action. So what we know already, empirical study from research to action, from action to public policies, from public policy to further action, further action, further research, and that is a circle, a never ending story. But it has to be like that. Whenever you say it's like that, the question changed and you are wrong again. And so don't be sure ever. This is a very easy way to present population health surveys. With age, in general, things gets worse. Things are still different according to genders, but yet worse with age, either with girls or with boys. With socioeconomic problems, everything gets worse. We know that. Also in Portugal, for instance, we have a terrible period here in 2002. And then we have a good period here in 2008. And that was, this is our life concerning adolescence health. Everything that is good was worse in 2002, better till 2008, and then decreasing again. So compared Portugal with Europe, the royalties Europe, some things are better, some things are worse. I will not say what why but you can, you can see in the platform that's why it's so fantastic to have access to that. When we try to model, we have consequences and determinants, and we have that kind of models that academic does know perfectly, and the journalist hated and professionals as well. That means that school, for instance, concerning adolescence and adolescence well being school and family and friends are relevant scenarios. When well being is guaranteed, everything gets better. Whatever well being is. And so, what is that useful for besides looking bizarre. It's look, it's, it's okay for for thinking action and sorry. And so how we know now that we have now manuals, we have online peace, we have ways to promote health and well being in schools. We have evidence to say that young people have to have active engagement in the promotive actions in school, and that we have that we have forms we have the blitz that you can download from here in Portuguese unfortunately, most of them. And these are booklets that teachers can use about different topics of the Western self, we did that from research and from that. So that we can translate the data into something useful for professionals. Okay, again. So having problems because I put our face in a way that I cannot see the text. But this is a study we did with with the university students, first year in the university during cover the rate, and we inquire a lot of things I will not talk about that but I will talk only about the effects of cover. And we see that substance use was actually decreasing during the lockdown times online games are increasing but excessive screen time increased tremendously. And so we have an issue and call for action. Let's talk to them. And we did qualitative research. And I will not read that, but they told us that they are drinking less than that smoking less cannabis, because they take medicine. And they take prescribed medicine. They are afraid, because they think that now that we are not locked down anymore. Substant use can increase tremendously in the next couple of months here. But it's their fear, not minds. Those are codes from young people not adolescents. Yes, adolescents perhaps first, first year in the university. And so also they say that yes, screen time is their life, and they actually very useful. Otherwise, during lockdown, they will not be able to work. And they have ideas about what can be done. Tell us what to do, not only what not to do. We need alternatives. What can we do to manage emotions to to have fun to live a life. And that was that those are the promotive questions. And so moving research into action. We have a lot of resources now, especially a collaboration with the National Erasmus Agency. And also, we intend to build a platform identifying good practices in university settings. So, also with the specific work was done with with Generation Z, but also their parents and their grandparents. And we want to set a scenario inter generation, not to have that, that, you know, that split between the old ones, the young ones, and we want like that. And we promote a dialogue among generations, and it came up the need for sustainable intergenerational solutions. That is the worst word to say in English intergenerational. So, I mean, we have to solve problems but in a way that the next generation is not getting worse problems. And so we have now a public intergenerational debate and national future dialogue. And I will go to Bogota in a couple of weeks for a World Leadership Congress about how to put generation talking to each other. Okay, we did another survey with students from a municipality. I will not tell you all the thing but only the mental thing and the COVID and the results girls more frequently said and depressed and anxious and the young people better than old people, the same thing that in national studies. So, age is a risk factor, being a female is a risk factor, and the COVID provoke another bad context. What shall we do now? The beginning actions from the municipalities because if municipalities can, of course we need national service and we need European level service, but then the municipality has to be able to pick up the ideas, syncretic issues there so that they can what promote actions and the policies. Okay, and that was the last one. It was actually it's being delivered today to our country, to Portugal. And this is a survey that we did after seeing that mental health issues were increasing with COVID. And we did, this is Portugal, and we did a national survey on mental health and the psychological health for peoples and for students. And we did that with the Ministry of Education. And actually the results are that one every three people have any sign of psychological distress and one every two teachers have an issue. Also, the region thing is not very important for you, but we could pick up regional differences, age difference and gender difference. And what do we need that for? To enforce public policies. And now the Ministry of Education has a strong commitment to the country and to ourselves to take to engage in a lot of measure from now on in the next six months. So that is about Alex was talking about prevention and promotion, and that is a nice picture of it. So we can prevent it's nice, we can protect it, we can promote, and we can leave people to participate. But that is from people point of view. But we also need public policies and friendly environment. And so the sea has the affordance of allowing your bus. And we can we have to see the environment like affordance, like opportunities. And we have to be able to pick up the opportunities of the environment. And so for me, if you allowed me the metaphor of the way this is a metaphor for what I think about prevention and promotion. And this is us. The, and that's our things in PR, and my email. And thank you very much. Thank you very much, my good even for the very thought provoking presentation. I think it was a very good introduction to what comes also next and a lot of questions came to my mind. I forgot to mention for those watching online. Hello, first and second, if you have questions, please do write them in the Q&A section in your screen or in the chat so that after the four speakers talk we will go through the questions and ask them to the speakers. I would now move to the second question of this morning to Sabrina Molinado. And I'm very happy because today we are launching the ESPA data portal. Sabrina will talk about it today. It has been a long process, but I'm very happy it's out and it's out there and people can explore it. So Sabrina will be presenting the ESPA data tool, which allows access to 20 years of ESPA data on substance use amongst 15 to 16 year old students, adolescents. So Sabrina, please the floor is yours. And I will share a video as soon as you tell me. Thank you Joao, thank you for the presentation and thank you MCDA for the invitation and also thank to Alexis for the beautiful introduction. I'm very happy because today is a big day for the ESPA community. As Joao says, this is the final treasure of a big work started more than 10 years ago together with MCDA. Because before to be able to develop this portal, we needed to develop the ESPA trend databases. That is a really great big database with all data inside. So finally, from today, our project will open its data not only to the scientific community, but also to all the stakeholders who will be able to use all the information of ESPA. That's the real news because inside the database, there are many, many information that normally are not shown in the report or in the normal communication. What does it mean that from today, you will be able to have access to all the information inside the the questioner. We developed this portal thinking three different profiles of users, people who want to take a look for general information, people who want to take a look inside some specific information and for expert users. To be honest, I have to tell you that all the micro data of ESPA has already used from the scientific community by another portal that you just need to ask for this kind of micro data and you can have access to them. So, let me just show you some preliminary information just to recap you what is important to know about ESPA. I already know all of you already know what ESPA is. It is ESPA, the European School of Surveillance, alcohol and other drugs and our objective. I'm the ESPA coordinator of science 2016 and with my research group, we put together a lot of stuff in order to collect much more cross-national representative data and to advance the scientific knowledge on adult and substance use and to investigate all the new addictive behaviors because right now ESPA is not only taking account information about illegal substance use and other psychotic substance use but also about gambling, gaming and other risk behavior. And we, with the aim also to support evidence-based policy and to expand as much as possible the research network of international collaborators. So if you are a researcher from a country that is not already part of the ESPA project, please contact us because here you have a picture of all the countries that during the time collaborate with our studies, a big, big number of countries but we miss some of you. So we would like to enlarge our partnership. We are looking for some partners from UK for example. And here you can see how many student participants in the service from 1995 to 2019. So we have more than 600,000 questions from students collected in this big database and our commitment of course is to enlarge the project network and to develop innovative data collection method. We are trying to push our collaborator in ESPA to move, to switch from the paper and pencil collection to the web-administrated collection of fully in the future we will be able to do that so it will be much faster. And to improve the access for research and all the stakeholders and the inspiration from the general public in the data. So from today, the ESPA data will be not only a report that is a beautiful report, it's fantastic and you have to read it. Inside the report we have a lot of information and we have also all the additional table that you can look for but is also a portal, a data portal. Now, Joao please stand the video and then I will show you in this part of the report. Can you share it now? Can you see it now? Ciao, I'm Sabrina Molinaro, ESPA coordinator. ESPA, the European school, serve on alcohol and other drugs. It's a collaborative study that involves more than 40 countries in the European area. ESPA collects data since 1995 among 16 years old students about alcohol use, drug use and other risk behaviors. As a further develop of ESPA project we put together all data from seven waves of ESPA data collection. That means that now we have this huge trend database that include more than 20 years data collection. This sectional treasure is now available for open data consultation. Whatever you are a journalist, a student or a teacher, you can freely join the portal data.espa.org. It's my pleasure to introduce you to the coordination team. I'm Sonia Cerrai, I'm the communication manager. I'm Elisa Benedetti, the project manager. And now enjoy the trend data portal. In the ESPA data portal you can find an interactive map in which you can select substances and domain parameters to see the related results. Trend data are also available for the main substances and indicators. If you are interested in a particular topic you can select it or digit a keyword. All the questions available in the ESPA questionnaires will appear. Then you can refine your search. In case you need to deepen the analysis you can use the advanced search that will be available after registration. Enter a keyword, select the indicators and the data will be visualized in the bottom chart which you can adapt to your needs. You might be interested in comparing results from specific countries and again choose how to visualize them. You can also choose another indicator and select all the available years to obtain the trend and the specific chart. And what if you wish to compare substances and stratify by gender? You will be able to download the charts or save your research in your personal account. Thank you, thank you very much. I think it's a little late so I'm going to show you quickly some part of the website just to let you know how simple it is to go through the data portal. As you see inside the data portal you can have the first level that is a very, very simple to look at. So you will find all the information regarding the southern wave of ESPA. But you also have the possibility to have some maps with some indicator. For example we can choose whatever you like. It is something interesting, all the information of data when you choose the indicator and you can also take a look at different wave and the data from different wave. Inside you have all the information for each country. Of course you can also go and see exactly what is going on in that country. But not only this, in the first level you can also take a look at the trend data. So you have all the information for all the country that collected data in ESPA. For example here we can choose the Greece and of course you can see all the data from all the wave where the country collected and the indicator that we put in. You can split the graph by gender. You have in this part also this interesting section about some topics. Inside you will find all the information, all the publication about some specific topic and it's something that you can consult. So it's very general but it's full of information. Then of course you can move to the second level and the second level is a little bit more complicated but not so much. So for example I asked for a risk and here we found 14 results matching with the term risk. And inside you as you can see you find all the item of ESPA where the word risk is in. For example here you have all the data from the 2019 100,000 of answer and you have all the information. You can also ask for example for Austria data or for I don't know Croatia result in this item and you can choose male and female. So you have all the information collected. That's something that you can do not only for the substances. For example cannabis and you will find all the items related with the word cannabis but also with other for example availability. See you will find all the item related to this topic for the availability we found 25 results. Exactly the same way is very simple is a descriptive level but it's something that I never found in other studies so it's something that make all the data really really usable for all the people. Then you can move to the third level but it's a level that require much more knowledge about the ASPA the questioner because you here you can organize your analysis. Of course we are always talking about the descriptive analysis but let me show you for example for cannabis you find all the indicator related. To the cannabis and here for example we can put an indicator cannabis lifetime and you have the information that is not exactly what I attended but this is the good part of the line. Okay, here as you can see you have the number of occasion for the cannabis but we can hide the is that occasion that normally is the. Bar in the graph and here you have the distribution of the occasion of the cannabis using the lifetime but I'm not happy only with this information, for example, and I want to see this information for all years. Selected so I can compare what was going on in all here that we analyze but I'm not happy either with this information and I want to choose only one countries, for example, Italy, because it's something that is easy for me. And here I have data from Italy that's not the best way to show these so I will change it and I will put years on the bar and I will show another indicator that is the prevalence rate. Then I don't want to the bar but I want to the line and. Here I have another graph that is the trend for the cannabis use in Italy but I want to add another country, for example, let me put. Ukraine and here I have the trend for Italy and the trend from Ukraine, I can have another. Substance, for example, let me see tobacco if I want to see the relationship between the tobacco use cigarette use and here let me find. For example, here I have all the e cigarette is up, first cigarette, e cigarette, e cigarette, down, down is not. On my new case on the market cigarette, on my new case on the most market cigarette here, and here I can compare the cigarette to use with the cannabis use in Italy and in Ukraine, but if I'm not happy with these I can also put the gender and here I have too many. Let me leave the old student too many line so I'm going to split the chart by gender, for example, so that's something that we can do easily and at the very hand I can save my research with the name. The classic Italian name for save something is people and when I go back in the in the in this area will have to log in because I can. I can. register all my research, I will find back all the information that they already collected. That's just the taste of the web portal and here for all your questions, and I hope you will enjoy that's. easily reachable to the as per the portal that is a boo boo boo dot as per dot org so you will find everything you can go in and enjoy or the information. Thank you very much Sabrina for the little presentation I'm very happy that the portal is live and kicking, and I remind you that the dot s about or if you want to access it. I public you want to really thank Sabrina and her team, the Lisa Sonia Lord and and all the colleagues involved in developing the tool but also my colleagues here, David Sonia, Silica Rosberg ethic putting helping and putting out the news release and communication on the portal. So, we will move to the third question with the two last speakers of this morning. And it touches a bit on the as per data so how as per data can be used for interventions and also how virtual reality can influence social norms and I will ask Stephanie and Christian to present so the floor is yours. Again, questions do not forget in the q amp a and chat and we will share with the speakers afterwards. Thank you. Thank you very much for all for the nice introduction also Alexis. I want to present today findings about using as per data for guiding substance use prevention, and some of the findings that you will see here you can probably do also with the data tool which was very impressive thank you Sabrina for this presentation. And first of all, I want to start with the basis for substance use prevention and we'll tell you a little bit more about factors that are associated with alcohol use and cannabis use among European school students. So, we conducted analysis and publish this analysis in 2021. You can see also my co authors among others Joe and other colleagues from the MCDA and also a statistician from the Leibniz Institute of Prevention Research and Epidemiology in Bremen. And thanks again for the nice collaborative work and you can find I think the publication already in the comments. So if you want to have a deeper look in it. Just go ahead. And but first I want to start looking deeply at substance use prevention. Because I think most of you know that accumulating evidence is showing us that the initiation of substance use early in life, contributes to high levels of use and abuse later in life so of course substance use prevention is important. And what does substance use prevention mean, and for many people prevention still means just informing about risks and dangers of behaviors or of substances. And this information alone is not sufficient and there's many students that already show us that they such campaign can even encourage drug use, or they show that students were more curious about using drugs after such campaigns so it's very important that they need a greater understanding of factors that are associated with listed illicit substance use to develop and evaluate effective prevention approaches. For that we did analysis of SBAT data from 2011 and we analyzed data of 26 participating EU countries as you can see I think Savina showed it before it were not all of the participating countries but not all of them included the data that we were interested in. And we had a look at two outcome variables that were proxies for us for risky substance use, and we included drinking to drunkenness in the last 30 days that you can see on the left side, and also using cannabis or use cannabis during the last 12 months on the right side. And the different time spans just that we just choose or they were just choosing because the visit substance use was considerably higher than the illicit substance use. And then we wanted to see which possible factors are associated with substance use and we looked at three different levels we looked at the contextual level the social level and the behavioral level. And we included factors such as perceived rules, peer substance use or school performance. Not all of these factors can be tackled by intervention but most of them or some of them so this could be very interesting, but all of them can inform interventions or preventive interventions. So and first of all I want to show you the data from 2011 in regard to the risky substance use behavior, and we found that the risky substance use behavior was not the behavior of the majority so most of the school students did not drink to drunkenness in the last 30 days. And most of the school students did not use cannabis in the last 12 months. However, there were considerably higher numbers. You can see in Denmark, 36.6% of the students reported drinking to drunkenness in the last 30 days. And in France 35% of the participating school students reported that they used cannabis in the last 12 months. So there's a lot of potential I can see for the preventive interventions. And for this we conducted binary logistic regressions. Don't think about the term but we wanted to find out which factors are associated with the risky substance use behavior. And here you can see on the left side that this is the most important variable that we could found in our model. And this is the perceived substance use of friends. So we asked them how many of your friends get drunk and if they report that all of their friends get drunk or drink to drunkenness or if they perceive that most of the friends or all of the friends drink to drunkenness they have 18 times higher likelihood to drink to drunkenness on their own. So this was a striking result. But also other factors are associated with substance use or with drinking to drunkenness in this regard. Parental support adherence to rules but also school performance. And we repeated this model as well in regard to cannabis use and we found there again that the perceived norms were very, very important. And we found an odds ratio that I've never seen before in my research career of 97. So it means if they perceive that all of the friends use cannabis they have a 97 times higher likelihood to use cannabis on their own. I think this is a very important and this these findings can inform our preventive campaigns that we include this information in, yeah, in prevention. So as social factors are of importance for substance use we think entire perceptions of peer use and parental care, for example, were associated with own substance use. And I think as but provides a very nice database for the planning of interventions or preventive interventions and should be used more often in the future. So my colleague Christiana will continue and tell you about interventions that were based on this findings. Yeah, thank you very much, Stephanie for this introduction so you have now already learned how important the social influence is and I would like to introduce you into two studies to intervention studies that try to influence social norms and another one that tries to build resistance skills and refusal skills with the use of virtual reality with new media. So this these two studies have been conducted in Denmark at the University of Southern Denmark I'm also affiliated with together with quite many colleagues and have been supported by the Danish Druck Foundation. So in the social norm study, the interventions name is the good life in Danish to go Leo. And we developed social norms messages, and they were based on the self reported data of school adolescents on echo use and other drugs. And we highlighted in this intervention, the difference the discrepancy between the perceived norms because adolescents often overestimate what others do as risky behavior, and we show them that the actual reported norms are often much lower. So our intervention and the whole campaign focus on positive and factual behavior among peers. And the messages were tailored for each grade and school because we know that only then social norms messages are relevant for adolescents if they really can identify with the information given. So the intervention consisted of a session in the classroom. In addition with posters and a web application, and the overall duration of the intervention was four to six weeks at each school and grade. So how did the intervention the social norms intervention look like it had actually three components. The first component was a quiz in the classroom where they should guess what their peers are doing. And then they received the actual in the same grade measured percentage like 74% do not drink. The second component was then. In addition, we had then the posters that were hang up at schools in the classroom but also on the floors. And they looked like this they were quite appealing to the kids and they had also social norms messages, like seven out of 10 pupils in ninth grade at Nesb school have never been drunk so it always put the positive moderate behavior in the center. And in addition, we had also a quiz that they could download on their smartphones, which actually had basically the same kind of messages but and they could get guess the right answer. So, Alexis, who still also said it is very important to measure whether the interventions are effective so we did an evaluation and the objective here was to study and investigate if this intervention was able to reduce the perceptions like the overestimation of pure alcohol and drug consumption in this age range of 13 to 17 year old Danish adolescents. We did this in randomized controlled trial where the schools were randomized. And we had a baseline data collection and the three months follow up and in between in the intervention schools, the program was run. And we measured the effect on three different outcomes, whether it was able to reduce the overestimation, whether it was able to reduce the frequent binge drinking as Stephanie has pointed out this is a major problem in and whether the intervention is successful in reducing alcohol related harms. So, in short, the effects of the intervention were that the overestimation like the attitude change was quite successful in the intervention school the overestimation was significantly reduced and the alcohol related harms were significantly reported to a lower degree. We did not find a significant effect on frequent binge drinking, though that was also what Alexis already pointed out from our prevention interventions we cannot expect that each and everyone changes behavior. Right away. However, we found actually also a reduced drinking in a subgroup of pupils and that was those who had the intention to drink more were motivated to drink more in the future. What we also learned from our study was and I will show you these slides in a minute that the more intervention dose the better. The conclusion of the outcome evaluation was that receiving the good life intervention had a positive effect on non perceptions. And frequent binge drinking was only changed among those with motivation to drink more. Our main message is that the social norms intervention have the potential to decrease norm perceptions of peer drinking. So what we also learned from this program and the evaluation of it was that not all pupils actually saw the posters it was only half of them and not all use the web application. But the vast majority took part in the feedback session so this classroom session was very important for the program. We also saw that most of the students liked the all three components and that was also a very important finding here. And what we could also see from our study was that it is when doing social norms interventions it's very important to have a sufficient dose. So because the effect was larger among those who received all three intervention components and it was also larger among those with a high satisfaction who liked the intervention more and those who could recall the social norms messages better. We could not see a dose effect relationship with posters but we know that the posters have been very important for the overall success of the program. So to conclude the participation in our program was highest for the feedback session and lowest for the web app. However, students had overall positive ratings regarding all three intervention components and a high dose of the intervention high satisfaction and high recall of the social norms messages enhanced the effectiveness of this program the good life. I would like now to briefly touch upon a new project, which is using new technology it's called VR FestLab because it aims to achieve better resilience to social pressures among Danish and we have also a German component adolescents. So the objective was to develop a virtual reality training tool. And we wanted to use also an empowerment based living lab approach to grow co produce this game at the simulation together with adolescents. We developed it, therefore not very quick, but it was through a series of workshops with together with young people. And the group consisted of young people of game developers video production experts but also of course prevention practitioners practitioners that are in the field in the schools and with public health experts. So we developed a prototype, and it is now an app that can be downloaded on a smartphone. And that consists of a virtual party simulation where the player can steer his or her own party experience through a series of active choices which are controlled by eye movement. And throughout the simulation, the player is presented to different party scenes and is offered drinks, either alcoholic or soft drinks, but the user can also experience the consequences as shown here in the in the middle picture of alcohol consumption, but also can engage in other fun things than drinking alcohol, like flirting or dancing and will receive social feedback. Again, the social influence component is also embedded in this game the next morning. So we had a very quick user testing with it and you can see here that the overall user feedback was quite positive, most like the game and would like to explore it further. But of course we need more research on this tool. So we have learned already that new technologies such as virtual reality are attractive for pupils. We think it could be a door opener for other alcohol prevention components in this age group, and it may be a helpful component also for multi component interventions for the prevention of substance use. But as I said, more research in this new field is definitely needed. Thank you for your attention. Thank you, Christian and Stephanie, we're still seeing a black screen. Yeah. I think it was very interesting and also for me, quite new dispute on virtual reality and how this can be used for prevention. I think with the four speakers we did like a full circle like we said with the who so what are we talking about when we talk about young people nowadays, then how, how do we find out their characteristics, what they do, if they use dress if they use alcohol if they don't. And, and for what are we collecting the data for so how can we use better data for very interventions and better public health policies. So now it's time for questions from the audience. I've seen that some but please, please feel free to write them down as well. I see a lot of congratulations in the chat so that's for the speakers. I see one question is the expert data portal going to be available in other languages. I find, I guess, the spotlight around on us on this one. I think as a policy which we are trying to have products more and more translated in different languages. We haven't discussed internally and with the aspect coordination about having it available in other languages. So I think one step at a time. Now we published it today. I think we will discuss this and see if it's if it's feasible, because it's quite a complex tool with a lot of information in the background, but on the other hand, we have all the information translated by the countries in the national region, so all the, the aspect questioner so let's see, I don't want to commit because technically I don't know how easy and feasible it is but we will look into it. I would say, is wow that is an interesting question that let us understand that there is an interest and appetite for having this transmitted in more languages. Another question as I suspect the director is still with us would be nice he also read the question and it is about the possible use of this platform or inspiration from this platform for our data for our statistical bulletin. I think again is a nice suggestion I don't know Alexis if you feel you can comment on this. Yes, can you hear me. Yes, we can. Yes, thank you for the question and once more congratulations for the presentations and and regarding the two questions actually I think Jean, you are totally right. That is certainly something we would, we would be ready to do we need to discuss with the partners and colleagues of SPAD of course, we need also to see technically how we can achieve this at also an affordable cost, but certainly this should be done because one of the challenges we we face for everything we do at the CDB actually not only in the cooperation with the SPAD. Sorry is that the majority of people who are working on the field, they are not fluent in English. So certainly there is no way to make those data reaching most of the people who would benefit from it if the information is available only in English. Now, the advantage of the data of SPAD is that we talk about data so the constraints about text are not the same obviously then when we have dedicated sections of our website. But still, I think it's a it's a bit like the smartphones. You get a smartphone that is not in your language until you find where you can find the comment to change the language or to try to understand sometimes you may lose some time. And we talk about something that people know by heart and don't need to know almost to read where they need to click. So, still for SPAD, I certainly would welcome the idea we need to explore the feasibility but certainly I'm happy to support the idea and to explore the feasibility together with SPAD. For the statistical bulletin. Yes, of course. Something I did not mention, because actually that's not the topic of the day is that a new business model was proposed and was adopted by your management board last December. The objective is to transform the MCDDA into a more customer-centric organization. And the way in which we will reach this objective is to in transforming the MCDDA and all the wealth of information it asks into a digital ecosystem over the next three to five years. We are actually working on preparing the next step for the implementation. We have many priorities, but I would say that the two legs of the work and the travel we have to do together are first customers' needs. Because to be customer-centric means that to produce data or collect data for the sake of collecting data is not anymore an objective per se. It was the case 25 years ago because 25 years ago there were no data available at all on the drug situation. So the needs have changed. This is why we need to adapt or offer. And also over the time we have been moving from being an information hub and transforming ourselves into a service provider. So certainly in the second pillar is data foundations. And we need to continue the voyage, the travel using those two main legs, which is one understanding better what are the needs of our key customers. And then to see what are the data or the analysis that we need in order to help them to find an answer to those questions. And this is why the work on data foundations and the work on customer's needs and services to customers will continue to evolve in parallel at the center. And I think there is a lot of work that is developed by Jean and by the other scientific colleagues in order to streamline to improve the data definitions, the metadata, the way we can have queries and the way we make and make them available because I think the very nice demonstration made by Sabrina, what it shows that data should be able to be extracted easily, which is not that easy to make possible. And I think Sabrina had not too much time, but she was quite eloquent in explaining that it has been a long effort. And the second thing is that we need also to assess what are the ways we can help to visualize the data that makes sense. We've been making a lot of work and effort in the last 10, 15 years. The last two, three years we have doing certainly there was an acceleration of analysis of what are the technical needs, the issues, but also the potential we have developed a lot of new dashboards. But now we need to make this available exactly, I think in line with the questions that was asked. We need to make this available through a dynamic interface. And the last word I can say on this for today, we can have a webinar maybe one day about the needs of our customers, for instance. But I think the main difference is when we were established 25 or 30 years ago, the objective was to answer to the question, how many, how much. And we need to create and invent data to answer to that question. Today, there are much more questions before the way to communicate to answer to this question was through reports and through a statistical bulletin and through a first, first generation of website, which means in that time communication was publishing today communication means interaction. And this is why we have, we have done the preparatory work and we table the proposal to our management board to completely change the business model of the center to make this interaction with our partners who are at the same time providers and customers to make it even more agile and more useful in the community. Thank you Alexis. We have a couple more questions. This one is to Sabrina as far as every four years, is it long period every two years will be better or what. Yes, it would be better, but it would be very hard to do so we put together data from 40 countries and we have to homogenize the data collection and the methodology is not easy because as per the is a volunteer network and that means that people have to collect the data from themself and then someone voluntarily with the help with the help of them CDDA of course have to put together the data and it's, it's a good, it's a good study, but for real say is enough for the moment maybe in the future if it will be an indicator and we will find a way to do it in a much more structured way, maybe when we will move in the web, we'll be able to illustrate a data collection it would be easy, but for the moment for you to say the best that we can do. Thank you Sabrina. Yeah, from our side I can confirm that it's working with I think now for the countries it's a long process so every four years I think at the moment is the most feasible option There is a particular interest on the virtual reality components. Have you explored developing this tool for other diseases areas related to changing behavior, to address harms related to substance use or other lifestyle choices, like for example, fat, sleep or disease? No, I personally did not, but of course virtual reality is widely used already in in psychological treatment, especially in terms of anxiety treatment. I myself have also considered to using it for, for instance, sexual behavior and in the sphere of sexual health. So that was also an idea, but I haven't explored it further yet. Thank you, Christian. I saw that you also posted some links in the chat for those that who are asking for references. Exactly, yes. And we got several participants asking for the PowerPoints. We will be making this webinar available on our YouTube channel, so everything will be public quite soon after some editing work. I'm just checking if there are more questions left. We are also reaching our time. Marika, do you see anything else that I missed? Yes, no, just a comment. I saw that Sabrina Smartly is showing us the data on Ukraine. As we are working on some preparedness recommendations for the countries receiving Ukrainian displaced people, I think that this data you depicted can also be useful to check, because up to now we know that people, male, adult male, cannot leave the country, but this does not apply to the young people. So probably we need to study better your data to be able to provide some help to the younger people that can be joining at least the neighboring countries if not the head of Europe. So one more useful application. I think Alexis has already given a lot of input to the webinar, but there is a tradition that is the one concluding in general. I don't know if Alexis, you feel you would like to add something. You are always very generous with your contribution to our work. We really appreciate it. Thank you, Marika. I think I've been listening carefully to the speakers. So first of all, I would like to thank you all. This was very interesting, very useful. Each presentation was different, which is an advantage, because they were complementary, and they gave different perspectives and highlights. One of the things, I would not comment more, please, Diane, to see the new way to make available the DSP data. I think that's really extremely important milestone. So congratulations to Sabrina and the colleagues. Congratulations to my staff who made possible this also cooperation from our side, and we certainly have even more work to do together in the future. I wanted to highlight just a few words or terms or concepts that are nothing new for those of you who know this even better than me, but that I think that are a few points interesting to make. Just telling you what I would keep in mind when I'm leaving this webinar. So what I think it's always very interesting when people work on data, like Margarita said, we are not going to start presenting data. I think that's a good way to start the discussion, because as it was shown also by Stephanie and Christian, the point is we should start from the questions. And sometimes, and I think both the presentation from Margarita, but also from Stephanie and Christian, very well reflected that not only as I learned in my courses of methodology and statistics at the university, everything starts and has to start with the question. And then the second thing that is even more important is that sometimes we need to remind ourselves or some partners or some decision makers that in the best case scenario, at least traditional statistics make only possible for you to conclude that the hypothesis is not wrong. So we are not talking about absolute truth. And this leads me to the third point, which is very well highlighted by those presentation is the fact that what is even more interesting is maybe not to try to prove at any cost that something was successful. Okay, we all wish and hope it has not been a complete failure, even though sometimes we learn more from failure than that from successes. But it's also the fact that from all the research and use of the data that was presented today, we see there are new questions coming. And I think that's really proper to what we can call scientific evidence and scientific work. I have a friend who's a professor in neurobiology at the university. And he was already professor for 20 years when we met and discussed for the first time those things. And I remember I was very surprised I was a young psychologist at that time, still extremely faithful in the power of science. And then he was telling me that basically the more he knew, the less he knew, the more he realized that we knew so little. And therefore, to remind and refresh the minds about that is very important. And this is why I think the different experiences and research presented today are a very good illustration. Already that's very, was very nice to get a reminder that when we speak about youth, there is not one youth that the same everywhere for everybody at the same time. So it also means that when we say we need to move research or transform research into action, is not only one type of action in one single place at a unique time. And I think you each of you, you gave some some interesting examples. What I found also interesting was the reference to the intergenerational approach, which means not only individual or school or family, which I think is very important. There was a reference to mental health issues that are increasingly becoming problematic with the impact of COVID that is still a bit underestimated, I think. But also with the, as Margarita mentioned, the importance of environment. And again, and I think also the presentation from Stephanie and Christian was very interesting with this new project of virtual reality. It's that one thing is to try to influence, to have an influence on behaviors. But also it's also equally important to make available some support, something concrete in the environment. If it is only to speak to people about something, obviously the likely long-term impact is more difficult to guarantee and even to assess. And it reflects also, it's an echo to what we have been told two years ago in one of the first webinars we organized during the first COVID lockdown, which is the fact that many professionals from the field told us how important it was to keep, to maintain and to develop more inclusive policies. That what allowed to be useful for some of the interventions during the COVID pandemic and during the lockdown in some countries was not so much or not only the fact that there were some specialized services or addictive behaviors, but also social services, medical services. And that it's only together that in some cases they managed to innovate and to provide the new responses to emerging new needs and problems. So I really love the prevent, protect, promote, participate overview. And to finish, I think the reflection about the research on the social norms and the perceptions is very interesting and important too, because that's one of the things that usually is not really taken into account or at least not really well understood. And I think your example was very good. It reminded me a few other examples in some of the new member states than those who have been involved in that project, in which, for instance, the fact that the prevalence in cannabis use was so high or had become so high had also in turn an impact on the social perception. So in some cases, the social perception may be kind of overestimated the importance of the new perceptions or new attitudes. Sometimes it's the contrary, it's the increase in the consumption, for instance, the increase in the prevalence that can give the impression that now it's mainstream, so it's normal. So maybe I should do, I should continue. And I can tell you that when this happened, we were discussing in a meeting of the National Drug Coordinators, I think more or less 10 years ago, that some decision makers and also we at EMCDDA, we had to question ourselves and say, those of us who were thinking or sometimes saying that, well, cannabis use was maybe not so harmful or so dangerous because likely to have less negative impact than hard drugs, as they were called 15 or 20 years ago. When you see the concentration in THC, the potency has doubled in the last 10 years. Obviously, we were led to interrogate ourselves and wonder, maybe we kind of, unfortunately and unwillingly, encouraged this change in the perception or this wrong social perception, that it was not so serious or not such a problem and that this has maybe also contributed to a social perception that that became different and that was giving the false impression that, finally, that's normal. And if you want to be normal and mainstream, you should also use. So I think that this move, this cycle of getting some analysis, some information starting from a question, understanding that in fact, it creates or causes some new questions to occur to our mind and to try to design a way to better find a response. I think it's a fantastic opportunity. It was given to us today, starting from the SPAD school survey. I think the effort to make those data available is really important. I can promise we are going to see together with the SPAD coordination and the partners how it would be possible to make it available in more languages in the future. But I think it's extremely important. That's a very concrete and very useful contribution to show what means scientific evidence and how can we use scientific evidence in our work and knowing that this also implies modesty and humility in our work and in the way we present the reasons, because I think that's the really scientific approach. So that was a fantastic example. And I certainly will leave this meeting encouraged and stimulated to continue or travel towards an even more useful EMC DDA, including the different communities of practice around the center. So once more, thank you very much. Thank you to you, Alexis, always a great contributions and commitment to the work. I take this opportunity to thank everybody. We don't add any more words to the conclusion, conclusive remarks by the director. Thank you very much, Sabrina. Thank you, Cristiane. Thank you, Stefanie. And thank you to Margarita Matos, who had to leave before because she had a lesson. Thank you to my colleagues, Joao Maties and Alessandra Bo and all the others that are collaborating to these webinars. I just leave the session open a little bit because it's not nice to expel all the people, but you can go. Thank you very much. Thank you, everybody.