Alcohol is the substance that causes the greatest harm, Minimum Unit Pricing proposals near completion
- Combined Substance Use Strategy achieved 89% overall progress by end of 2025, with 56% of actions completed, whilst alcohol identified as substance causing greatest harm in Bailiwick
- Approximately nine alcohol-specific deaths occur annually, with rate of 12.7 per 100,000; 23.7% of adults drank more than recommended 14 units weekly in 2023
- Comprehensive vaping legislation introduced including ban on sales to under-18s, disposable vapes and advertising restrictions; adult smoking prevalence fell to 9.1%, below 10% target
- QuitVape service launched for 12-18 year olds with 54% of Quitline clients successfully quitting at four-week follow-up; over 700 hours of substance use education delivered in schools
- Up to two-thirds of cannabis used without prescription consists of diverted medicinal cannabis; Community Drug and Alcohol Team received 236 referrals with 78% alcohol-related
Guernsey and Alderney's Combined Substance Use Strategy has achieved 89% overall progress by the end of 2025, with more than half of planned actions completed, according to the annual report published this week.
The strategy outlines progress made to improve the health and wellbeing of islanders and minimise harm caused by alcohol, tobacco, vapes and drugs in Guernsey and Alderney.
A Joint Strategic Needs Assessment completed in 2025 identified alcohol as the substance causing the greatest harm in the Bailiwick, aligning with international evidence showing high levels of alcohol-related ill-health, mortality and socioeconomic impact.
Approximately nine alcohol-specific deaths occur annually in Guernsey and Alderney. Between 2022 and 2024, alcohol-specific deaths were the second leading cause of years of life lost, resulting in 138 years of life lost and 61 working years of life lost annually.
The age-standardised rate for alcohol-specific mortality stood at 12.7 per 100,000, with a significantly higher rate for males at 21.2 per 100,000 compared to 4.6 per 100,000 for females. The alcohol-related mortality rate reached 30.7 per 100,000.
The 2023 Wellbeing Survey revealed that 23.7% of all adults aged 16 and over drank more than the recommended 14 units of alcohol in the previous week. Among adults who drink alcohol, 35.2% exceeded the 14-unit weekly guideline, whilst 15.8% engaged in binge drinking and 18.2% had risky drinking behaviours, with a further 5.9% displaying high-risk behaviours.
The 2026 Annual Budget approved an RPIX increase of 3.3% on alcohol duty rates, whilst the Policy & Resources Committee signalled support for Minimum Unit Pricing. Work is ongoing to bring forward detailed MUP recommendations for the 2027 budget.
By setting a floor value below which a unit of alcohol cannot be sold, Minimum Unit Pricing aims to reduce alcohol-related harm by targeting consumption by those whose drinking is hazardous or harmful, while reducing overall population-level consumption.
Deputy George Oswald, President of the Committee for Health & Social Care, said: "The Strategy has delivered substantial progress across its three operational themes... Through collective effort, we can continue to build a healthier and safer community where the harms of substances are minimised."
Key terms
The Health Improvement Commission delivered multiple public awareness campaigns in 2025, including the annual drink-drive campaign launched on 28 November promoting the Bus, Lift, Taxi message. The Commission also strengthened its Count 14 campaign through refreshed messaging at the Airport and Harbour.
A comprehensive suite of vaping legislation was introduced during 2025 and early 2026 to protect children and young people. On 1 June 2025, a ban on the sale and supply of vapes to under-18s came into effect. On 31 January 2026, a ban on the sale and importation of disposable vapes was implemented.
From 31 March 2026, a ban on advertising and display of vapes was introduced alongside a formal licensing scheme for vape retailers. These measures aim to reduce both the availability and appeal of vape products to young people, who have been disproportionately targeted through marketing and product design.
The 2026 budget introduced a duty rate of £2.20 per 10ml of vaping liquid to be implemented during 2026. Health & Social Care emphasised that duty should be set to make vapes more expensive than tobacco products, recognising vaping's evidence-based role as a smoking cessation tool.
The States Assembly approved a 13.3% increase in tobacco duty for 2026, equating to £1.14 on average per packet of cigarettes. A review of duty-free allowances for tobacco will be brought forward as part of the 2027 budget, responding to concerns that duty-free provision undermines price-related control measures.
Adult smoking prevalence fell to 9.1% according to the 2023 Wellbeing Survey, below the 10% target of the Combined Substance Use Strategy. However, disparities persist with smoking more prevalent among younger adults, individuals living in affordable housing and those with lower incomes. Smoking remains a major cause of preventable mortality, accounting for 10% of all deaths among people aged 35 and over in Guernsey and Alderney.
The Health Improvement Commission's 'Clearing the Air' public consultation published in 2025 found strong support for future tobacco control measures. Some 73% of respondents strongly supported or supported increasing the legal age of sale from 18 to 21, whilst 64% strongly supported or supported increasing the legal age each year, effectively creating a tobacco sales ban for all born after a set date. A total of 65% supported banning smoking in outdoor areas of cafes and restaurants.
The Health Improvement Commission launched a smoke- and vape-free outside dining scheme, working with cafes and hospitality venues. The initiative supports healthier environments, reduces exposure to second-hand smoke and vapour, and reduces visibility of smoking and vaping around children and young people.
Over 700 hours of substance use education covering drugs, alcohol, tobacco and vaping were delivered in 2025 across all schools by Action for Children. Tobacco and vaping lessons were reviewed and revised, supported by the Health, Personal Development and Partnerships Officer.
The Health Improvement Commission continued providing 'Last Orders' by Solomon Theatre Productions to all Year 9 students. For the first time, Alderney pupils joined this event in person in Guernsey, helping students develop skills to understand harm, social pressures and safer decision-making around alcohol use.
A pilot of Risk Avert, a targeted evidence-based intervention programme providing resilience-based early intervention sessions designed to reduce risky behaviours among young people, was delivered in one secondary school in Autumn Term 2025 by Action for Children.
The QuitVape service launched in June 2025, providing tiered support for young people aged 12 to 18 who wish to stop vaping. Tier 1 offers a self-help booklet available online and at schools and community spaces. Tier 2 provides a face-to-face service offering vape tapering advice with extended behavioural support for six sessions. Tier 3 delivers a face-to-face service with immediate vaping cessation and nicotine replacement therapy for those severely addicted to nicotine.
While uptake was lower than anticipated, the pilot demonstrated positive outcomes for those who engaged, confirming the need for an ongoing quit vaping option accessible when young people are ready to quit.
The Quitline Stop Smoking Service saw significant staffing improvements in 2025, now operating with two full-time equivalent permanent staff members supported by three bank staff for community and prison clinics.
In 2025, 210 clients registered with the service and 222 client outcomes were reported. Some 54% successfully quit at four-week follow-up, 21% did not successfully quit and 25% were unable to be contacted or lost to follow-up. The 210 client registrations resulted in 827 face-to-face follow-ups and 443 telephone follow-ups.
The service supported 22 clients to stop vaping, with seven successfully stopping after completing the eight-week programme, six completing the programme but not successfully stopping, and seven not completing the programme.
The rate of pregnant women smoking at booking fell to 8.8%, down from 12.2% in 2024. The rate at delivery decreased to 9.7% from 10.4% in 2024. The higher prevalence at delivery compared to booking indicates relapse among some who initially stopped, highlighting the importance of sustained support.
Of 11 individuals referred to the Quitline Maternity service, five registered for smoking cessation support during pregnancy and fewer than five successfully quit. Low engagement was noted with frequent declined or missed appointments.
Les Nicolles prison has been smoke-free since 2013. The bespoke Quitline service for prisoners supported 26 individuals in custody, with nine successfully completing the programme, six receiving advice only, eight seen pre-release from prison and fewer than five seen in the community post-release.
Prescription-only medication Varenicline was reintroduced in early 2025, extending the range of pharmacotherapy options available to support clients in quit attempts.
The Quarry
The 2023 Wellbeing Survey revealed that 11.9% of respondents used cannabis in the last 12 months, with 1.3% using in the last month and 4.0% in the last week. Of those using cannabis in the last 12 months, 78.8% did not have it prescribed, whilst 66.9% of those without prescriptions reported using medicinal grade cannabis.
This suggests up to two-thirds of cannabis used without prescription consists of diverted medicinal cannabis. Stakeholders expressed concerns regarding widespread normalisation of cannabis use, particularly its visibility around children and young people.
The age-standardised rate of drug poisoning deaths for 2022 to 2024 was 10.9 per million, showing a consistent decrease over time. However, wide and overlapping confidence intervals due to very small numbers mean statistical significance cannot be confirmed with certainty.
The 2023 Wellbeing Survey indicated 2.0% of adults reported using illegal drugs, not including cannabis, in the past year.
The Community Drug and Alcohol Team received 236 referrals in 2025, down from 254 in 2024, with 53% accepted for assessment. Of 199 total assessed referrals, 78% related to alcohol-related problems, 20% to drug-related problems, fewer than 2% to both alcohol and drugs, and fewer than 2% unknown.
Desirable prescribing trends continued for Opioid Substitute Therapy, with stable numbers of service users prescribed opiate substitutes in 2025. However, lack of community-based supervised OST services remains a significant concern due to global pharmacist shortage limiting local capacity.
A critical gap exists in Sunday supervision capacity, currently only delivered by one pharmacy group. CDAT's Sunday supervised clinic was stopped in 2024 due to staffing shortages, increasing risk of diversion of unsupervised substances into the community.
As of October 2025, approximately 100 clients were on Opiate Substitute Therapy, with 88% on supervised consumption. Types prescribed include Buprenorphine, Methadone and Dihydrocodeine. While the 88% supervision rate appears promising, this includes clients on any amount of supervision, hiding instances where more supervision would be beneficial but cannot currently be offered. Only a minority of OST clients are supervised seven days a week.
Independence provides needle exchange services aiming to reduce transmission of blood-borne viruses, provide safer injecting advice and offer opportunities to connect to support services.
The Health Improvement Commission delivered a stigma-reduction workshop for staff at a local media organisation to strengthen understanding of how language influences public perceptions, provide guidance on avoiding stigmatising terminology and encourage constructive reporting highlighting recovery, resilience and support routes.
Several actions are rated red as unlikely to be completed by the end of 2026. These include legislation to ban multi-buys of alcohol, legislation to ban alcohol sponsorship at local sporting events, and legislation to reduce the permissible blood alcohol concentration level for driving to a maximum 50mg per ml, as recommended by the World Health Organisation.
Reasons for non-advancement include complexity of drafting provisions meeting policy intent, limited cross-committee support and strategic shift toward higher-priority legislation such as vaping reforms. These actions have been incorporated into the refreshed Strategy 2027-2032 to ensure continued progress.
Other red-rated actions include delivery of Very Brief Advice, which requires additional resources, and Making Every Contact Count, which is gradually being included but would benefit from dedicated resource to speed implementation.
The refreshed Combined Substance Use Strategy 2027-2032 will build on foundations laid since 2021 and extend scope to include all nicotine products, addressing emerging concerns about nicotine pouches. The strategy will incorporate actions on alcohol marketing, advertising and promotion, continue focus on alcohol as the primary substance of harm, and further consider reducing the permissible BAC limit for driving.
The Quarry
Work is underway to refresh the Young People's Survey, last conducted in 2022, to better understand patterns, attitudes and emerging trends, inform design and targeting of prevention activities, strengthen understanding of local substance use patterns and enable a responsive approach to young people's needs and experiences.
Dr Nicola Brink, Director of Public Health, said: "Alcohol, tobacco, vapes and drugs continue to cause significant and preventable harm in our community. This year's report demonstrates the value of taking a coordinated, evidence-based approach to prevention, policy and support, particularly in protecting children and young people from harm. Our close partnership with the Health Improvement Commission helps ensure that action across legislation, education and services delivers meaningful change to improve health and wellbeing, reduce harm and build a safer, healthier future for all islanders."
Andrea Nightingale, Substance Use Lead for the Health Improvement Commission, said: "Alongside our ongoing prevention activities within the community, our commissioned partners play a vital role in supporting islanders, from prevention and early intervention to treatment and recovery. Their commitment to delivering high-quality, person-centred services ensures people can access the right help when they need it most."
The Strategy operates through collaborative governance involving Health & Social Care, Home Affairs, Health Improvement Commission, commissioned agencies and the Substance Use Technical Team, a multidisciplinary team overseeing implementation.
The full report and annual reports from commissioned services can be accessed via https://www.gov.gg/CSUSAnnualReports.
The Combined Substance Use Strategy (2021-2026) can be accessed via https://www.gov.gg/substanceuse.
Q&A
Q: What progress has the Combined Substance Use Strategy made?
A: The strategy has achieved 89% overall progress by the end of 2025, with 56% of actions completed. A Joint Strategic Needs Assessment identified alcohol as the substance causing the greatest harm in the Bailiwick.
Q: What vaping legislation has been introduced?
A: A ban on sale and supply of vapes to under-18s came into effect on 1 June 2025. From 31 January 2026, disposable vapes were banned from sale and importation. From 31 March 2026, advertising and display of vapes was banned and a formal licensing scheme for vape retailers introduced. The 2026 budget also introduced a duty rate of £2.20 per 10ml of vaping liquid.
Q: What are the alcohol consumption patterns in the Bailiwick?
A: The 2023 Wellbeing Survey found 23.7% of all adults drank more than the recommended 14 units weekly. Among adults who drink, 35.2% exceeded the 14-unit guideline, 15.8% engaged in binge drinking, 18.2% had risky drinking behaviours and 5.9% had high-risk behaviours. Approximately nine alcohol-specific deaths occur annually.
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