All authors declare support from the Gates Foundation (INV-056091, INV-048897) for the Commission on Adolescent Health and Wellbeing. DI-J, LTG, SC, LL, SD, RT, AM-K, JMN, YD, and OB report honoraria for their contributions as Youth Commissioners. SS reports royalties from Oxford University Press. AOO reports consulting payments from IPAS, the Society for Family Health, and Plan International Nigeria; royalties from Oxford University Press; a volunteer position on an independent scientific advisory board for a Wellcome Trust-funded study; and nonpaid membership in various organisations, including the Society for Adolescent and Young People’s Health in Nigeria and WHO GAMA. SAM reports honoraria payments from Yale University, Vanderbilt University, Harvard University, New York University, American University, Columbia University, Carleton University, and Northwestern University. DI-J reports payment as a member of the PMNCH Board, is a Youth Advisory Group member of the UGood Project and a board member of IPAS, and holds stock in Pfizer. SAM declares travel support for attending meetings from Wissenschaftskolleg zu Berlin. AOO is a non-paid member of the Society for Adolescent and Young People’s Health in Nigeria and WHO’s Global Action for Measurement of Adolescent Health. AC received travel support to attend meetings afrom the Wellcome Trust, the Australian National Health and Medical Research Council, the Australian Research Council, the European Climate Foundation, the Australian Department of Health and Aged care; the Royal Australasian College of Physicians, and the Victorian Department of Heath. SS declares travel support for meetings from the Human Sciences Research Council and Mastercard Foundation. Commissioners received travel and accommodation support to attend Commission meetings in Kenya (2023) and South Africa (2023), with no payments made to them or their institutions unless otherwise stated. SMS reports an unpaid role as past president of the International Association for Adolescent Health. AE reports financial support through flexible startup funds from Drexel University (made possible by support from Dana and David Dornsife to the Dornsife School of Public Health at Drexel University) for research time and travel. MO’S received subcontract payments through her institutions for her coordination roles for the Commission. JMN, AOO, CL, AKG, CWK, and AM-K received subcontract payments through their institutions for analysis work done for the Commission. All other authors declare no competing interests.
Poor mental health, rising obesity rates, exposure to violence and climate change are among the key challenges facing our adolescents today, according to a global report.
The landmark report, by experts in adolescent health including from Murdoch Children’s Research Institute (MCRI), has revealed how supporting young people’s health and wellbeing could improve economic, social and public health for generations to come.
The 2025 Lancet Commission on Adolescent Health and Wellbeing found investment in adolescents’ health and wellbeing doesn’t match the scale of the problems faced by young people. Bringing together 44 Commissioners and 10 Youth Commissioners, the Commission stated while adolescents make up 24 per cent of the population (about two billion people), they receive just 2.4 per cent of global development and health funding.
By 2030, more than half of adolescents will be living in countries where their demographic experiences an excess burden of complex disease.
The report found the ongoing challenges faced by this age group included:
- High cases of poor mental health and limited support services
- Increasing rates of obesity due to complex environmental and commercial factors
- Lack of digital safety and exposure to cyberbullying and misinformation
- Experiencing violence in conflict-affected areas and within the home
- Ongoing fallout from the COVID-19 pandemic and related public health measures
- Widening gaps in reproductive rights, particularly for young women
- Environmental challenges and climate change impacts
Published in The Lancet, the report predicted that by 2050, 70 per cent of the world’s adolescents will be living in urban areas. While this potentially brings benefits, rapid unplanned urbanisation may also accelerate poverty, isolation and insecure housing, it found.
The report stated that urban, public spaces should be more amenable and tailored to young people, such as safe and engaging spaces to congregate, which would have a powerful effect on health outcomes.
It also found urgent action was required to better protect young people from violence and ensure equitable access to education and reproductive rights. Almost half of adolescents have experienced violence, profoundly impacting their social and emotional development and wellbeing. Whilst global efforts have largely closed the gender gap in high school education, by 2030, almost a third of young women will not be in post-secondary education, employment or training.
MCRI Professor Peter Azzopardi said there was a great need for targeted actions that focused on early intervention.
“Meaningful, evidence-based, multi-sector partnerships with young people will be the key to improving health and wellbeing,” he said. But we must remain accountable by ensuring that any progress is monitored closely and reported on regularly. As our population ages and fertility rates decline, the health of our adolescents becomes even more crucuial.”
Potential solutions and actions outlined included:
- Advocating for change and amplifying the needs and voices of young people
- Developing goal-centred approaches through the Office of the UN Secretary with a focus on measuring and improving adolescent health and wellbeing
- Involving young people in community-based environmental programs
- Scaling up public health programs that improve sexual and reproductive health outcomes and reduce gender-based violence
- Strengthening actions within health and education sectors while reinforcing collaborations
- Limiting the exposure of advertising targeting adolescents
- Promoting and encouraging the healthy use of social media and online spaces
MCRI Professor Susan Sawyer said partnerships with young people were a cornerstone of the report, which aimed to draw on their capability and leadership to help shape the world they wanted to live in.
“This report represents a wealth of current information about the state of our young people’s health,” she said. The findings are alarming and they demand urgent action and accountability, in collaboration with adolescents, to create safer spaces and meaningful change.”
But Professor Sawyer said lack of national leadership around adolescent health remained a major barrier to overcoming the challenges.
“A common myth is that adolescents are healthy and therefore don’t need health services,” she said. Yet our findings show that in every country, adolescents need access to responsive health services that can confidentially identify and respond to their emerging health needs.”
The report will be launched at the World Health Organization’s 78th Health Assembly in Geneva.
Publication: Sarah Baird, Shakira Choonara, Peter S Azzopardi, Prerna Banati, Judith Bessant, Olivia Biermann, Anthony Capon, Mariam Claeson, Pamela Y Collins, Nicole De Wet-Billings, Surabhi Dogra, Yanhui Dong, Kate L Francis, Luwam T Gebrekristos, Allison K Groves, Simon I Hay, David Imbago-Jacome, Aaron P Jenkins, Caroline W Kabiru, Elissa C Kennedy, Luo Li, Chunling Lu, Jun Ma, Terry McGovern, Augustina Mensa-Kwao, Sanyu A Mojola, Jason M Nagata, Adesola O Olumide, Olayinka Omigbodun, Molly O’Sullivan, Audrey Prost, Jennifer H Requejo, Yusra R Shawar, Jeremy Shiffman, Avi Silverman, Yi Song, Sharlene Swartz, Rita Tamambang, Henrik Urdal, Joseph L Ward, George C Patton, Susan M Sawyer, Alex Ezeh and Russell M Viner. ‘A call to action: the second Lancet Commission on adolescent health and wellbeing,’ The Lancet. DOI: 10.1016/S0140-6736(25)00503-3
Available for interview:
Professor Peter Azzopardi, MCRI Group Leader, Global Adolescent Heath
Professor Susan Sawyer, MCRI Group Leader, Adolescent Heath
Standardising the colour and branding of disposable vaping devices may deter young people who have never smoked or vaped from trying them in the first place, suggests a comparative study, published online in the journal Tobacco Control.
But a potential trade-off is that there is a risk it may lead to fewer people switching from smoking to vaping, say the researchers.
Vaping has surged in popularity among young people in many countries over the past decade in tandem with the introduction of cheap disposable devices, point out the researchers.
Previously published research suggests that colourful branded packaging can increase the appeal of cigarettes and vapes to young people. But there’s no current evidence on whether standardising the appearance of disposable vape devices themselves would affect their appeal and perceptions of harm, they add.
To find out, the researchers drew on 15,259 respondents to the 2023 online International Tobacco Control Youth and Youth Adult Tobacco & Vaping Survey. All the respondents were aged between 16 and 29 and living in England, Canada, or the US.
They were randomly assigned to view images of either 4 branded disposable vapes (7638 participants) or 4 standardised white disposable vapes (7621) and asked which vape products they would be interested in trying, and how harmful they thought they were.
Analysis of the responses showed that standardisation increased the percentage of those reporting no interest in trying at least one of the vapes displayed. Just over 67% of those in the standardised group said they weren’t interested in trying any of the devices shown, compared with just under 63% of those in the branded group.
The smallest effect of standardisation was observed among those who had never vaped or smoked: 93% of those in the standardised group reported no interest compared with just over 91% of those in the branded group.
The greatest impact was observed among those who had smoked, but not vaped, within the past month–47.5% in the standardised group vs 37.5% in the branded group–and these are people who would stand to gain from switching entirely from smoking to vaping, say the researchers.
Among those who had vaped, but not smoked, 20% of those shown standardised packaging reported no interest in trying them compared with 16.5% shown branded devices.
Similar effects were observed among people who both smoked and vaped (13.5% vs 9.5%) and among those who formerly smoked or vaped (just over 72.5% vs 65%).
The effects of standardisation on participants’ harm perceptions of the vaping product displayed were minimal, however.
Just over 31% of those in the standardised group viewed the vape product as less harmful than smoking compared with just under 33% in the branded group. There was no clear difference in how standardisation affected harm perceptions across smoking and vaping groups.
Product and packaging regulations have been used by several countries to reduce the appeal of cigarettes. And in January 2024, the UK government announced plans to introduce new measures to ensure that vape manufacturers implement standardised packaging for their products, but it’s not clear what this would look like, say the researchers.
“Our findings suggest that the integration of regulation on device design into new policy further reduces the appeal of vapes to young people. However, compared with people who have never smoked or vaped, the reduction in interest was more pronounced among smokers, who might benefit from using vapes to quit smoking.
There is a risk that the public health benefits of preventing youth uptake of vaping could be offset by a decline in the number of young people transitioning from smoking to exclusive vaping, or an increase in relapse from exclusive vaping to smoking, including dual use,” they add.
They conclude: “For countries interested in discouraging vaping among young people, standardising the colour of vaping devices could be considered alongside standardised packaging as a potential policy option.
“However, there may be unintended consequences in terms of discouraging those who smoke from switching to vaping, which should be further investigated and possibly balanced with other targeted policies to encourage smoking cessation.”
Method of Research
Observational study
Subject of Research
People
Article Title
Impact of standardising the colour and branding of vape devices on product appeal among young people: a randomised experiment in England, Canada and the United States
Article Publication Date
20-May-2025
COI Statement
Competing interests The authors have never had any financial links to the tobacco or e- cigarette industries or their representatives. JB has received unrestricted research funding from Pfizer and J&J, who manufacture medically licensed smoking cessation medications. DH has served as a paid expert witness on behalf of public health authorities in response to legal challenges from tobacco, vaping, and cannabis companies.
