The survey Epidemiological Survey on Substance Abuse in Germany 2018 (ESA) is a representative survey on the use and abuse of psychoactive substances among adolescents and adults aged 18 to 64 years, which has been conducted regularly nationwide since 1980. The data collection took place between March and July 2018 and was conducted by infas Institut für angewandte Sozialwissenschaft GmbH on behalf of the IFT, Institute for Therapy Research in Munich. The nationwide study was conducted in a mixed-mode design as a standardised telephone survey (CATI: Computer Assisted Telephone Interview), as a written-postal survey (PAPSI: Paper and Pencil Self Interview) and as an online survey. The study is financially supported by the Federal Ministry of Health. The survey covered 30-day, 12-month and lifetime prevalence of tobacco use (tobacco products as well as shisha, heat-not-burn products and e-cigarettes), alcohol, illicit drugs and medicines. For conventional tobacco products, alcohol, selected illicit drugs (cannabis, cocaine and amphetamines) and medications (painkillers, sleeping pills and tranquillisers), additional diagnostic criteria were recorded with the written version of the Munich Composite International Diagnostic Interview (M-CIDI) for the period of the last twelve months. Furthermore, a series of socio-demographic data, the physical and mental state of health, nutritional behaviour, mental disorders as well as modules on the main topics of children from families with addiction problems, reasons for abstinence in the field of alcohol and the perception or knowledge of the health risk posed by alcohol were recorded. Physical and mental health status: self-assessment of health status; self-assessment of mental well-being; chronic illnesses; frequency of physical problems or pain without clear explanation, anxiety attack / panic attack, frequent worries, strong fears in social situations, strong fears of public places, means of transport or shops, strong fears of various situations, e.g. use of lifts, tunnels, aeroplanes as well as severe weather, sadness or low mood, loss of interest, tiredness or lack of energy, unusually happy, over-excited or irritable, stressful traumatic events, psychiatric, psychological or psychotherapeutic treatment in the last 12 months; physical activity and diet in the last three months: frequency of physical activity (moving from place to place, recreational sports, work-related physical activity) per week; duration of physical activity; consumption of selected foods (low-fat dairy products, raw vegetables, fresh salads, herbs, fresh fruit, cereal products, herbal tea or fruit tea); illness caused by excessive alcohol consumption. 2. Medication use: type of medication use (painkillers, sleeping pills, tranquilizers, stimulants, appetite suppressants, antidepressants, neuroleptics and anabolic steroids) in the last 12 months; frequency of use of painkillers, sleeping pills, tranquilizers, stimulants, appetite suppressants, antidepressants and neuroleptics in the last 30 days and respective prescription by a physician; use of painkillers, sleeping pills or tranquilizers in the last 12 months; tendencies towards dependence: In the last 12 months, the following were asked: significant problems related to the use of painkillers, sleeping pills and tranquillisers (neglect of household and children, poor performance, injury-prone situations while under the influence of medication, unintentional injuries such as accidents or falls, legal problems, accusations from family or friends, broken relationship, financial difficulties, physically attacking or hurting someone, use in larger quantities or for longer periods than prescribed or intended by the doctor, discomfort when stopping the medication. discomfort when stopping the medication and then continuing to take the medication to avoid discomfort, higher doses required for desired effect or weakened effect, unsuccessful attempts to reduce or stop medication use, large amount of time required to obtain medication or recover from effects, restriction of activities, taking medication despite knowledge of harmful effects, craving for medication so strong that resisting or thinking otherwise was not possible. 3. Smoking: smoking status; smoking behaviour: smoked more than 100 cigarettes, cigars, cigarillos, pipes in total during lifetime; type of tobacco use (cigarettes, cigars, cigarillos, pipe); age of initiation of tobacco use; time of last tobacco use; specific number of days in the last month on which cigarettes (or cigars, cigarillos or pipes) were smoked and average number smoked per day; average daily consumption of 20 or more cigarettes (or 10 cigarillos, 7 pipes, 5 cigars) in the last 12 months; smoking behaviour in the last 12 months (had to smoke more than before to get the same effect, effect of smoking decreased, smoked much more than intended, tried unsuccessfully to cut down or quit smoking for a few days, chain smoker, gave up important activities because of smoking, continued to smoke during serious illness, smoking interfered with work, school or housework, smoked in situations where there was a high risk of injury, continued to smoke even though it made other people angry or unhappy, unable to resist strong cravings for tobacco, unable to think of anything else because of strong cravings for tobacco); physical or mental health problems in the last 12 months due to smoking; continued to smoke in spite of physical or mental health problems; health problems due to smoking cessation in the last 12 months (low mood, insomnia, irritability/annoyance, restlessness, difficulty concentrating, slow heartbeat, weight gain); started smoking again to avoid complaints; serious attempts to stop smoking in the last 12 months; successful attempt to quit smoking; ever used shisha (hookah), a Neat-Not-Burn product or an e-cigarette, e-shisha, e-pipe, e-cigar and time of last use; age at first use of e-cigarette/e-cigar/e-shisha/e-pipe and frequency of use in the last 30 days; use of e-cigarettes/e-cigars/e-shishas/e-pipes with or without nicotine. 4. Alcohol consumption: age at first glass of alcohol; alcohol consumption at least once a month; age of onset of regular alcohol consumption; alcohol excesses (binge drinking) in the past and frequency of alcohol excesses in the last 12 months; age at first alcohol excess; time of last alcohol consumption; total number of days with alcohol consumption in the last 30 days or 12 months; concrete information on the average amount of beer, wine/sparkling wine and mixed drinks containing alcohol (alcopops, long drinks, cocktails or punch) consumed in the last 30 days or 12 months. 12 months; concrete information on the average amount of beer, wine/sparkling wine, spirits and mixed drinks containing alcohol (alcopops, long drinks, cocktails or punch) consumed in the last 30 days or in the last 12 months; number of days with consumption of at least five glasses of alcohol in the last 30 days or 12 months; problems caused by alcohol in the last 30 days or 12 months; number of days with consumption of at least five glasses of alcohol in the last 30 days or 12 months. 12 months; problems caused by alcohol in the last 12 months (significant difficulties at work, school or home, situations involving risk of injury, trouble with the police, accusations from family or friends, broken relationship, financial difficulties, physically attacking or hurting someone); alcohol consumption behaviour in the last 12 months (had to drink more than before to get the same effect, effect of alcohol consumption decreased, drank much more than intended, tried unsuccessfully to drink less alcohol or to stop drinking altogether, drank a lot of alcohol over several days, been drunk or suffered from the effects of alcohol, gave up important activities because of alcohol, could not resist strong craving for alcohol, could not think of anything else because of strong craving for alcohol); symptoms after alcohol withdrawal (trembling, insomnia, anxiety, sweating, hallucinations (seizure), nausea, vomiting, urge to move, rapid heartbeat); drank alcohol to avoid such complaints; physical illnesses or mental problems related to alcohol in the last 12 months; alcohol consumption despite physical or mental problems; increased cancer incidence in the last 12 months; alcohol consumption in spite of physical or mental problems. increased cancer risk due to alcohol consumption (stomach cancer, ovarian cancer, breast cancer, mouth and oesophagus cancer, brain tumour, bowel cancer, liver cancer, bladder cancer); alcohol consumption in the last 30 days; personal reasons for abstaining from alcohol (alcohol causes people to lose control, condition of illness worsens due to alcohol, parents had an alcohol problem, family is against alcohol consumption, alcohol consumption is against my spiritual/religious attitude, I do not like the taste and/or smell of alcohol, own pregnancy or partner´s pregnancy). 5. Drug use: drug experience with cannabis (hashish, marijuana), stimulants, amphetamines, ecstasy, LSD, heroin, other opiates such as e.g. codeine, methadone, opium, morphine), cocaine, crack, sniffing substances and mushrooms as intoxicants or never tried any of these drugs before; ever used substances that imitate the effect of illegal drugs (legal highs, research chemicals, bath salts, herbal mixtures or new psychoactive substances (NPS); used such legal substances in the last 12 months; form of substances consumed (herbal mixtures for smoking, powders, crystals or tablets as well as liquids); generally tried drugs; frequency of drug use in total, in each case related to cannabis (hashish, marijuana), stimulants, amphetamines, ecstasy, LSD, heroin, other opiates, cocaine, crack cocaine, sniffing substances, mushrooms resp. Legal highs, research chemicals, bath salts, herbal mixtures, NPS; time of last use of any of the above drugs (in the

The survey Epidemiological Survey on Substance Abuse in Germany 2018 (ESA) is a representative survey on the use and abuse of psychoactive substances among adolescents and adults aged 18 to 64 years, which has been conducted regularly nationwide since 1980. The data collection took place between March and July 2018 and was conducted by infas Institut für angewandte Sozialwissenschaft GmbH on behalf of the IFT, Institute for Therapy Research in Munich. The nationwide study was conducted in a mixed-mode design as a standardised telephone survey (CATI: Computer Assisted Telephone Interview), as a written-postal survey (PAPSI: Paper and Pencil Self Interview) and as an online survey. The study is financially supported by the Federal Ministry of Health. The survey covered 30-day, 12-month and lifetime prevalence of tobacco use (tobacco products as well as shisha, heat-not-burn products and e-cigarettes), alcohol, illicit drugs and medicines. For conventional tobacco products, alcohol, selected illicit drugs (cannabis, cocaine and amphetamines) and medications (painkillers, sleeping pills and tranquillisers), additional diagnostic criteria were recorded with the written version of the Munich Composite International Diagnostic Interview (M-CIDI) for the period of the last twelve months. Furthermore, a series of socio-demographic data, the physical and mental state of health, nutritional behaviour, mental disorders as well as modules on the main topics of children from families with addiction problems, reasons for abstinence in the field of alcohol and the perception or knowledge of the health risk posed by alcohol were recorded.
1. Physical and mental health status: self-assessment of health status; self-assessment of mental well-being; chronic illnesses; frequency of physical problems or pain without clear explanation, anxiety attack / panic attack, frequent worries, strong fears in social situations, strong fears of public places, means of transport or shops, strong fears of various situations, e.g. use of lifts, tunnels, aeroplanes as well as severe weather, sadness or low mood, loss of interest, tiredness or lack of energy, unusually happy, over-excited or irritable, stressful traumatic events, psychiatric, psychological or psychotherapeutic treatment in the last 12 months; physical activity and diet in the last three months: frequency of physical activity (moving from place to place, recreational sports, work-related physical activity) per week; duration of physical activity; consumption of selected foods (low-fat dairy products, raw vegetables, fresh salads, herbs, fresh fruit, cereal products, herbal tea or fruit tea); illness caused by excessive alcohol consumption.

1. Medication use: type of medication use (painkillers, sleeping pills, tranquilizers, stimulants, appetite suppressants, antidepressants, neuroleptics and anabolic steroids) in the last 12 months; frequency of use of painkillers, sleeping pills, tranquilizers, stimulants, appetite suppressants, antidepressants and neuroleptics in the last 30 days and respective prescription by a physician; use of painkillers, sleeping pills or tranquilizers in the last 12 months; tendencies towards dependence: In the last 12 months, the following were asked: significant problems related to the use of painkillers, sleeping pills and tranquillisers (neglect of household and children, poor performance, injury-prone situations while under the influence of medication, unintentional injuries such as accidents or falls, legal problems, accusations from family or friends, broken relationship, financial difficulties, physically attacking or hurting someone, use in larger quantities or for longer periods than prescribed or intended by the doctor, discomfort when stopping the medication. discomfort when stopping the medication and then continuing to take the medication to avoid discomfort, higher doses required for desired effect or weakened effect, unsuccessful attempts to reduce or stop medication use, large amount of time required to obtain medication or recover from effects, restriction of activities, taking medication despite knowledge of harmful effects, craving for medication so strong that resisting or thinking otherwise was not possible.

2. Smoking: smoking status; smoking behaviour: smoked more than 100 cigarettes, cigars, cigarillos, pipes in total during lifetime; type of tobacco use (cigarettes, cigars, cigarillos, pipe); age of initiation of tobacco use; time of last tobacco use; specific number of days in the last month on which cigarettes (or cigars, cigarillos or pipes) were smoked and average number smoked per day; average daily consumption of 20 or more cigarettes (or 10 cigarillos, 7 pipes, 5 cigars) in the last 12 months; smoking behaviour in the last 12 months (had to smoke more than before to get the same effect, effect of smoking decreased, smoked much more than intended, tried unsuccessfully to cut down or quit smoking for a few days,...