Abstract: The European School Survey Project on alcohol and Other Drugs (ESPAD) is a collaborative effort of independent research teams in more than forty European countries, making it the largest cross-national research project on adolescent substance use in the world. ESPAD was founded in 1993, on the initiative of the Swedish Council for Information on alcohol and Other Drugs (CAN) and with the support of the Pompidou Group at the Council of Europe. In later years, ESPAD has also established co-operation with the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), a body of the European Union. Most of the European continent is now covered by ESPAD, meaning that it provides a reliable overview of trends in substance use among 15-16-year-old European students. Data are collected every four years. This report presents the results from the fifth wave, conducted in 36 countries during spring 2011. It gives a comprehensive picture of the present situation among European young people as regards the use of tobacco, alcohol, cannabis and other substances, as well as an overview of trends in 1995-2011.