Drug Use - It features quite prominently in the game but the drugs are fictionalised (some aren't even remotely based on "real world" drugs). They are used to temporarily boost stats in specific skill areas (e.g. "Psycho" boosts your ability to damage enemies, "Med-X" increases your resistance to damage...). Most of them carry health consequences for the player, including addiction, which can only be cured by going cold turkey and visiting a doctor. This is, potentially, a good lesson for kids.
Violence - Probably the strongest "adult" content in the game. Normal fighting is not much more explicit than your average FPS, although that does include decapitating and dismembering enemies with gunfire. The real hard stuff is when the player utilises the turn-based VATS combat system - you can spend "action points" to slow down the action and select enemies' body parts to attack (head, legs, antennae, whatever...), giving you a strategic advantage in a gunfight, and then the action is played out in slow motion, including slo-mo blood spurts and disintegrating limbs. This is the real reason the game is rated "18" in the UK.
Sexual Themes - Pretty much negligable. There are is one bar when you can rent a room to sleep in, and a female NPC (apparently a hooker) comes in and lies on the bed next to your character. No sexual dialogue, no nudity, nor any real suggestion that anything other than sleeping actually takes place. There are some other bits and pieces elsewhere - slavers trying to capture women and children to sell (they never really say what for, but I can guess), some very oblique dialogue references, etc. All much milder than even, say, a Bond movie.
Language - There is some strong language in the game, but it's not over used. You get some very occasional f-words in dialogue with characters (one of them a kid), and the odd obscenity shouted by raiders and evil characters when you attack them. Honestly though, I've been playing this game for weeks and on average I don't think I've heard more than one "fuck" or "bastard" per hour of gameplay. So yeah, it's there, but compared to a lot of games these days (Grand Theft Auto 4 and even Rainbow Six Vegas 2, for example), it's playground stuff.
Would I let a 12 year old play it? Well, it depends on the 12 year old. If your son has a clear understanding of right and wrong and is streetwise enough not to be disturbed by some gore and swearing, then I'd say it it's fine. But if he is young for his age and still has a developing "moral compass", I'd think twice. You are free to make a lot of choices in this game - you can become an utter scoundrel who kills helpless people and sells the survivors into slavery, or you can become a chivalrous champion for hope and freedom in the Wasteland, with consequences for both choices. If you think your son is old enough to understand this, I'd go as far to say the game could actually teach him a few valuable lessons, but if not... I'd wait a year or two.
My little brother is 11 and play it, though. And he's not started murdering people yet... 
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Originally Posted by CoinReturn
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