Cigarette and alcohol use at historic low among teens

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The 2011 Monitoring the Future Survey from the National Institute on Drug Abuse (NIDA) shows continued high levels of abuse of alternate tobacco products, marijuana and prescription drugs

Cigarette and alcohol use by eighth, 10th and 12th-graders are at their lowest point since the Monitoring the Future (MTF) survey began polling teenagers in 1975, according to this year's survey results. However, this positive news is tempered by a slowing rate of decline in teen smoking as well as continued high rates of abuse of other tobacco products (e.g., hookahs, small cigars, smokeless tobacco), marijuana and prescription drugs. The survey results appear to show that more teens continue to abuse marijuana than cigarettes; and alcohol is still the drug of choice among all three age groups queried.

MTF is an annual survey of eighth, 10th, and 12th-graders conducted by researchers at the University of Michigan, Ann Arbor, under a grant from the National Institute on Drug Abuse (NIDA), part of the National Institutes of Health. The survey was conducted in classrooms earlier this year.

"That cigarette use has declined to historically low rates is welcome news, given our concerns that declines may have slowed or stalled in recent years," said NIDA director Dr. Nora D. Volkow. "That said, the teen smoking rate is declining much more slowly than in years past, and we are seeing teens consume other tobacco products at high levels. This highlights the urgency of maintaining strong prevention efforts against teen smoking and of targeting other tobacco products."

The 2011 results showed that 18.7 percent of 12th-graders reported current (past-month) cigarette use, compared to a recent peak rate of 36.5 percent in 1997 and 21.6 percent five years ago. Only 6.1 percent of eighth-graders reported current smoking, compared to a recent peak of 21 percent in 1996 and 8.7 percent five years ago.

"While it is good news that cigarette use has declined to historically low rates, we can and must do more to accelerate that decline," said Howard K. Koh, MD, MPH, assistant secretary for health. "The actual decline is relatively small compared to the sharp declines we witnessed in the late nineties."

For alcohol, 63.5 percent of 12th-graders reported past year use, compared to a recent peak of 74.8 percent in 1997. Similarly, 26.9 percent of eighth-graders reported past year use of alcohol in 2011, compared to a recent peak rate of 46.8 percent in 1994. There also was a five-year decrease in binge drinking, measured as five or more drinks in a row in the past two weeks, across all three grades. Binge drinking was reported by 6.4 percent of eighth-graders, 14.7 percent of 10th-graders, and 21.6 percent of 12th-graders, down from the 2006 rates of 8.7 percent, 19.9 percent and 25.4 percent respectively.

Despite the declines noted in the report, use of marijuana has shown some increases in recent years and remains steady. Among 12th-graders, 36.4 percent reported past year use, and 6.6 percent reported daily use, up from 31.5 and 5 percent, respectively, five years ago. The upward trend in teens' abuse of marijuana corresponded to downward trends in their perception of risk. For example, only 22.7 percent of high school seniors saw great risk in smoking marijuana occasionally, compared to 25.9 percent five years ago. Similarly, 43.4 percent of eighth-graders reported that they saw great risk in smoking marijuana occasionally, compared to 48.9 percent five years ago. In addition, concerns about the use of synthetic marijuana, known as K2 or spice, prompted its inclusion in the survey for the first time in 2011. Surprisingly, 11.4 percent of 12th-graders reported past year use.

"K2 and spice are dangerous drugs that can cause serious harm," said Gil Kerlikowske, director of National Drug Control Policy. "We will continue to work with the public health and safety community to respond to this emerging threat but in the meantime, parents must take action. Parents are the most powerful force in the lives of young people and we ask that all of them talk to their teens today about the serious consequences of using marijuana, K2, or spice."

There was mixed news seen in the non-medical use of prescription drugs. Abuse of the opioid painkiller Vicodin was reported by 8.1 percent of 12th graders -- similar to 2010 and down from 9.7 percent in 2009. There was also a decline reported by 10th graders -- to 5.9 percent from 7.7 percent in 2010. However, no such declines were seen for the opioid painkiller OxyContin.

In 2011, the non-medical use of the ADHD medicines Adderall and Ritalin remained about the same as last year among 12th-graders, at 6.5 and 2.6 percent, respectively. There was, however, a significant decline in the abuse of over-the-counter cough medicine among eighth-graders, down to 2.7 percent in 2011 from 4.2 percent in 2006, when the survey first asked about its abuse. A similar decline in cough medicine abuse was seen among 12th-graders, to 5.3 percent from 6.9 percent five years ago.

"To help educate teens about the dangers of prescription drug abuse, NIDA is launching an updated prescription drug section on our teen website," said Dr. Volkow. "Teens can go to our PEERx pages to find interactive videos and other tools that help them make healthy decisions and understand the risks of abusing prescription drugs. We are also encouraging teens to provide feedback on these resources through NIDA's teen blog, Sara Bellum, Twitter, Facebook, YouTube, or email." PEERx can be seen at http://teens.drugabuse.gov/peerx.

Overall, 46,773 students from 400 public and private schools participated in this year's MTF survey. Since 1975, the survey has measured drug, alcohol, and cigarette use and related attitudes in 12th-graders nationwide. Eighth and 10th graders were added to the survey in 1991. Survey participants generally report their drug use behaviors across three time periods: lifetime, past year, and past month. Questions are also asked about daily cigarette and marijuana use. NIDA has providing funding for the survey since its inception by a team of investigators at the University of Michigan, led by Dr. Lloyd Johnston. Additional information on the MTF Survey, as well as comments from Dr. Volkow, can be found at http://www.drugabuse.gov/drugpages/MTF.html. To hear the audiocast of the event, visit: http://www.visualwebcaster.com/MonitoringTheFuture.

MTF is one of three major surveys sponsored by the U.S Department of Health and Human Services that provide data on substance use among youth. The others are the National Survey on Drug Use and Health and the Youth Risk Behavior Survey. The MTF website is: http://monitoringthefuture.org.

The National Survey on Drug Use and Health, sponsored by the Substance Abuse and Mental Health Services Administration, is the primary source of statistical information on substance use in the U.S. population 12 years of age and older. More information is available here.

The Youth Risk Behavior Survey, part of HHS' Centers for Disease Control and Prevention's Youth Risk Behavior Surveillance System, is a school-based survey that collects data from students in grades 9-12. The survey includes questions on a wide variety of health-related risk behaviors, including substance abuse. More information is available here.

The National Institute on Drug Abuse is a component of the National Institutes of Health, U.S. Department of Health and Human Services. NIDA supports most of the world's research on the health aspects of drug abuse and addiction. The Institute carries out a large variety of programs to inform policy and improve practice. Fact sheets on the health effects of drugs of abuse and information on NIDA research and other activities can be found here.

About the National Institutes of Health (NIH): NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases.

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