Use of cigarettes by American teenagers decreased from 2000 to 2001 according to the annual Monitoring the Future Survey released today by the Department of Health and Human Services. This decline, observed for 8th and 10th graders, continues a decreasing trend begun around 1996. Decreases have also been found for seniors in recent years. These reductions in teenage smoking come on the heels of increases from the early to mid-1990s and are excellent news in the nation's battle to reduce the toll exacted by this leading cause of preventable death and disease.
The survey also found that the rise in use of MDMA (ecstasy) in teenagers seen over the past 2-3 years slowed from 2000 to 2001 among students in grades 8, 10, and 12. In addition, rates of heroin use decreased notably among 10th and 12th graders, and a gradual decline in use of inhalants continued in 2001 with a significant decrease occurring among 12th graders.
"The finding that fewer teenagers are smoking is very encouraging as more teens are making smart choices that will help them avoid tobacco-related health threats," said HHS Secretary Tommy G. Thompson. "Overall, drug use among America's teenagers has remained level or declined for the fifth year in a row, and that's good news. But we must remain vigilant to the threats that heroin, ecstasy, marijuana, alcohol and other dangerous drugs pose to our youth."
Use of most other illicit drugs remained stable from 2000 to 2001. Illicit drug use rates are below their recent peaks in 1996 for 8th graders; for 10th and 12th graders, they remain largely unchanged from recent peak levels seen in 1997. Long-term trends available for 12th graders indicate current levels of illicit drug use are well below their 27-year peaks, which occurred in the late 1970s and early 1980s.
"We are pleased that the trend we noted in 1999 and 2000 that showed teens increasingly using ecstasy appears to have slowed in 2001. And we hope that our concerted effort to give adolescents science-based information about the health risks of ecstasy and other drugs will contribute to a further reduction in the use of these drugs," said Dr. Glen Hanson, acting director, National Institute on Drug Abuse (NIDA).
The most notable change in the 2001 survey was a continuation of the decrease in cigarette use among 8th and 10th graders. Decreases were observed for 8th and 10th graders based on the lifetime, past month, and daily use measures. Past month use declined from 14.6 percent to 12.2 percent among 8th graders, and from 23.9 percent to 21.3 percent among 10th graders. These changes continue a general pattern of declines seen between 1996 and 2000.
The increase in MDMA reported in the last two Monitoring the Future surveys slowed in 2001. While increases were observed in all three grades, they were generally not as steep as in the past two years and were not statistically significant. In addition, the perceived risk of harm from trying MDMA once or twice increased among seniors. Increases in perceived risk are often harbingers of future reductions in rates of use.
Also on the encouraging side, lifetime and past year use of heroin decreased among 10th and 12th graders, and past month use decreased among 12th graders. These changes reflected declines in heroin use without a needle.
Rates of marijuana use in the lifetime, past year, and past month remained unchanged in all three grades, continuing a pattern seen in recent years. Among 8th graders, marijuana use is below its recent peak in 1996. Rates of use among 10th and 12th graders have been stable since their recent high points in 1997.
In addition, 10th graders showed a reduction in use of cocaine. Decreases were found in lifetime use of crack, lifetime use of cocaine in any form, and past year use of cocaine powder.
Alcohol prevalence rates were mostly stable; only two changes were statistically significant: having been drunk in the past year declined among 8th graders; and, daily alcohol use increased among 12th graders.
Marijuana
- Marijuana use in the lifetime, past year, and past month remained statistically unchanged from 2000 to 2001 in each grade. In 2001, past year rates of marijuana use were 15.4 percent of 8th graders, 32.7 percent for 10th graders, and 37.0 percent for 12th graders.
- In the 27 years that the MTF study has collected data, past year prevalence rates for self-reported marijuana use by seniors peaked at 50.8 percent in 1979 and declined to a low of 21.9 percent in 1992. Since then, it reached a relative maximum of 38.5 percent in 1997 and is now at 37.0 percent in 2001.
Cocaine
- Cocaine use, including both cocaine powder and crack, decreased from 2000 to 2001 among 10th graders. Lifetime use of cocaine in any form declined from 6.9 percent to 5.7 percent in this group, lifetime use of crack decreased from 3.7 percent to 3.1 percent, and past year use of cocaine powder declined from 3.8 percent to 3.0 percent.
Heroin
Heroin use declined from 2000 to 2001 among 10th and 12th graders. For 10th graders, past year use decreased from 1.4 percent to 0.9 percent, and for 12th graders it was down from 1.5 percent to 0.9 percent. In addition, lifetime heroin use declined for both these grades. This decrease in overall heroin use among 10th and 12th graders resulted largely from a decrease in use of the drug without a needle (i.e., snorting or smoking it).
- This year's decrease in heroin use among 12th graders reverses an increase in use of the drug in this grade between 1999 and 2000 that brought it to the highest level seen in the history of the survey; the new rate for 2001, 0.9 percent for past year use, is the lowest seen since 1994.
Inhalants
- Rates of inhalant use continued the gradual declining trend seen in recent years, though the decrease from 2000 to 2001 was statistically significant only for 12th graders' past year use of these substances; the rate declined from 5.9 percent to 4.5 percent. In 2001, 9.1 percent of 8th graders, 6.6 percent of 10th graders, and 4.5 percent of 12th graders reported using inhalants in the past year.
Hallucinogen/LSD
- Hallucinogen use overall remained stable from 2000 to 2001 among 8th, 10th and 12th grade students. This stability follows declines between 1999 and 2000 in past month use of these drugs among 10th and 12th graders and in past year use among 12th graders.
- In an exception to this overall pattern of stability for hallucinogens, LSD use showed mixed changes from 2000 to 2001. Past month use increased among 12th graders from 1.6 percent to 2.3 percent, but among 10th graders past year use of the substance declined from 5.1 percent to 4.1 percent.
Steroids
- Seniors' use of steroids in the lifetime, past year, and past month increased from 2000 to 2001. Past year use increased from 1.7 percent to 2.4 percent. Comparable 2001 figures for past year steroid use in other grades were 1.6 percent for the 8th and 2.1 percent for the 10th.
Use of Cigarettes and Smokeless Tobacco
- Cigarette use by 8th and 10th graders declined in several categories between 2000 and 2001. Lifetime use decreased from 40.5 percent to 36.6 percent among 8th graders and from 55.1 percent to 52.8 percent among 10th graders. Past month use declined from 14.6 percent to 12.2 percent among 8th graders, and from 23.9 percent to 21.3 percent among 10th graders. Daily use in the past month declined from 7.4 percent to 5.5 percent among 8th graders and from 14.0 percent to 12.2 percent among 10th graders.
- Recent years have seen several declines in smoking by youth. Reductions in smoking between 1999 and 2000 involved students in all three grades and several categories of use; between 1998 and 1999 past month use declined among 8th graders; and between 1997 and 1998 cigarette use decreased among 10th and 12th graders.
- Use of bidis decreased among 8th and 10th graders. Past year use of these small, flavored cigarettes went from 3.9 percent to 2.7 percent among 8th graders and from 6.4 percent to 4.9 percent among 10th graders.
- Rates of smokeless tobacco use remained statistically unchanged between 2000 and 2001. In 2001, 4.0 percent of 8th graders, 6.9 percent of 10th graders, and 7.8 percent of 12th graders reported using smokeless tobacco in the past month.
Alcohol Use
- Between 2000 and 2001, alcohol use indicators remained mostly stable with some signs of decrease but only two changes that were statistically significant: Having been drunk in the past year declined among 8th graders, from 18.5 percent in 2000 to 16.6 percent in 2001. In an exception to the overall pattern, daily alcohol use increased among 12th graders, from 2.9 percent to 3.6 percent.
Perceived Harm, Disapproval, and Perceived Availability
- Perceived harmfulness of using inhalants increased among 8th and 10th graders. Perceptions of "great risk" from trying inhalants once or twice increased from 41.2 percent to 45.6 percent among 8th graders and from 46.6 percent to 49.9 percent for 10th graders.
- Perceived harmfulness of regularly smoking marijuana decreased from 74.8 percent to 72.2 percent among 8th graders.
- Perceived harmfulness of regularly taking LSD declined from 57.5 percent to 52.9 percent among 8th graders and from 72.0 percent to 68.8 percent among 10th graders.
- Perceived harmfulness of trying MDMA once or twice increased among seniors, the only grade asked; the proportion seeing "great risk" increased from 37.9 percent to 45.7 percent.
- Seniors' disapproval of using heroin once or twice without a needle declined from 94.0 percent in 2000 to 91.7 percent in 2001.
- Disapproval of steroid use decreased among seniors.
- Perceived availability of MDMA (ecstasy) increased sharply among seniors, from 51.4 percent to 61.5 percent.
- The perceived availability of crack and cocaine powder declined among 10th graders. The percent that thought cocaine powder would be "very" or "fairly easy" to get went from 34.5 percent to 31.0 percent.
The Monitoring the Future Survey, conducted by the University of Michigan's Institute for Social Research and funded by the National Institute on Drug Abuse (NIDA), at the National Institutes of Health, has tracked 12th graders' illicit drug use and attitudes towards drugs since 1975. In 1991, 8th and 10th graders were added to the study. The 2001 study surveyed a representative sample of more than 44,000 students in 424 schools across the nation about lifetime use, past year use, past month use, and daily use of drugs, alcohol, and cigarettes and smokeless tobacco.
Monitoring the Future is one of three major surveys sponsored by HHS that provide data on substance use among youth. The other two are the National Household Survey on Drug Abuse (NHSDA) and the Youth Risk Behavior Survey (YRBS).
The NHSDA, sponsored by the Substance Abuse and Mental Health Services Administration, is the primary source of statistical information on illicit drug use in the U.S. population 12 years of age and older. Conducted periodically from 1971 and annually since 1990, the NHSDA collects data in household interviews, currently using computer-assisted self-administration for drug-related items.
The NHSDA reported decreases in rates of smoking among youth 12-17 and 18-25 years of age between 1999 and 2000. These new findings from Monitoring the Future being released today indicate that this positive trend is continuing, particularly among the youngest students. The 2000 NHSDA also found no statistically significant changes in rates of lifetime, past year, or past month illicit drug use among youth 12-17 years old. Data from Monitoring the Future going into year 2001 confirm the continuation of this pattern for the most part, although, as noted previously the new survey findings indicate a drop in heroin use among 10th and 12th graders between 2000 and 2001 and other changes more specific to individual grades. Also consistent with the findings from Monitoring the Future, the NHSDA found an increase from 1999 to 2000 in lifetime use of MDMA among persons 12-17 years old, as well as other age groups.
The Youth Risk Behavior Survey (YRBS), part of the Centers for Disease Control and Prevention's Youth Risk Behavior Surveillance System, is a school survey that collects data from students in grades 9-12. YRBS, which began in 1990 and has been conducted biennially since 1991, includes questions on a wide variety of health-related risk behaviors, not simply drug abuse. The most recent findings from YRBS, for 1999, are available at https://www.cdc.gov/healthyyouth/data/yrbs/index.htm.
While it is somewhat difficult to make comparisons due to the differences in time period, the findings of YRBS and Monitoring the Future appear reasonably consistent with respect to smoking trends. The most recent data from the YRBS reported trends for 1991 through 1999. Toward the end of the period, rates of smoking were becoming stable or declining. The reductions in smoking observed in the Monitoring the Future surveys have been irregular over the 1996-2001 period and varied by individual grades and recall periods but have been particularly important in the past two years. Data from the 2001 YRBS, scheduled for released in the summer or early fall of 2002, will provide a basis for further comparison.
In-depth studies comparing the methodologies of these surveys of youth substance use were published in the summer 2001 issue of the Journal of Drug Issues (volume 31, number 3). These comparisons, commissioned by HHS, concluded that the design, implementation, and documentation of all three surveys are of high quality and that the surveys exhibit no flaws in the execution of basic survey procedures. In addition, the comparison found that the goals and approaches of these three surveys are very different, making comparisons between them difficult. The surveys differ significantly in terms of populations covered, sampling methods, mode of data collection, questionnaires, and estimation methods. Estimates of substance use are generally highest from the YRBS and lowest from the NHSDA. The NHSDA probably produces lower rates because it is done in the home, whereas the other two surveys collect data in school classrooms, away from parents and other family members.
"Lifetime" refers to use at least once during a respondent's lifetime. "Past year" refers to an individual's drug use at least once during the year preceding their response to the survey. "Past month" refers to an individual's drug use at least once during the month preceding their response to the survey.