National Adolescent Drug Trends in 2017

Tables summarizing estimates for the drugs discussed below, as well as additional drugs, are here: https://goo.gl/w78A5e. The findings summarized here will be published by the end of April in a forthcoming volume.

Marijuana Use Edges Upward

ANN ARBOR—Marijuana use among adolescents edged upward in 2017, the first significant increase in seven years. Overall, past-year use of marijuana significantly increased by 1.3% to 24% in 2017 for 8th, 10th, and 12th graders combined. Specifically, in 8th, 10th, and 12th grades the respective increases were 0.8% (to 10.1%), 1.6% (to 25.5%) and 1.5% (to 37.1%). The increase is statistically significant when all three grades are combined.

“This increase has been expected by many” said Richard Miech, the Principal Investigator of the study. “Historically marijuana use has gone up as adolescents see less risk of harm in using it. We’ve found that the risk adolescents see in marijuana use has been steadily going down for years to the point that it is now at the lowest level we’ve seen in four decades.”

The results come from the annual Monitoring the Future study, now in its 43rd year. About 45,000 students in some 380 public and private secondary schools have been surveyed each year in this U.S. national study, designed and conducted by research scientists at the University of Michigan’s Institute for Social Research and funded by the National Institute on Drug Abuse. Students in grades 8, 10, and 12 are surveyed.

This increase in marijuana drove trends in any illicit drug use in the past year. In both 12th and 10th grade this measure increased (although the increase was not statistically significant), while use of any illicit drug use other than marijuana declined (although the decrease was not statistically significant). In 8th grade neither of these drug use measures significantly changed, although they both increased slightly.

First-Ever U.S. Standard Estimates for Vaping of Nicotine, Marijuana, and Flavoring

The 2017 survey also reports first-ever national, standard estimates of nicotine vaping, marijuana vaping, flavoring-only vaping, and any vaping. Previously, no national study has published estimates for vaping of specific substances for the standard time periods of past 30 days, past year, and lifetime.

Levels of marijuana vaping are considerable. One in ten 12th grade students vaped marijuana in the past year, and levels were 8% and 3% for 10th and 8th grade students, respectively. These annual levels are about the same as the levels for lifetime prevalence1 of vaping marijuana use, indicating that almost all marijuana vaping had occurred within one year of the survey.

Levels of nicotine vaping are also considerable, with 19% of 12th grade students vaping nicotine in the past year. The annual prevalence levels were 16% and 8% for 10th and 8th grade students, respectively. It is also possible that additional students are getting nicotine in what they vape but are not aware of it, so these are lower bound estimates.

Levels of overall vaping were similar in 2017 to their previous levels in 2016, although the measures are not directly comparable. Updated vaping questions in 2017 asked about vaping of specific substances, while in previous years vaping questions were about any vaping in general. With this caveat, the percentage of students in 2017 who reported vaping flavoring, marijuana, or nicotine was similar to those who reported that they had vaped anything in 2016, with the two respective percentages for use in the past 30 days at 17% in 2017 and 13% in 2016 among 12th grade students, 13% and 11% for 10th grade students, and 7% and 6% for 8th grade students.

“These findings emphasize that vaping has progressed well beyond a cigarette alternative,” said Richard Miech. “Vaping has become a new delivery device for a number of substances, and this number will likely increase in the years to come.”

Cigarettes and Several Other Tobacco Products Decline in Use

Cigarette smoking by teens continued to decline in 2017. For the three grades combined, all measures (lifetime, 30-day, daily, and half-pack/day) are at historic lows since first measured in all three grades in 1991. Since the peak levels reached in the mid-1990s, lifetime prevalence has fallen by 71%, 30-day prevalence by 81%, daily prevalence by 86%, and current half-pack-a-day prevalence by 91%. The prevalence of smoking a half-pack-per-day in the 30 days before the survey now stands at just 0.2% for 8th graders, 0.7% for 10th graders, and 1.7% for 12th graders.

“The health implications of these dramatic declines in smoking are enormous for this generation of young people,” says Lloyd Johnston, the previous director of the study. “Long-term increases in perceived risk and personal disapproval of smoking have accompanied these changes, as has a long-term drop in the perceived availability of cigarettes to these age groups.”

Lifetime prevalence and daily prevalence both fell significantly in 2017; 30-day prevalence fell, but not significantly, and half-pack-a day prevalence held steady at low levels.

Smokeless tobacco also showed a continuing decline this year with 30-day prevalence reaching a low point for the three grades individually and combined. It has fallen for the grades combined by nearly two-thirds, from 9.7% in 1992 to 3.5% in 2017, including a non-significant drop in 2017 of 0.7%.

Snus, a form of smokeless tobacco, showed a significant decline in use this year for the three grades combined (annual prevalence fell from 3.6% to 2.6%).

Use of a hookah pipe to smoke tobacco had been increasing earlier in the decade and reached a substantial proportion of the age group, but annual prevalence has fallen by more than half since 2014, from 23% to 10% in 2017 for the three grades combined (including a significant decline this year of 2.9 percentage points). “The use of hookah appears to be fading out,” conclude the investigators.

Use of both flavored little cigars and regular little cigars is down modestly since first being measured in all three grades in 2014, but did not continue to decline this year. Thirty-day prevalence is at 5.4% for flavored and 3.7% for regular little cigars.

Alcohol Use Levels, After a Long Decline

In general, alcohol use by adolescents has been in a long-term decline that actually first began in the 1980s and was interrupted for a few years during the relapse phase in the substance use epidemic in the 1990s.

In 2017, however, lifetime prevalence, annual prevalence, 30-day prevalence, and daily prevalence all showed little or no change with no significant changes for any grade or for the three grades combined. This is the first time this has happened in many years and may herald the end of the long-term decline in adolescent alcohol use. It is worth noting, however, that prior to this year lifetime prevalence and annual prevalence for the three grades combined both trended down by roughly four-tenths from the peak levels of use reached in the mid-1990s; 30-day prevalence is down by about one-half since then; and daily prevalence is now down by two-thirds. “These are dramatic declines for such a culturally ingrained behavior and good news to many parents,” note the investigators. “However, we saw no further declines in 2017.”

Two measures of heavy alcohol use–having been drunk in the past 30 days and binge drinking (having had five or more drinks in a row at least once in the prior two weeks)—similarly have trended down by over half from their peak rates reached in the mid-to-late-1990s. However, the decline did not continue into 2017. In 2017 binge drinking was reported by 4% of 8th graders, 10%, of 10th graders, and 17% of 12 graders. Extreme binge drinking, defined as drinking 10 or more drinks, or even 15 or more drinks, in a row during a single occasion in the past two weeks was added to the study in 2005. Fortunately, both measures have seen a drop of more than half since their peak rates observed in 2006, but here also no further decline this year.

Use of Inhalants Increases among 8th graders

Use of inhalants significantly increased among 8th grade students in 2017. Inhalant use includes sniffing glue, gases, or sprays, and is an unusual type of substance use because it is more common among younger than older adolescents. In 2017, the percent of 8th grade students who had ever used inhalants in their lifetime increased 1.2% to 8.9%, a significant increase; use in the past 12 months increased 0.9% to 4.7%, also a significant increase. This upturn may mark the end of a gradual decline that started nearly a decade earlier in 2008.

For some years MTF has warned that inhalant use is primed to increase. Perceptions of risk from using inhalants among 8th graders have been steadily declining since 2010 (Table 8-1), which is often a leading indicator of future increases in prevalence.

Any illicit drug use including inhalants also significantly increased among 8th grade students in 2017. Lifetime use increased 2.7% to 23.3% and past 12 month use increased 2.3% to 15.8%, both significant increases. These increases were driven primarily by the upturn in inhalant use.

Heroin and Opioid Use Remains Low Among Adolescents

The opioid epidemic among adults has received much attention in recent months, and MTF offers the opportunity to see what is happening with opioid use among adolescents. Heroin use by adolescents has always been low, and did not significantly change in the 8th, 10th, or 12th grades in 2017, with annual use levels at 0.4% or lower in all three grades.

Misuse of prescription opioids is reported only for 12th grade students; it continued a decade-long decline in 2017, although this year’s decline was not statistically significant. Use in the past 12 months decreased 0.5% to 4.2% in 2017, and is now at a level that is less than half of the 9.5% prevalence recorded in 2004. Vicodin, which has had the highest level of use among the opioid analgesics, showed a significant decline in past 12 month use among 12th graders in 2017 from 2.9% to 2.0%. Its annual prevalence is now at the lowest levels in all three grades observed since it was first included in the study in 2002.

Tables summarizing estimates for the drugs discussed below, as well as additional drugs, are here: https://goo.gl/w78A5e.
The findings summarized here will be published by the end of April in a forthcoming volume.

1 Prevalence refers to the percent of the study sample that report using a drug once or more during a given period — i.e., in their lifetime, past 12 months [annual prevalence], past 30 days, and daily in the past 30 days.

About the Study

Monitoring the Future has been funded under a series of competing, investigator initiated research grants (R01 DA001411 and R01 DA016575) from the National Institute on Drug Abuse, one of the National Institutes of Health. The lead investigators are Richard Miech (principal investigator), John Schulenberg, Lloyd Johnston, Patrick O’Malley, Jerald Bachman, and Megan Patrick—all research professors at the University of Michigan’s Institute for Social Research. Surveys of nationally representative samples of American high school seniors were begun in 1975, making the class of 2017 the 43rd such class surveyed. Surveys of 8th and 10th graders were added to the design in 1991, making the 2017 nationally representative samples the 27th such classes surveyed. The samples are drawn separately at each grade level to be representative of students in that grade in public and private secondary schools across the coterminous United States. The findings summarized here will be published in January in a forthcoming volume: Johnston, L. D., O’Malley, P. M., Miech, R.A., Bachman, J. G., & Schulenberg, J. E. (2018). Monitoring the Future national results on adolescent drug use: Overview of key findings, 2017. Ann Arbor, Mich.: Institute for Social Research, the University of Michigan. The content presented here is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Drug Abuse, or the National Institutes of Health.

Contact

Nicholas Prieur, 734-763-5043, mtfpressrelease@umich.edu

Teen use of any illicit drug other than marijuana at new low, same true for alcohol

6347809375_ec4ddee347_bANN ARBOR—Teenagers’ use of drugs, alcohol and tobacco declined significantly in 2016 at rates that are at their lowest since the 1990s, a new national study showed.

But University of Michigan researchers cautioned that while these developments are “trending in the right direction,” marijuana still remains high for 12th-graders.

The results derive from the annual Monitoring the Future study, now in its 42nd year. About 45,000 students in some 380 public and private secondary schools have been surveyed each year in this national study, designed and conducted by research scientists at U-M’s Institute for Social Research and funded by the National Institute on Drug Abuse. Students in grades 8, 10 and 12 are surveyed.

Overall, the proportion of secondary school students in the country who used any illicit drug in the prior year fell significantly between 2015 and 2016. The decline in narcotic drugs is of particular importance, the researchers say. This year’s improvements were particularly concentrated among 8th- and 10th-graders.

Considerably fewer teens reported using any illicit drug other than marijuana in the prior 12 months—5 percent, 10 percent and 14 percent in grades 8, 10 and 12, respectively—than at any time since 1991. These rates reflect a decline of about one percentage point in each grade in 2016, but a much larger decline over the longer term.

In fact, the overall percentage of teens using any of the illicit drugs other than marijuana has been in a gradual, long-term decline since the last half of the 1990s, when their peak rates reached 13 percent, 18 percent and 21 percent, respectively.

Marijuana, the most widely used of the illicit drugs, dropped sharply in 2016 in use among 8th-graders to 9.4 percent, or about one in every 11 indicating any use in the prior 12 months. Use also declined among 10th-graders as well, though not by a statistically significant amount, to 24 percent or about one in every four 10th-graders.

The annual prevalence of marijuana use (referring to the percentage using any marijuana in the prior 12 months) has been declining gradually among 8th-graders since 2010, and more sharply among 10th-graders since 2013. Among 12th-graders, however, the prevalence of marijuana use is higher (36 percent) and has held steady since 2011. These periods of declining use (or in the case of 12th-graders, stabilization) followed several years of increasing use by each of these age groups.

Daily or near-daily use of marijuana—defined as use on 20 or more occasions in the previous 30 days—also declined this year among the younger teens (significantly so in 8th grade to 0.7 percent and to 2.5 percent among 10th-graders). However, there was no change among 12th-graders in daily use, which remains quite high at 6 percent or roughly one in every 17 12th-graders—about where it has been since 2010.

Prescription amphetamines and other stimulants used without medical direction have constituted the second-most widely used class of illicit drugs used by teens. Their use has fallen considerably, however. In 2016, 3.5 percent, 6.1 percent and 6.7 percent of 8th-, 10th- and 12th-graders, respectively, say they have used any in the prior 12 months—down from recent peak levels of 9 percent, 12 percent and 11 percent, respectively, reached during the last half of the 1990s.

Prescription narcotic drugs have presented a serious problem for the country in recent years, with increasing numbers of overdose deaths and emergencies resulting from their use. Fortunately, the use of these drugs outside of medical supervision has been in decline, at least among high school seniors—the only ones for whom narcotics use is reported. In 2004, a high proportion of 12th-graders—9.5 percent, or nearly one in 10—indicated using a prescription narcotic in the prior 12 months, but today that percentage is down by half to 4.8 percent.

“That’s still a lot of young people using these dangerous drugs without medical supervision, but the trending is in the right direction,” said Lloyd Johnston, the study’s principal investigator. “Fewer are risking overdosing as teenagers, and hopefully more will remain abstainers as they pass into their twenties, thereby reducing the number who become casualties in those high-risk years.”

Users of narcotic drugs without medical supervision were asked where they get the drugs they use. About four in every 10 of the past-year users indicated that they got them “from a prescription I had.”

“That suggests that physicians and dentists may want to consider reducing the number of doses they routinely prescribe when giving these drugs to their patients, and in particular to teenagers,” Johnston said.

Heroin is another narcotic drug of obvious importance. There is no evidence in the study that the use of heroin has risen as the use of prescription narcotics has fallen—at least not in this population of adolescents still in school, who represent over 90 percent of their respective age groups.

In fact, heroin use among secondary school students also has declined substantially since recent peak levels reached in the late 1990s. Among 8th-graders, the annual prevalence of heroin use declined from 1.6 percent in 1996 to 0.3 percent in 2016. And among 12th-graders, the decline was from 1.5 percent in 2000 to 0.3 percent in 2016.

“So, among secondary school students, at least, there is no evidence of heroin coming to substitute for prescription narcotic drugs—a dynamic that apparently has occurred in other populations,” Johnston said. “Certainly there will be individual cases where that happens, but overall the use of heroin and prescription narcotics both have declined appreciably and largely in parallel among secondary school students.”

The ecstasy epidemic, which peaked at about 2001, was a substantial one for teens and young adults, Johnston said. Ecstasy is a form of MDMA (methylenedioxy-methamphetamine) as is the much newer form on the scene, “Molly.”

“The use of MDMA has generally been declining among teens since about 2010 or 2011, and it continued to decrease significantly in 2016 in all three grades even with the inclusion of Molly in the question in more recent years,” Johnston said.

MDMA’s annual prevalence now stands at about 1 percent, 2 percent and 3 percent in grades 8, 10 and 12, respectively.

Synthetic marijuana (often sold over the counter as “K-2” or “Spice”) continued its rapid decline in use among teens since its use was first measured in 2011. Among 12th-graders, for example, annual prevalence has fallen by more than two-thirds, from 11.4 percent in 2011 to 3.5 percent in 2016. Twelfth-graders have been showing an increased appreciation of the dangers associated with these drugs. It also seems likely that fewer students have access to these synthetic drugs, as many states and communities have outlawed their sale by retail outlets.

Bath salts constitute another class of synthetic drugs sold over the counter. Their annual prevalence has remained quite low—at 1.3 percent or less in all grades—since they were first included in the study in 2012. One of the very few statistically significant increases in use of a drug this year was for 8th-graders’ use of bath salts (which are synthetic stimulants), but their annual prevalence is still only 0.9 percent with no evidence of a progressive increase.

A number of other illicit drugs have shown declining use, as well. Among them are cocaine, crack, sedatives and inhalants (the declining prevalence rates for these drugs may be seen in the tables and figures associated with this release.)

Alcohol

The use of alcohol by adolescents is even more prevalent than the use of marijuana, but it, too, is trending downward in 2016, continuing a longer-term decline. For all three grades, both annual and monthly prevalence of alcohol use are at historic lows over the life of the study. Both measures continued to decline in all three grades in 2016.

Of even greater importance, measures of heavy alcohol use are also down considerably, including self-reports of having been drunk in the previous 30 days and of binge drinking in the prior two weeks (defined as having five or more drinks in a row on at least one occasion).

Binge drinking has fallen by half or more at each grade level since peak rates were reached at the end of the 1990s. Today, the proportions who binge drink are 3 percent, 10 percent and 16 percent in grades 8, 10 and 12, respectively.

“Since 2005, 12th-graders have also been asked about what we call ‘extreme binge drinking,’ defined as having 10 or more drinks in a row or even 15 or more, on at least one occasion in the prior two weeks,” Johnston said. “Fortunately, the prevalence of this particularly dangerous behavior has been declining as well.”

In 2016, 4.4 percent of 12th-graders reported drinking at the level of 10 or more drinks in a row, down by about two-thirds from 13 percent in 2006.

Rates of daily drinking among teens has also fallen considerably over the same intervals. Flavored alcoholic beverages and alcoholic beverages containing caffeine have both declined appreciably in use since each was first measured—again, particularly among the younger teens, where significant declines in annual prevalence continued into 2016.

Tobacco

Declines in cigarette smoking and certain other forms of tobacco use also occurred among teens in 2016, continuing an important and now long-term trend in the use of cigarettes. These findings, along with new results on the use of vaporizers like e-cigarettes and hookah, are presented in a companion news release: myumi.ch/LEDoK

The findings summarized here will be published in January in a forthcoming volume. The statistical breakdown by states are not available.

Monitoring the Future

Contacts

Jared Wadley, 734-936-7819, jwadley@umich.edu

Janice Lee, 734-647-1083, mtfinformation@umich.edu

Vaping, hookah use by US teens declines for first time

young woman smoking electronic cigarette on black background

Photo credit: Thinkstock

ANN ARBOR—Teens are lighting up less often when it comes to e-cigarettes and hookahs.

A new study finds that the percentage of U.S. teens who vape declined in 2016—the first significant reversal of a rapid rise in adolescent vaping. The rate grew from near-zero levels of use in 2011 to one of the most common forms of adolescent substance use by 2015, researchers said.

From 2015 to 2016, the percentage of adolescents who vaped in the last 30 days declined from 16 percent to 13 percent among 12th-grade students, from 14 percent to 11 percent among 10th-grade students, and from 8 percent to 6 percent among 8th-grade students. Each of these declines was statistically significant.

These findings come from the University of Michigan’s Monitoring the Future study, which tracks trends in substance use among students in 12th, 10th and 8th grades. Each year the national study, now in its 42nd year, surveys 40,000 to 50,000 students in about 400 public and private secondary schools throughout the United States.

The survey includes questions on the use of vaping devices, which are battery-powered devices with a heating element that produce an aerosol, or vapor, inhaled by users. The vapors come in thousands of flavors, including options such as bubble gum and milk chocolate cream, which are likely attractive to younger teens.

“Whether adolescent vaping has peaked or only paused is something we will be able to determine in the coming years,” said Richard Miech, a senior investigator in the Monitoring the Future project. “In the past, we have seen new drugs follow a pattern in which use increases at a fast pace during a honeymoon period and then reverses course and declines as knowledge of the substance’s drawbacks became known.”

Adolescents associated slightly greater potential harm with vaping in 2016 than they did the previous year, although overall they don’t see them as particularly dangerous to use.

E-cigarettes are the most common vaping device, and from 2015 to 2016, the percentage of adolescents who believe that regular e-cigarette use poses a risk of harm increased from 16 percent to 18 percent in 12th grade, from 17 percent to 19 percent in 10th grade, and from 19 percent to 21 percent in 8th grade.

One potential harm of vaping is that it may lead to use of regular cigarettes. Miech, who has written on the subject, notes that an increasing number of studies show that vaping predicts future cigarette smoking, even among adolescents who had little predisposition to smoke when they started vaping.

“Vaping may lead to friendship networks that encourage vapers to smoke,” he said. “Also, vapers may come to believe the dangers of smoking are exaggerated if they do not experience any immediate health consequences from vaping.”

Hookah use

young man smokes a fragrant hookah

Photo credit: Thinkstock/Okopiniy

Hookah use among U.S. 12th-grade students also declined in 2016, the first significant drop since the survey began tracking hookah use in 2010. From 2015 to 2016, use of a hookah in the past 12 months fell by more than one-third, from 20 percent to 13 percent among 12th-grade students (the survey tracks use only among 12th-grade students).

A hookah user breathes in through a mouthpiece attached to a rubber hose in order to inhale tobacco smoke that passes through water. The tobacco smoke inhaled by a hookah user is just as dangerous as cigarette smoke.

“Hookah use and vaping are two alternative cigarette products that rank among the most commonly used among U.S. youth,” Miech said. “The decline in their use is important so that any reduction in cigarette smoking among U.S. teens is a real reduction in nicotine consumption, and not just a change from one form of nicotine use to another.”

Cigarettes

Teenage girl smoking

Photo credit: PIKSEL/iStock

Cigarette smoking among teens in grades 12, 10 and 8 continued a decades long decline in 2016 and reached the lowest levels recorded since annual tracking began 42 years ago. From 2015 to 2016, the percentage of youth who smoked in the past 30 days fell from 11.4 percent to 10.5 percent among 12th-grade students, from 6.3 percent to 4.9 percent among 10th-grade students, and from 3.6 percent to 2.6 percent among 8th-grade students. The one-year declines in 10th and 8th grade were statistically significant.

“Since the peak year in 1997, the proportion of students currently smoking has dropped by more than three quarters—an extremely important development for the health and longevity of this generation of Americans,” said Lloyd Johnston, the principal investigator of the study.

Such a reduction can translate eventually into preventing hundreds of thousands of premature deaths as well as many serious diseases, he said. More than 400,000 Americans per year are estimated to die prematurely as a result of smoking cigarettes.

Concerted efforts to reduce youth smoking appear to be paying off. These have included increased taxes on tobacco products, restrictions on advertising and promotion, limiting where smoking is permitted, broad based anti-smoking ad campaigns, educational programs in schools, removal of added flavoring to cigarettes (except menthol), and quit smoking programs and products becoming more available. Increases in the price of cigarettes charged by manufacturers have also played an important role.

“While the improvements in the smoking numbers for just this one year are important, of course, the longer term declines are much more so,” Johnston said. “Since teen smoking reached a peak around 1996-1997, the levels of past 30-day smoking have fallen by nearly 80 percent among 8th- and 10th-graders, and by more than 70 percent among 12th-graders. Further, the proportional declines in daily smoking are even larger.”

One important cause of these declines in current smoking is that many fewer young people today have ever started to smoke. In 1996, 49 percent of 8th-graders said they had tried cigarettes, but by 2016 only 10 percent said they had done so—a drop of almost 80 percent in smoking initiation over the past two decades.

Illicit Drugs and Alcohol

Declines in almost all illicit drugs took place in 2016, including marijuana use among 8th- and 10th-grade students, synthetic marijuana and ecstasy. Alcohol use, including binge drinking, also declined. These findings, along with more results on these and other substances, are presented in a companion news release: myumi.ch/JYX4A

The findings summarized here will be published in January in a forthcoming volume. The statistical breakdown by states are not available.

Monitoring the Future

Contacts

Jared Wadley, 734-936-7819, jwadley@umich.edu

Janice Lee, 734-647-1083, mtfinformation@umich.edu

High school jobs: Impact is different for whites and minorities

Teen working

Photo by Thinkstock

ANN ARBOR — African American and Hispanic students are less likely than whites to work part-time in high school, according to a University of Michigan study. But those who do hold jobs tend to work longer hours, and are less likely to suffer negative consequences.

Those are among the findings of a new analysis of data on nearly 600,000 10th- and 12th-grade students, collected between 1991 and 2010 as part of the Monitoring the Future Study conducted by the U-M Institute for Social Research (ISR). The analysis was published online in Developmental Psychology, a journal of the American Psychological Association. Monitoring the Future is funded by the National Institute on Drug Abuse, part of the National Institutes of Health. Continue reading