Adolescent substance abuse in the U.S. declines with exception of cannabis and vaping

Examining data from 536,291 adolescents between 1991-2019, a team of researchers suggest that while the reasons for this phenomenon are not entirely clear they appear to correlate to a number of other social factors. These include increased parental monitoring and decreased partying and dating notable among them.

According to lead author, Noah Kreski, MPH, in the Department of Epidemiology at Columbia Mailman School, a number of demographic factors seem to correlate to increased substance abuse even today.

"Substance use prevalence decreases across decades were largest for the groups defined by significant paid employment or high levels of social time, either with low engagement in other activities or lower levels of supervision, though these groups had the highest initial prevalence of each variety of substance use," says Kreski.

Using data from the National Institute on Drug Abuse (NIDA)'s Monitoring the Future survey the researchers tracked trends in use of cigarettes, alcohol, cannabis, vaping of both nicotine and cannabis, and other substances for school-age student in grades 8 (13-14 years-old), 10 (15-16 years-old) and 12 (17-18 years old), and cross-referenced these habits against demographic factors such as level of social engagement, participation in structured activities, level of adult supervision, and employment. They further analyzed these patterns across race, sex, parental education along with other demographics.

Conversely, substance abuse was higher overall in the highly social and highly engaged groups with less supervision. Time at a paid job was also a significant factor in increasing the chances of trying illicit substances.

Cannabis use increased among all groups, but especially among adolescent workers. Nicotine vaping increased the most among the highly social and engaged group that was less supervised, and cannabis vaping increased most among social but disengaged teens.

"Social settings where adolescents interact with peers, at parties, for example, provide opportunities for substance use, especially in the absence of adult supervision," Kreski says. "These social settings may produce peer pressure for adolescents to engage in substance use in order to fit in."

This may be particularly true of employed adolescents, who regularly interact with older teens and adults. Employed adolescents often come from lower income brackets and are thus propelled into an early "pseudoadulthood," leading them to adopt the habits more typical of people older than they are. Further, cannabis users in particular appear to seek out other cannabis users, leading to social circles in which the drug plays a significant role. Vaping was similarly correlated to social influence.

Analyzing the data further, results show:

• 15 percent of respondents reported any past two-week binge drinking
• 27 percent drank alcohol in the past month
• 15 percent of adolescents smoked cigarettes in the past month
• 13 percent reported any past-month cannabis use
• 9 percent reported past-month use of other substances
• 12 percent reported nicotine vaping
• 6 percent reported cannabis vaping from 2017 onward.

In summary, Kreski noted: "Uncovering these links between complex patterns of time use and substance use outcomes could reveal new opportunities for intervention and education of adolescents surrounding substances, helping to promote declines in use.

"Taken together, while the prevalence of substance use varied drastically between the groups, the trends in substance use tended to be relatively consistent across groups. Further research is now needed to investigate the factors driving these universal trends in adolescent substance use."

The authors suggest that a variety of peer-led and community-based programs may be effective in diminishing use across a broad spectrum of adolescent demographics. They urge further examination of mental health conditions that may lead to substance abuse.

Co-authors are Magdalena Cerdá, NYU Grossman School of Medicine; Qixuan Chen, Deborah Hasin, Silvia Martins, Pia Mauro, Mark Olfson, and Katherine Keyes, Columbia Mailman School of Public Health.

The study was supported by the National Institute on Drug Abuse (grant R01DA048853).