Widespread drops in youth use might be alcohol- and tobacco-related

National leaders are attributing some historic decreases in youth use of illicit substances to declines in use of tobacco and alcohol, which might be serving to shrink the pool of young people likely to experiment with illegal drugs.

Federal officials sounded a largely upbeat tone Tuesday as they formally unveiled the results of the 2016 Monitoring the Future survey. In addition, the architect of the annual survey stated in his retirement year that he was hard-pressed to recall another year in which use declines in all grade levels included in the survey (8th, 10th and 12th) were so widespread.

“Many fewer young people today are using cigarettes or alcohol, which tend to be the first drugs that many young people get into,” University of Michigan investigator Lloyd D. Johnston, PhD, said during a media teleconference on Tuesday morning. “I think that it's quite possible that that's contributing to the number of people who move on to the illicit [substances].”

The daily smoking rate for high school seniors now stands at 4.8%, after having been at 22.2% back in 1996. A number of measures of alcohol use also continue their downward trend of recent years. For example, the binge drinking rate among 12th-graders is now at 15.5%, after having been 31.5% at its peak in 1998, and binge drinking among 8th-graders is at its lowest rate since that statistic began being measured in 1991.

The gateway theory regarding tobacco appears to be bolstered by research findings indicating that nicotine affects the biology of the reward system in a way that can affect individuals' response to other drugs that they might try, said Nora D. Volkow, MD, director of the National Institute on Drug Abuse (NIDA).

Marijuana arguably remains the drug with the most-watched trends in recent youth use, because of changing public policies toward the drug. While moves toward legalization continue to drive a lower perceived risk from the drug, that does not appear to be translating to wider use by young people. The latest survey shows a decline in past-month use of marijuana among 8th-graders (from 6.5% last year to 5.4% in 2016), and relatively stable levels of past-month and past-year use among 10th- and 12th-graders (22.5% of high school seniors reported past-month use of marijuana in 2016).

“It's very encouraging to see more young people making healthy choices and choosing not to use substances,” said Michael Botticelli, director of the Office of National Drug Control Policy (ONDCP).

Effects of prevention

Johnston added that another factor likely at work in the overall declines in youth substance use involves the effects of efforts at the community level to reduce youth access to substances, particularly tobacco and alcohol.

Somel of the use decreases that are documented in the school-based Monitoring the Future survey came as a surprise to national leaders. University of Michigan researcher Richard A. Miech, PhD, who will lead the annual survey following Johnston's retirement, pointed out that use of electronic cigarettes declined in this year's survey for the first time since these devices emerged in the market. This news comes shortly after a U.S. Surgeon General's stern warning about potential harms associated with e-cigarettes, in a report issued last week.

“It could well be that the novelty of vaping has worn off,” said Miech, and/or that young people no longer consider it “cool” to use e-cigarettes. This year's survey documented some increases in the youth disapproval rate toward regular use of e-cigarettes.

Volkow added it is possible that certain factors not yet identified by researchers might be having a protective effect against youth substance use. One factor that merits further investigation involves whether widespread youth communication via social media is altering the social context under which substances might or might nor be used, she said.

Marijuana policy impacts

Volkow said that while efforts to legalize some marijuana use appear to be linked to increases in overall use among adults, those patterns do not appear to be occurring with young people overall. Still, marijuana use among 12th-graders is higher in states that have adopted medical marijuana laws than in states where there is no allowed medical use (38.3% past-year use in medical marijuana states and 33.3% in the other states).

Johnston added that because there is still not a critical mass of data available for states where recreational use of marijuana has been legalized, national surveys such as Monitoring the Future cannot yet capture trends in that area. Individual state surveys, such as in Colorado, have shown some recent increases in youth use, he said.

In response to a media question about the potential influence of healthcare professionals on youth prevention, Volkow said better evaluation of youths might uncover more instances in which young people are using substances to self-medicate an undiagnosed mental health issue. For example, she said, nicotine can result in improved attention capacity in youths with symptoms of attention-deficit/hyperactivity disorder (ADHD).