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According to the trend data in the report, an estimated 9.0 percent of youths age 12-17 reported current illicit drug use in 1999, meaning they used an illicit drug at least once during the 30 days prior to the time of the survey interview. There is a significant consistent downward trend over the last three years, from a 11.4 percent in 1997 to 9.9 percent in 1998 and 9.0 percent in 1999.

For the first-time ever, the survey provides state-by-state estimates of illicit drug, alcohol and cigarette use by age group, as well as information about the brands of cigarettes that Americans smoke. This new, expanded data on demographic and geographic populations will be a valuable tool for states and community-based organizations to better tailor their programs to their communities. According to this new expanded survey, current drug use varies substantially among states, ranging from a low of 4.7 percent to a high of 10.7 percent for the overall population, and from 8.0 percent to 18.3 percent for youths age 12-17.

"We now have a consistent downward trend in drug use among teenagers that is very gratifying," said Secretary Shalala. "We must continue to build on our recent efforts to push the rate of drug use down further and to address the real threat to our young people from tobacco and alcohol. Parents and teachers are our strongest allies in the battle to keep our young people drug-, alcohol- and tobacco-free, but Congress can and should do more to help communities in this fight."

Barry McCaffrey, Director of the White House Office of National Drug Control Policy, said, "The survey provides extremely encouraging news that teen drug use is going down significantly. However, we must be aware that the younger a person is when first trying marijuana, the greater the risk of drug dependency later. Young people may think that they are only experimenting, but, as this study shows, they are really gambling with their futures."

Marijuana use for youths age 12-17 has also decreased since 1997 (9.4 percent in 1997, 8.3 percent in 1998, and 7.0 percent in 1999). Among youths age 12-17, the rate for cigarette use was 15.9 percent in 1999, not statistically different than in 1998 (18.2 percent), but significantly lower than the rate in 1997 (19.9 percent). Marlboro, Newport and Camel account for the vast majority of adolescent cigarette smoking, with 54.5 percent of current smokers age 12-17 reporting Marlboro as their usual brand.

In a separate study, HHS reported that the number of emergency room visits for drug-related reasons decreased 11 percent for youths age 12-17 from 1998 to 1999. The 1999 Drug Abuse Warning Network (DAWN) records drug-related emergency department episodes, not drug use prevalence, and helps provide a fuller picture of drug problems across the country. Overall, there were more than 550,000 drug-related hospital emergency department episodes in the United States in 1999.

Among other national trend data, the National Household Survey also showed current use of cocaine, inhalants, hallucinogens and heroin for individuals age 12 and older was stable, and use of smokeless tobacco did decrease significantly from 3.1 percent in 1998 to 2.2 percent in 1999.

Among youths age 12-17, current use of cocaine, heroin, hallucinogens and inhalants remained stable. The survey also showed there were no significant changes in the percent of youths who report great risk of using marijuana once a month (30.8 percent in 1998 to 29.0 percent in 1999). Among youths age 12-17, perceived risk of cocaine use decreased significantly from 54.3 percent in 1998 to 49.8 percent 1999.

The national trends from the National Household Survey are generally consistent with results from other HHS surveys. Both the Monitoring the Future Study and the Youth Risk Behavior Survey have shown a leveling or declining trend in illicit drug use, marijuana and cigarette use among adolescents since 1997, after a period of significant increases in the early 1990s.

The rate of current alcohol use among youths 12B17 and the general population has remained relatively flat for the past several years. According to national trend data in 1999, 19 percent of youth age 12-17 reported that they drank at least once in the past month and 52 percent of Americans age 12 and older reported current alcohol use. In 1999, 7.8 percent of youths age 12-17 reported past month binge drinking and 3.6 percent reported past month heavy alcohol use.

Among adults age 18-25, the survey found increases in current illicit drug use. The rate increased between 1997 and 1999 (14.7 percent in 1997, 16.1 percent in 1998, and 18.8 percent in 1999). The rates for the age group 26-34 years old and 35 years and older in 1999 have not changed significantly since 1994.

Dr. Nelba Chavez, administrator of HHS' Substance Abuse and Mental Health Services Administration (SAMHSA), which directs the annual survey, said, "Our efforts appear to be paying off in lower levels of drug use among teens, but we must do more to reduce illicit drug use among adults, particularly those age 18 to 25. The need for drug treatment is real and growing. People need to know that treatment can help people get off and stay off drugs."

The National Household Survey provides annual estimates of the prevalence of illicit drug, alcohol and tobacco use in the U. S. and monitors the trends in use over time. It is based on a representative sample of the U.S. population age 12 and older, including persons living in households and in some group quarters such as dormitories and homeless shelters. The national trends in substance use presented in the 1999 report are based on data from a sample of 13,000 respondents using paper questionnaires similar to those used in prior years.

Over the years, SAMHSA has made improvements in the National Household Survey to provide better and more complete information on substance use. In 1999, a new, interactive, bilingual, computer-assisted questionnaire was introduced. A new sample design was implemented and the sample size was expanded almost fourfold to support the development of both national and state estimates of substance use. This new sample reflects information obtained from nearly 70,000 persons. Due to changes in the new methodology, national estimates from the expanded survey cannot be compared to data from prior surveys. The results from the expanded survey, however, will set a new baseline for better year-to-year comparisons for state and national levels. Highlights from the expanded survey follow.

1999 National Estimates from the New Expanded National Household Survey

Illicit Drug Use

• An estimated 14.8 million Americans were current users of illicit drugs in 1999, meaning they used an illicit drug at least once during the 30 days prior to the interview. This estimate represents 6.7 percent of the population 12 years and older.

• Among youths age 12-17, 10.9 percent reported past month use of illicit drugs in 1999. Marijuana is the major illicit drug used by this group; 7.7 percent of youths were current users of marijuana in 1999.

• Among youths age 12-17, the percent using illicit drugs in the 30 days prior to interview was slightly higher for boys (11.3 percent) than for girls (10.5 percent).

• The rates of current illicit drug use for major racial/ethnic groups were 6.6 percent for whites, 6.8 percent for Hispanics, and 7.7 percent for African-Americans. The rate was highest among the American Indian/Alaska Native population (10.6 percent) and among persons reporting multiple race (11.2 percent). Asian-Americans had the lowest rate at 3.2 percent.

Tobacco Use

• An estimated 66.8 million Americans reported current use of a tobacco product in 1999, a prevalence rate of 30.2 percent for the population 12 and older. Of the total population, 57.0 million (25.8 percent of the population) smoked cigarettes, 12.1 million (5.5 percent of the population) smoked cigars, 7.6 million (3.4 percent of the population) used smokeless tobacco, and 2.4 million (1.1 percent of the population) smoked tobacco in pipes.

• For the first time, the 1999 survey provides information on specific cigarette brands. Three brands account for most of adolescent cigarette smoking. Of current smokers age 12-17, 54.5 percent report Marlboro as their usual brand. Newport was reported by 21.6 percent of youth smokers, and Camel was reported by 9.8 percent. No other cigarette brand was reported by even 2 percent of youths.

• Race/ethnicity differences in usual cigarette brands used were evident among both adult and youth (age 12-17 years) smokers. More than half of white (58.4 percent) and Hispanic (59.7 percent) youth smokers reported Marlboro as their usual brand. About three quarters (73.9 percent) of African-American adolescent smokers reported Newport as their usual brand.

Alcohol Use

• In 1999, an estimated 105 million Americans age 12 and older (47.3 percent) reported current use of alcohol, meaning they used alcohol at least once during the 30 days prior to the interview. About 45 million people (20.2 percent) engaged in binge drinking, meaning they drank five or more drinks on one occasion during that 30 day period. An estimated 12.4 million were heavy drinkers, meaning they had five or more drinks on one occasion 5 or more days during the past 30 days.

• Although consumption of alcoholic beverages is illegal for those under 21 years of age, 10.4 million current drinkers were age 12-20 in 1999. Of this group, 6.8 million engaged in binge drinking, including 2.1 million who would also be classified as heavy drinkers.

• Among youths age 12-17, an estimated 18.6 percent used alcohol in the month prior to the survey interview. Of youths 12-17, 10.9 percent were binge drinkers and 2.5 percent were heavy drinkers.

New State-by-State Estimates

First-time estimates of substance use for all 50 states and the District of Columbia were developed using a small area estimation model that combines sample data from each state with a national regression model that includes local indicators related to substance use. State estimates are clustered in five categories ranging from the states with the highest estimates to the states with the lowest estimates.

Illicit Drug Use

• Prevalence estimates for overall current illicit drug use in the general population ranged from a low of 4.7 percent (Virginia) to a high of 10.7 percent (Alaska). Six of the 10 states with the highest rates of current illicit drug use in the population age 12 and older were in the western region. Eight of the 10 states with the lowest rates were in the southern region. However, within the regions, there was considerable variation. Utah, a western state, had a relatively low rate of past month illicit drug use of 6.2 percent. Delaware, a southern state, had one of the higher rates in the country at 8.5 percent.

• The range among states for past month use of illicit drugs among youth age 12-17 was from a low of 8.0 percent (Utah) to a high of 18.3 percent (Delaware).

• Six of the 10 states that were in the highest ranking category for past month use of any illicit drug for persons age12 and older were also in the highest group for youth ages 12-17. The rate for youth was lowest for the state of Utah (8.0 percent). The highest estimate for youth was in Delaware (18.3 percent).

Alcohol Use (Binge Drinking Only)

• The state with the highest rate of binge drinking for persons age 12 and older was North Dakota (28.7 percent). Most of the states with high rates were northern states and seven out of the top 10 were in the Midwest region. Most of the states with the lowest rates of binge drinking were southern states. The state with the lowest rate of binge drinking was Maryland at 15.3 percent.

• Among youths age 12-17, five of the 10 states in the top tier for binge alcohol use were Midwest states and four were western states.

Cigarette Use

• For cigarette use, five states ranked in the top 10 for both youths age 12-17 and the general population 12 and older. These states were Kentucky, West Virginia, Minnesota, Delaware and North Carolina.

• States that rank in the top ten for past month cigarette use among all ages 12 and older include Kentucky, West Virginia, Ohio, Oklahoma, North Carolina and Indiana. However, these states were not in the top 10 for illicit drug use or binge alcohol use.

Trends in New Use of Substances (Incidence)

Trends in new use of substances are estimated using the data reported on age at first use from the computer-based 1999 National Household Survey. Because information on when people first used a substance is collected on a retrospective basis, information on first-time use or incidence is always one year behind information on current use.

• An estimated 2.3 million persons first used marijuana in 1998. This translates to about 6,400 new marijuana users per day. More than two-thirds of these new users were under age 18.

• In 1998, an estimated 1.6 million people began smoking cigarettes on a daily basis. About half of these new smokers were younger than age 18.

• An estimated 4.9 million people tried cigars for the first time in 1998, about 13,000 people per day. This represents a threefold increase in cigar initiation since 1991, when there were only 1.5 million new cigar smokers.

The DAWN Report

The 1999 Drug Abuse Warning Network (DAWN) report, also conducted by SAMHSA, provides information on the impact of drug use on hospital emergency departments in the U.S. It reports the number of episodes in which visits to the emergency department were directly related to the use of an illegal drug or non-medical use of a legal drug. DAWN is not a measure of prevalence of use, but offers complementary information to the prevalence data found in the National Household Survey.

• In 1999, there were 554,932 drug-related hospital emergency department episodes in the U.S. and 1,015,206 drug mentions, which refers to a substance reported in an episode.

• The 1999 DAWN findings confirm an overall trend of stability in the number of drug-related emergency room visits over the past five years in the general population.

• Among 12-17 year olds, drug-related emergency department visits dropped 11 percent from 1998 to 1999.

• Total mentions of marijuana/hashish use for the first time exceeded mentions of heroin/morphine use in drug-abuse related visits to hospital emergency departments in 1999, changing a rank ordering of illicit drug mentions that had been constant since 1990.

HHS' continuing efforts to reduce tobacco, alcohol and illicit drug use in the U.S. include SAMHSA's State Incentive Grants for Community-Based Action, already awarded in 20 states and the District of Columbia to support coordinated substance abuse prevention services. Regional Centers for the Application of Prevention Technology work to ensure consistent implementation of research-based prevention programs, practices and policies. SAMHSA's new Targeted Capacity Expansion Grants also assist local governments and Indian tribal governments to address serious, emerging drug problems at the earliest possible stage.

Additionally, HHS' efforts to reduce marijuana use among America's youth continue through its comprehensive Marijuana Initiative begun in 1995. As part of this initiative, HHS has funded new research on the effects of marijuana and launched major prevention-oriented campaigns -- such as the anti-marijuana campaign "Reality Check" -- to help parents educate children about the dangers of drugs.

A new, updated version of our free publication, "Keeping Youth Drug Free," targeted at parents of young teenagers, was issued today. This publication and other free materials, "Marijuana: What Parents Need to Know" and "Tips for Teens," can be obtained by calling 1-800-729-6686 or by accessing SAMHSA'sNational Clearinghouse for Drug and Alcohol Information Web site www.health.org.

An actuality of Secretary Donna E. Shalala, regarding theNational Household Survey is available on the Internet at: www.hhs.gov/news/broadcast/20000831.wav. In addition, photographs of this announcement are available at www.hhs.gov/news/photos/index.html.

Note: Findings from the 1999 National Household Survey are available on the World Wide Web at www.samhsa.gov.

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