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2001 State Estimates of Substance Use |
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A variety of other surveys and data systems collect data on substance use, abuse, and dependence. It is useful to consider the results of these other studies when discussing the National Household Survey on Drug Abuse (NHSDA) data. In doing this, it is important to understand the methodological differences between the different surveys and the impact that these differences could have on estimates of substance use prevalence. This appendix briefly describes several of these other data systems, including recent results from them.
In-depth comparisons of the methodologies of the three major federally sponsored national surveys of youth substance use have been done. In 1997, a comparison between the NHSDA and Monitoring the Future (MTF) was published (Gfroerer, Wright, & Kopstein, 1997). In 2000, a series of papers comparing different aspects of the NHSDA, MTF, and the Youth Risk Behavior Survey (YRBS) was commissioned by the U.S. Department of Health and Human Services (DHHS). Under contract with the Office of the Assistant Secretary for Planning and Evaluation, Westat identified and funded several experts in survey methods to prepare these papers. The papers were published in the Journal of Drug Issues (Hennessy & Ginsberg, 2001). The major findings of this study were as follows:
Youth Risk Behavior Survey (YRBS)
The YRBS is a component of the Centers for Disease Control and Prevention's (CDC's) Youth Risk Behavior Surveillance System (YRBSS), which biennially measures the prevalence of six priority health risk behavior categories: (a) behaviors that contribute to unintentional and intentional injuries; (b) tobacco use; (c) alcohol and other drug use; (d) sexual behaviors that contribute to unintended pregnancy and sexually transmitted diseases (STDs); (e) unhealthy dietary behaviors; and (f) physical inactivity. The YRBSS includes national, State, territorial, and local school-based surveys of high school students.
Sites can add or delete questions in the core questionnaire to better meet the interests and needs of the State, territory, or city school district. School-based YRBS studies were last conducted in 2001 among students in grades 9 to 12 in 38 States; however, only 22 States had overall response rates of 60 percent or better. The YRBS uses a two-stage design, selecting schools first and then intact classes (Grunbaum et al., 2002). Although there are differences in the sampling and data collection methodology and in implementation, the NHSDA and YRBS shared some common results.
For past month use of alcohol, the 2001 YRBS State estimates were significantly higher than those for the 2000–2001 NHSDA, due in part to the generally older youths present in high schools than in the targeted household youths who were 12 to 17 years old at the time of the NHSDA interview. Both surveys showed North Dakota as the State with the highest rate of current use of alcohol. Of the top five States in the NHSDA, the YRBS did not survey two of them (Connecticut and New Hampshire) in 2001, included two of them (North Dakota and Massachusetts) in its top five, and ranked Vermont somewhat lower. For past month use of marijuana in 2001, Utah reported the least prevalence among students (from the YRBS) and youths from the 2000–2001 NHSDA. Rhode Island, Massachusetts, and Vermont ranked highest in the YRBS and also were in the top fifth for the NHSDA (CDC, 2003c).
Behavioral Risk Factor Surveillance System (BRFSS)
The Behavioral Risk Factor Surveillance System (BRFSS), administered and supported by CDC's Behavioral Surveillance Branch, is an ongoing data collection program designed to measure behavioral risk factors in the civilian noninstitutionalized adult population, 18 years of age or older, living in households. BRFSS was initiated in 1984 with 15 States collecting surveillance data on risk behaviors through monthly telephone interviews. The number of States participating in the survey increased, so that in 2001 the survey included all 50 States and the District of Columbia. Data are collected from a random sample of adults (one per household) through a telephone survey. Questions can be developed by participating States and added to the core questionnaire. State-added questions are not edited or evaluated by the CDC. In general, BRFSS collects information on access to health care, health status indicators, health risk behaviors (including cigarette and alcohol use), and the use of clinical preventive services by State.
Looking at the State estimates of current smokers obtained from the 2000 BRFSS, for persons age 18 or older, Kentucky reported the highest rate (30.5 percent) and Utah reported the lowest rate (12.9 percent) (CDC, 2003b). Comparing these BRFSS percentages with the 2000–2001 NHSDA past month cigarette use rates, for the population age 12 or older, Kentucky had the highest rate (32.5 percent) and Utah the lowest (16.8 percent). Considering the differences in sampling methods and the target populations, both surveys yielded similar results.
Monitoring the Future (MTF)
Monitoring the Future (MTF) is a national survey that tracks drug use trends and related attitudes among America's adolescents. This survey is conducted annually by the Institute for Social Research at the University of Michigan through a grant awarded by the National Institute on Drug Abuse (NIDA). The MTF and NHSDA are the Federal Government's largest and primary tools for tracking youth substance use. The MTF is composed of three substudies: (a) an annual survey of high school seniors initiated in 1975; (b) ongoing panel studies of representative samples from each graduating class that have been conducted by mail since 1976; and (c) annual surveys of 8th and 10th graders initiated in 1991. In 2001, for all three grades combined, 435 public and private schools and about 44,300 students were in the sample. The students completed a self-administered questionnaire during a regular class period (Johnston, O'Malley, & Bachman, 2002a, 2002b).
Comparisons between the MTF estimates and estimates based on students sampled in the NHSDA have generally shown NHSDA substance use prevalence levels to be lower than MTF estimates, with relative differences being largest for 8th graders. The lower prevalences in the NHSDA may be due to more underreporting in the household setting as compared with the MTF school setting. The MTF does not survey dropouts, a group generally shown (using the NHSDA) to have higher rates of use (Gfroerer et al., 1997). However, the direction of trends has generally been similar between the two surveys. Both surveys showed significant increases in illicit drug use among adolescents between 1992 and 1996. Comparisons of NHSDA and MTF results for 1999 through 2001, based on NHSDA data collected during January through June to control for seasonality, generally show similar trends in the prevalence of use of illicit drugs with a few exceptions. Between 2000 and 2001, the NHSDA showed a significant increase in past year and past month marijuana use for 10th graders. The NHSDA also showed an increase in lifetime and past year hallucinogen use for 8th graders, as well as an increase in past month use for 12th graders. The MTF trend for these drugs remained somewhat stable from 2000 to 2001 (see Table s H.1 to H.4).
Youth Risk Behavior Survey (YRBS)
The 2001 national school-based YRBS used a three-stage cluster sample design to produce a nationally representative sample of students in grades 9 through 12. The 2001 national YRBS sample included 13,601 students in grades 9 through 12 in the 50 States and the District of Columbia. The national survey and all of the State and local surveys were conducted during the spring of 2001, with the exception of Hawaii. The Hawaii surveys were conducted in the fall of 2001. The students completed a self-administered questionnaire during a regular class period (CDC, 2003c). In general, this school-based survey found higher rates of alcohol, cigarette, marijuana, and cocaine use for youths than those found in the NHSDA. Data from the YRBS showed a decrease in both lifetime and past month marijuana use, but steady prevalence levels for use of other illicit drugs among 9th through 12th graders. Although the NHSDA showed a significant increase in marijuana use among 12 to 17 year olds during this time period, the trend for other illicit drugs was similar to the YRBS. Although the two surveys generally have shown similar trends over the years, the prevalence estimates are much higher in the YRBS (23.9 vs. 8.0 percent in the NHSDA for past month marijuana use in 2001). This is likely due to the difference in the age groups that are sampled and the dissimilarity of the study designs (school-based vs. home-based).
National Longitudinal Study of Adolescent Health (Add Health)
The National Longitudinal Study of Adolescent Health (Add Health) is conducted to measure the effects of family, peer group, school, neighborhood, religious institution, and community influences on health risks, such as tobacco, drug, and alcohol use. The survey also asks about substance abuse (alcohol, tobacco, and illicit drugs). The survey consists of three phases. In Wave 1 (conducted in 1994–95), roughly 90,000 students from grades 7 through 12 at 144 schools around the United States answered brief questionnaires. Interviews also were conducted with about 20,000 students and their parents in the students' homes. In Wave 2, students were interviewed a second time in their homes. These interviews took place in 1996. Wave 3 consists of re-interviews of respondents from Wave 1 and began in July 2001. Survey results from the first two waves indicated that nearly one fourth of teenagers had ever smoked marijuana. Nearly 7 percent of 7th and 8th graders used marijuana at least once in the past month as did 15.7 percent of 9th through 12th graders (Resnick et al., 1997).
Partnership Attitude Tracking Study (PATS)
The Partnership Attitude Tracking Study (PATS) is an ongoing national research study that tracks drug use and drug-related attitudes among children, teenagers, and their parents. It is sponsored by the Partnership for a Drug Free America (PDFA). In the 2001 PATS, 6,937 teenagers in grades 7 through 12 completed self-administered questionnaires. The study showed a decline in overall drug use for adolescents between 1997 and 1999. Drug use rates have been stable since then. The one exception to this trend is teenage use of Ecstasy. In 2001, PATS reported that lifetime teenage Ecstasy use was 12 percent, up from 10 percent in 2000 (PDFA, 2003). The 2001 NHSDA showed a similar trend in that lifetime Ecstasy use for 12 to 17 year olds was 3.2 percent, up from 2.6 percent in 2000. Another exception to the trend was a significant decrease in inhalant use. The 2001 PATS found that 18 percent of teenagers used inhalants at some point in their life, down from 21 percent in 2000. Past year and past month use showed similar declines. The NHSDA showed stable rates of inhalant use between 2000 and 2001 for 12 to 17 year olds. The NHSDA reports notably lower prevalence rates than PATS. The major difference in these prevalence estimates is likely to be due to the different study designs. The youth portion of the PATS is a school-based survey. This may elicit more reporting of sensitive behaviors than the home-based NHSDA.
National Survey of Parents and Youth (NSPY)
The National Survey of Parents and Youth (NSPY) is sponsored by the National Institute on Drug Abuse (NIDA) to evaluate the Office of National Drug Control Policy's (ONDCP's) National Youth Anti-Drug Media Campaign. The survey is specifically designed to evaluate Phase III of the campaign, which began in September 1999 and will run at least until 2003. The NSPY is divided into two phases. In Phase I, a sample of youths age 9 to 18 and their parents were recruited to participate in the in-home survey. In Phase II, the respondents from Phase I participate in two additional interviews at intervals of 6 to 24 months. The recruitment phase is broken into three waves, which each consist of national cross-sectional surveys. In October 2001, ONDCP released its third semiannual report of findings that contained data from all three waves (available on-line at ONDCP, 2003).
The first two waves of data were collected between November 1999 and December 2000. Waves 3 and 4 were collected between January 2001 and December 2001. For past month use of marijuana, the NSPY reported an increase from 7.2 percent in 2000 to 8.0 percent in 2001 for 12 to 18 year olds (see Table H.5 and Hornik et al., 2002). Although this did not represent a significant increase in the NSPY, the levels mirror the rates reported in the NHSDA for 12 to 17 year olds between 2000 and 2001, 4.8 percent and 5.4 percent, respectively. The increase in the NHSDA was statistically significant.
The parent component of the NSPY showed slight, but not statistically significant, increases in both lifetime and past month marijuana use. Lifetime use was 52.8 percent in 2000 and 53.7 percent in 2001 (see Table H.6). Past month marijuana use rose from 2.7 percent in 2000 to 3.4 percent in 2001. The NHSDA showed significant increases in both lifetime and past month marijuana use among adults. The lifetime estimate for adults age 18 or older increased from 36.0 percent in 2000 to 38.9 percent in 2001. Past month use rose from 4.5 percent in 2000 to 5.1 percent in 2001.
National Health Interview Survey (NHIS)
The National Health Interview Survey (NHIS) is a continuing nationwide sample survey that collects data using personal household interviews. The survey is sponsored by the National Center for Health Statistics (NCHS) and provides national estimates of selected health measures. The survey estimated that 22.9 percent of the population age 18 or older were current cigarette smokers in 2001 (down from 23.4 percent in 2000) (NCHS, 2003). Among males, 25.3 percent reported current cigarette smoking compared with 20.8 percent of females age 18 or older.
In the NHIS, current smokers are defined as those who smoke daily, smoked on 1 or more days in the past month, or quit smoking fewer than 30 days ago (for those who smoked 100 or more cigarettes in their lifetime). In the NHSDA, current cigarette smoking is defined as any use in the past month. The 2001 NHSDA rate was 31.1 percent for those 18 or older. However, when using a definition similar to the NHIS's, the 2001 NHSDA estimates that 24.7 percent of adults age 18 or older were current smokers. Among males, 27.1 percent reported current cigarette smoking compared with 22.5 percent of females. These do not represent significant changes from 2000. Although the two surveys employ different methodologies, the NHSDA produces very similar estimates when using the NHIS definition. The two surveys also have shown very similar trends in smoking over the years. See Table H.7 for an in-depth comparison of smoking rates between these two surveys.
The NHIS defines past year alcohol use as having 12 or more drinks in a lifetime and having 1 or more drinks in the past year. The NHIS rate for past year alcohol use among those 18 or older was 62.7 percent in 2001, which was not a significant change from 2000 (61.5 percent). The rates for both males and females remained stable in 2001 (69.3 and 56.6 percent, respectively). For the NHSDA, past year alcohol use is defined as having had at least one drink in the past year. The 2001 NHSDA rate for those 18 or older, however, showed a significant increase in 2001. The rate rose from 65.3 percent in 2000 to 67.1 percent in 2001. Although the NHSDA rate for males remained stable, females showed a significant increase in alcohol use. Their rate was 59.4 percent in 2000 and 62.7 percent in 2001. Although the two surveys use different definitions and methodologies, they have produced similar estimates for past year alcohol use over the past several years. See Table H.8 for a comparison of past year alcohol use between the two surveys.
Monitoring the Future (MTF)
This school-based survey showed increases in smoking rates among students from 1991 to 1997. Cigarette smoking peaked in 1996 among 8th and 10th graders nationwide and in 1997 among 12th graders. Since those peak years, cigarette use has gradually declined. Past month smoking rates found in the MTF for 8th graders were 17.5 percent in 1999, 14.6 percent in 2000, and 12.2 percent in 2001. Among 10th graders, current smoking rates were 25.7 percent in 1999, 23.9 percent in 2000, and 21.3 percent in 2001. For 12th graders, smoking rates rose steadily from 28.3 percent in 1991 to 36.5 percent in 1997, but then showed a statistically significant decline to 31.4 percent in 2000 (Johnston et al., 2002a). This trend continued in 2001 with a rate of 29.5 for 12th graders. The NHSDA also showed a statistically significant decline in past month cigarette use among 8th and 12th graders from 1999 to 2000, and the rates remained stable in 2001 for those two grades. See Table H.9 for a comparison of the MTF and NHSDA cigarette use estimates.
The MTF data have indicated alcohol use among teenagers to be fairly stable over the past several years. Alcohol consumption in the month prior to the survey was reported by 21.5 percent of 8th graders, 39.0 percent of 10th graders, and 49.8 percent of 12th graders in the 2001 survey. Table H.10 shows how these numbers compare with NHSDA estimates. Although the NHSDA estimates are lower, they show the same stability in teenage alcohol use as the MTF.
Youth Risk Behavior Survey (YRBS)
The YRBS found significant declines in lifetime and past month cigarette use among students in grades 9 to 12. Lifetime cigarette use declined from 70.4 percent in 1999 to 63.9 percent in 2001 (CDC, 2003c). Past month smoking declined from 34.8 percent in 1999 to 28.5 percent in 2001. The NHSDA also has shown decreases in smoking for youths age 12 to 17. The NHSDA lifetime rate declined from 37.1 percent in 1999 to 33.6 percent in 2001. The past month rate showed a similar trend, falling from 14.9 percent in 1999 to 13.0 percent in 2001.
Alcohol use among 9th through 12th graders in the YRBS has remained fairly stable over the past few surveys. Past month alcohol use was 47.1 percent in the 2001 survey, which was not a significant change from the estimate of 50.0 percent in the 1999 survey. In contrast, the NHSDA showed a significant increase in past month alcohol use for youths age 12 to 17 from 2000 to 2001. The rate was 16.5 percent in 1999 and 17.3 percent in 2001. Episodic heavy drinking (defined as having five or more drinks on one or more occasions in the 30 days prior to the survey) also held steady with prevalence rates of 31.5 percent in 1999 and 29.9 percent in the 2001 YRBS. Although the corresponding 2001 NHSDA rate for binge alcohol use among 12 to 17 year olds was much lower (10.6 percent), the NHSDA also showed a level trend between 1999 and 2001.
Partnership Attitude Tracking Study (PATS)
Data from the 2001 PATS shows a continuing decline in cigarette use among teenagers. For adolescents in grades 7 through 12, the prevalence of past month cigarette use was 28.0 percent in 2001, down from 34.0 percent in 2000 (PDFA, 2003). The NHSDA showed a steady prevalence level from 2000 to 2001 with rates of 13.4 percent in 2000 and 13.0 percent in 2001 among youths age 12 to 17. Again, the lower prevalence estimates in the NHSDA are likely due to its home-based study design.
The 2001 PATS found that alcohol use declined from 2000 to 2001. In 2001, 53.0 percent of teenagers reported using alcohol in the past year, down from 58.0 percent in 2000. This compares with 33.9 percent of youths age 12 to 17 reporting past year use in the 2001 NHSDA. The 2001 PATS also found that 35.0 percent of teenagers reported past month alcohol use, down from 39.0 percent in 2000. The binge drinking estimate decreased slightly from 31.0 percent in 2000 to 30.0 percent in 2001. In comparison, the 2001 NHSDA rates for past month alcohol use and binge drinking for 12 to 17 year olds were 17.3 and 10.6 percent, respectively. The 2001 NHSDA past month alcohol use rate was significantly higher than the 2000 rate (16.4 percent).
Behavioral Risk Factor Surveillance System (BRFSS)
The median percentage of adults reporting current cigarette use in 2000 for the Behavioral Risk Factor Surveillance System (BRFSS) was 23.2 percent, a slight increase from 1999 (22.6 percent) (CDC, 2003a). The corresponding NHSDA rate (26.3 percent) was not statistically different from the 1999 rate (27.0 percent). In 1999, the median percentage of adults who reported current alcohol use in BRFSS remained stable at 54.2 percent. The 2000 NHSDA estimate of 50.2 percent also was not a significant change from 1999.
National Longitudinal Study of Adolescent Health (Add Health)
Results from the 1994–95 National Longitudinal Study of Adolescent Health (Add Health, described above) indicate that nearly 3.2 percent of 7th and 8th graders smoked six or more cigarettes a day as did 12.8 percent of 9th through 12th graders (Resnick et al., 1997). In addition, the Add Health study found that 7.3 percent of 7th and 8th graders used alcohol on 2 or more days in the past month as did 23.1 percent of 9th through 12th graders.
National Survey of Parents and Youth (NSPY)
The NSPY also collects information on cigarette and alcohol use. In 2001, this survey estimated that 34.9 percent of youths age 12 to 18 had used cigarettes at some point in their lifetime (see Table H.11). This represented a significant decline from 2000 (38.0 percent). Past month cigarette use showed a small, but not statistically significant, decline from 2000 to 2001 (12.9 to 11.7 percent). The NHSDA rates, however, did not show this pattern. The lifetime rate showed a small decline for 12 to 17 year olds from 2000 to 2001, but the change was not statistically significant (34.6 to 33.6 percent). The past month smoking rate for 12 to 17 year olds showed no change. The rate was 13.4 percent in 2000 and 13.0 percent in 2001. The two surveys have produced very similar smoking estimates over the past few years.
In 2001, the NSPY estimated that 45.9 percent of youths age 12 to 18 had used alcohol at some point in their lifetime. This does represent a slight increase, but it is not a statistically significant change from 2000 (47.3 percent). The estimate for past month use was 36.5 percent for the same age group. Again, this is not a significant change from 2000 when the rate was 37.7 percent. Although the NHSDA lifetime rate remained stable from 2000 to 2001, the past month alcohol rate showed a significant increase for 12 to 17 year olds. The rate rose from 16.4 percent in 2000 to 17.3 percent in 2001. The NSPY generally produces higher alcohol use rates than the NHSDA, but the trends tend to move in the same direction.
The parent component of the NSPY showed stable rates for lifetime cigarette use. Past month use, however, showed a significant decline from 2000 to 2001. The rate declined from 27.5 percent in 2000 to 25.2 percent in 2001. Both the lifetime smoking rate and the past month smoking rate remained stable in the 2001 NHSDA. The lifetime and past month smoking rates for those age 18 or older were 71.1 and 26.3 percent, respectively. Again, the two surveys produce very similar estimates for this age group.
Harvard School of Public Health College Alcohol Study (CAS)
In 1993, the Harvard School of Public Health conducted a mail survey of students from a nationally representative sample of colleges. The purpose of the study was to gather data on the drinking patterns of college students. The study was repeated in 1997, 1999, and 2001. The survey found that the overall rate of binge drinking did not change substantially from 1993 to 2001 (43.9 to 44.4 percent) (Wechsler et al., 2002). The College Alcohol Study (CAS) defined binge drinking as the consumption of five or more drinks in a row for men and four drinks in a row for women. The study found a sizable increase in both the number of students who binge drank frequently (22.8 percent in 2001 vs. 19.7 percent in 1993) and those who did not drink at all (19.3 percent in 2001 vs. 16.4 percent in 1993). The 2001 NHSDA binge drinking rate among full-time undergraduates age 18 to 22 was 42.5 percent. It is useful to note that the NHSDA defines binge drinking as five or more drinks in a row on at least one occasion in the past month for both men and women. Despite the different definition of binge drinking, the CAS estimate and the NHSDA estimate are very similar.
National Comorbidity Survey (NCS)
The National Comorbidity Survey (NCS) was sponsored by the National Institute of Mental Health (NIMH), National Institute on Drug Abuse (NIDA), and the W. T. Grant Foundation. It was designed to measure the prevalence of the illnesses in the Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R) (American Psychiatric Association [APA], 1987). The NCS was a household survey consisting of more than 8,000 respondents age 15 to 54. The interviews took place between 1990 and 1992. The NCS used a modified version of the Composite International Diagnostic Interview (the University of Michigan's UM-CIDI) for its diagnoses. The results showed that 3.6 percent of the population abused or were dependent on some type of drug in the previous 12 months (Kessler et al., 1994). The corresponding NHSDA rate for this age group in 2001 was 3.3 percent. Alcohol abuse or dependence, however, showed a much higher prevalence in the NCS with 14.1 percent of the population abusing or dependent on the drug in the previous year. Alcohol also had a much higher prevalence in the 2001 NHSDA (7.7 percent), but it was still well below the NCS rate. When comparing these two studies, one should keep in mind that they were conducted in two different time periods and they each use a different set of diagnostic questions. The 2001 NHSDA estimates for abuse and dependence are based on the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) (APA, 1994).
National Longitudinal Alcohol Epidemiologic Survey (NLAES)
The National Longitudinal Alcohol Epidemiologic Survey (NLAES) was conducted in 1992 by the U.S. Bureau of the Census for the National Institute on Alcohol Abuse and Alcoholism. Face-to-face interviews were conducted with 42,862 respondents age 18 or older in the contiguous United States. NLAES was designed to study the drinking practices, behaviors, and related problems in the general public. The survey included an extensive set of questions designed to assess the presence of symptoms of alcohol and drug abuse and dependence during the prior 12 months, based on the criteria from the DSM-IV (APA, 1994). This study based its diagnoses on the updated DSM-IV. The survey found that 7.4 percent of adults were abusing or dependent on alcohol (Grant, 1995). In 2001, the NHSDA found that 6.0 percent of adults were abusing or dependent on alcohol. NLAES also found that 1.5 percent of adults were abusing or dependent on some type of illicit drug in the past year. In comparison, the 2001 NHSDA found that 2.2 percent of adults were abusing or dependent on some illicit drug. Although the estimates from these two surveys are relatively close, one should note that they were conducted in different time periods using different methodologies.
National Survey of Parents and Youth (NSPY)
The NSPY, described above, is distinct in that it measures drug use and attitudes among youths as young as 9. The NSPY results show that youths age 9 to 11 are strongly opposed to marijuana use. Wave 3 of the survey estimates that only 0.3 percent of youths age 9 through 11 had used marijuana in the past year. The corresponding rates for Waves 1 and 2 were 0.8 and 0.0 percent, respectively (ONDCP, 2003).
Washington, DC, Metropolitan Area Drug Study (DC*MADS)
The Washington, DC, Metropolitan Area Drug Study (DC*MADS) was designed (a) to estimate the prevalence, correlates, and consequences of drug abuse among all types of people residing in one metropolitan area of the country during one period of time with special focus on populations who were underrepresented or unrepresented in household surveys and (b) to develop a methodological model for similar types of research in other metropolitan areas of the country. Sponsored by the National Institute on Drug Abuse (NIDA) and conducted from 1989 to 1995 by RTI and Westat, Inc., as the principals, the project included 11 separate but coordinated studies that focused on different population subgroups (e.g., homeless people, institutionalized individuals, adult and juvenile offenders, new mothers, drug abuse treatment clients) or different aspects of the drug abuse problem (e.g., adverse consequences of drug abuse). DC*MADS provided a replicable methodological approach for developing representative estimates of the prevalence of drug abuse among all population subgroups, regardless of their residential setting, in a metropolitan area. The key population domains in DC*MADS were the homeless, the institutionalized, and the household. A major finding of DC*MADS was that, when data are aggregated for populations from each of the three domains, the overall prevalence estimates for use of drugs differ only marginally from those that would be obtained from the household population alone (i.e., from the NHSDA), largely because the other populations are very small compared with the household population. However, a somewhat different picture emerged when the numbers of drug users were examined. Adding in the nonhousehold populations resulted in an increase of approximately 14,000 illicit drugs users compared with the corresponding estimates for the household population. About 25 percent of past year crack users, 20 percent of past year heroin users, and one third of past year needle users were found in the nonhousehold population (Bray & Marsden, 1999).
Department of Defense Survey of Health Related Behaviors Among Military Personnel
The 1998 DoD Survey of Health Related Behaviors Among Military Personnel (7th in a series of studies conducted since 1980) was sponsored by the Department of Defense (DoD) and conducted by RTI. The sample consisted of 17,264 active-duty Armed Forces personnel worldwide who completed self-administered questionnaires anonymously that assessed substance use and other health behaviors. For the total DoD, during the 30 days prior to the date that a survey was completed, heavy alcohol use declined from 20.8 percent in 1980 to 15.4 percent in 1998; cigarette smoking decreased from 51.0 percent in 1980 to 29.9 percent in 1998; and use of any illicit drugs declined from 27.6 percent in 1980 to 2.7 percent in 1998 (Bray et al., 1999). For the latest survey, military personnel exhibited significantly higher rates of heavy alcohol use than their civilian counterparts (14.2 vs. 9.9 percent) when demographic differences between the military and civilian populations were taken into account (civilian data were drawn from the 1997 NHSDA and adjusted to reflect demographic characteristics of the military). Differences in military and civilian heavy alcohol use rates were largest for men age 18 to 25. Among this age group, the military rate was nearly twice as high as the adjusted civilian rate (26.9 vs. 14.9 percent). In contrast, military personnel showed lower rates of cigarette use (29.1 vs. 32.8 percent) compared with civilians, a finding that seems largely due to an increase in smoking among civilians rather than a significant decrease among military personnel since the prior survey in 1995. Similarly, rates of illicit drug use in the military were significantly lower than those observed for the comparable civilian population when demographic differences between the military and civilian populations were taken into account (2.6 vs. 10.7 percent). Differences in illicit drug use between the military and civilian populations were more pronounced for males than females. For males age 18 to 55, 2.8 percent of those in the military used drugs in the 30 days prior to survey compared with 11.4 percent of the civilian population (adjusted). For females age 18 to 55, 1.9 percent of those in the military used drugs in the 30 days prior to survey compared with 6.2 percent of the civilian population (adjusted). Nearly all military personnel reported having been tested for drugs since joining the military.
Survey of Inmates in State and Federal Correctional Facilities
The 1997 Survey of Inmates in State and Federal Correctional Facilities sampled inmates from a universe of 1,409 State prisons and 127 Federal Prisons for the Bureau of Justice Statistics (BJS). Systematic random sampling was used to select the inmates for the computer-assisted personal interviews. The final numbers interviewed were 14,285 State prisoners and 4,041 Federal prisoners. Among other items, these surveys collect information on the use of drugs in the month before the offense for convicted inmates. Women in State prisons (62 percent) were more likely than men (56 percent) to have used drugs in the month before the offense (BJS, 1999). Women also were more likely to have committed their offense while under the influence of drugs (40 vs. 32 percent of male prisoners). Among Federal prisoners, men (45 percent) were more likely than women (37 percent) to have used drugs in the past month. Male and female Federal prisoners were equally likely to report the influence of drugs during their offense (23 percent of male and 19 percent of female prisoners). The survey results indicate substantially higher rates of drug use among State and Federal prisoners as compared with the household population.
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Hennessy, K., & Ginsberg, C. (Eds.). (2001). Substance use survey data collection methodologies [Special issue]. Journal of Drug Issues, 31(3), 595–727. [Available at http://www2.criminology.fsu.edu/~jdi/31n3.htm]
Hornik, R., Maklan, D., Cadell, D., Prado, A., Barmada, C., Jacobsohn, L., Orwin, R., Sridharan, S., Zador, P., Southwell, B., Zanutto, E., Baskin, R., Chu, A., Morin, C., Taylor, C., & Steele, D. (2002, May). Evaluation of the National Youth Anti-Drug Media Campaign: Fourth semi-annual report of findings (prepared by Westat, Inc., and Annenberg School for Communication, University of Pennsylvania, under Contract No. N01DA–8–5063). Rockville, MD: National Institute on Drug Abuse.
Johnston, L. D., O'Malley, P. M., & Bachman, J. G. (2002a). Monitoring the Future national survey results on drug use, 1975–2001: Secondary school students (NIH Publication No. 02–5106, Vol. I). Rockville, MD: National Institute on Drug Abuse. [Available at http://monitoringthefuture.org/pubs.html#monographs]
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Resnick, M. D., Bearman, P. S., Blum, R. W., Bauman, K. E., Harris, K. M., Jones, J., Tabor, J., Beuhring, T., Sieving, R. E., Shew, M., Ireland, M., Bearinger, L. H., & Udry, J. R. (1997). Protecting adolescents from harm: Findings from the National Longitudinal Study on Adolescent Health. Journal of the American Medical Association, 278, 823–832.
Wechsler, H., Lee, J. E., Kuo, M., Seibring, M., Nelson, T. F., & Lee, H. (2002). Trends in college binge drinking during a period of increased prevention efforts: Findings from 4 Harvard School of Public Health College Alcohol Study surveys: 1993–2001. Journal of American College Health, 50, 203–217.
20501
Table H.1 Percentages Reporting Lifetime, Past Year, and Past Month Use of Marijuana among 8th, 10th, and 12th Graders in the NHSDA and MTF: 1999 through 2001| Time Period, by Current Grade Level | Survey | |||||
|---|---|---|---|---|---|---|
| NHSDA (January to June) | MTF1 | |||||
| 1999 | 2000 | 2001 | 1999 | 2000 | 2001 | |
| Lifetime Use | ||||||
| 8th grade | 10.9 | 9.2 | 10.3 | 22.0 | 20.3 | 20.4 |
| 10th grade | 27.7 | 26.9 | 29.4 | 40.9 | 40.3 | 40.1 |
| 12th grade | 41.4 | 37.1 | 38.4 | 49.7 | 48.8 | 49.0 |
| Past Year Use | ||||||
| 8th grade | 8.1 | 6.8 | 7.7 | 16.5 | 15.6 | 15.4 |
| 10th grade | 21.6 | 20.0a | 23.5 | 32.1 | 32.2 | 32.7 |
| 12th grade | 29.7 | 26.8 | 26.7 | 37.8 | 36.5 | 37.0 |
| Past Month Use | ||||||
| 8th grade | 4.5 | 3.3 | 3.7 | 9.7 | 9.1 | 9.2 |
| 10th grade | 10.7 | 10.1a | 12.8 | 19.4 | 19.7 | 19.8 |
| 12th grade | 16.4 | 15.4 | 15.1 | 23.1 | 21.6 | 22.4 |
20501
Table H.2 Percentages Reporting Lifetime, Past Year, and Past Month Use of Cocaine among 8th, 10th, and 12th Graders in the NHSDA and MTF: 1999 through 2001| Time Period, by Current Grade Level | Survey | |||||
|---|---|---|---|---|---|---|
| NHSDA (January to June) | MTF1 | |||||
| 1999 | 2000 | 2001 | 1999 | 2000 | 2001 | |
| Lifetime Use | ||||||
| 8th grade | 0.8 | 0.9 | 0.8 | 4.7 | 4.5 | 4.3 |
| 10th grade | 3.2 | 3.2 | 3.3 | 7.7 | 6.9 | 5.7 |
| 12th grade | 7.5 | 5.4 | 5.1 | 9.8 | 8.6 | 8.2 |
| Past Year Use | ||||||
| 8th grade | 0.3 | 0.7 | 0.5 | 2.7 | 2.6 | 2.5 |
| 10th grade | 1.9 | 2.8 | 2.2 | 4.9 | 4.4 | 3.6 |
| 12th grade | 4.6 | 2.5 | 3.0 | 6.2 | 5.0 | 4.8 |
| Past Month Use | ||||||
| 8th grade | 0.2 | 0.1 | 0.0 | 1.3 | 1.2 | 1.2 |
| 10th grade | 0.7 | 0.9 | 0.8 | 1.8 | 1.8 | 1.3 |
| 12th grade | 1.2 | 0.3 | 0.9 | 2.6 | 2.1 | 2.1 |
20501
Table H.3 Percentages Reporting Lifetime, Past Year, and Past Month Use of Inhalants among 8th, 10th, and 12th Graders in the NHSDA and MTF: 1999 through 2001| Time Period, by Current Grade Level | Survey | |||||
|---|---|---|---|---|---|---|
| NHSDA (January to June) | MTF1 | |||||
| 1999 | 2000 | 2001 | 1999 | 2000 | 2001 | |
| Lifetime Use | ||||||
| 8th grade | 10.8 | 9.7 | 8.4 | 19.7 | 17.9 | 17.1 |
| 10th grade | 10.6 | 10.2 | 9.9 | 17.0 | 16.6 | 15.2 |
| 12th grade | 12.2a | 9.5 | 8.5 | 15.4 | 14.2 | 13.0 |
| Past Year Use | ||||||
| 8th grade | 4.5 | 3.8 | 3.4 | 10.3 | 9.4 | 9.1 |
| 10th grade | 4.5 | 3.5 | 3.5 | 7.2 | 7.3 | 6.6 |
| 12th grade | 4.8 | 3.7 | 3.5 | 5.6 | 5.9 | 4.5 |
| Past Month Use | ||||||
| 8th grade | 1.4 | 0.8 | 0.9 | 5.0 | 4.5 | 4.0 |
| 10th grade | 0.8 | 0.7 | 0.7 | 2.6 | 2.6 | 2.4 |
| 12th grade | 1.2 | 0.8 | 0.9 | 2.0 | 2.2 | 1.7 |
20501
Table H.4 Percentages Reporting Lifetime, Past Year, and Past Month Use of Hallucinogens among 8th, 10th, and 12th Graders in the NHSDA and MTF: 1999 through 2001| Time Period, by Current Grade Level | Survey | |||||
|---|---|---|---|---|---|---|
| NHSDA (January to June) | MTF1 | |||||
| 1999 | 2000 | 2001 | 1999 | 2000 | 2001 | |
| Lifetime Use | ||||||
| 8th grade | 2.7 | 2.3a | 3.8 | 4.8 | 4.6 | 4.0 |
| 10th grade | 7.8 | 7.3 | 8.4 | 9.7 | 8.9 | 7.8 |
| 12th grade | 13.6 | 12.2 | 12.7 | 13.7 | 13.0 | 12.8 |
| Past Year Use | ||||||
| 8th grade | 1.7a | 1.6a | 3.0 | 2.9 | 2.8 | 2.5 |
| 10th grade | 5.4 | 4.9 | 6.5 | 6.9 | 6.1 | 5.2 |
| 12th grade | 8.7 | 6.8 | 9.1 | 9.4 | 8.1 | 8.4 |
| Past Month Use | ||||||
| 8th grade | 0.4 | 0.2 | 0.5 | 1.3 | 1.2 | 1.2 |
| 10th grade | 1.4 | 1.6 | 1.7 | 2.9 | 2.3 | 2.1 |
| 12th grade | 2.4 | 1.9a | 3.6 | 3.5 | 2.6 | 3.2 |
| Use Measure | Age Group | Percent Reporting Use | |||
|---|---|---|---|---|---|
| Year 2000 Average Waves 1 and 2 (%) |
Year 2001 Average Waves 3 and 4 (%) |
Year 2000 to 2001 % Change |
95% CI on 2000–2001 Change |
||
| Lifetime | |||||
| 12 to 13 | 4.9 | 4.1 | -0.8 | (-2.4, 0.8) | |
| 14 to 15 | 15.1 | 18.9 | 3.8 | (-0.3, 7.8) | |
| 16 to 18 | 40.3 | 39.9 | -0.4 | (-5.4, 4.6) | |
| 12 to 18 | 21.9 | 22.6 | 0.8 | (-1.7, 3.2) | |
| Past Year | |||||
| 12 to 13 | 3.3 | 2.6 | -0.6 | (-2.1, 0.8) | |
| 14 to 15 | 11.3 | 13.8 | 2.5 | (-1.0, 5.9) | |
| 16 to 18 | 29.1 | 26.8 | -2.3 | (-6.9, 2.3) | |
| 12 to 18 | 15.8 | 15.5 | -0.3 | (-2.5, 1.9) | |
| Past Month | |||||
| 12 to 13 | 1.4 | 1.1 | -0.3 | (-1.2, 0.7) | |
| 14 to 15 | 3.6 | 7.2 | 3.6a | (0.9, 6.3) | |
| 16 to 18 | 14.6 | 14.0 | -0.6 | (-4.3, 3.0) | |
| 12 to 18 | 7.2 | 8.0 | 0.8 | (-0.9, 2.5) | |
| Regular | |||||
| 12 to 13 | 0.5 | 0.3 | -0.3 | (-0.7, 0.2) | |
| 14 to 15 | 2.2 | 5.4 | 3.3a | (1.1, 5.4) | |
| 16 to 18 | 12.4 | 11.7 | -0.7 | (-4.1, 2.7) | |
| 12 to 18 | 5.6 | 6.3 | 0.7 | (-0.8, 2.1) | |
| Drug Use | 2000 | 2001 | Year 2000 to 2001 Change | |||
|---|---|---|---|---|---|---|
| Percent | 95% CI | Percent | 95% CI | Percent | 95% CI | |
| Cigarettes | ||||||
| Lifetime | 69.8 | (67.9, 71.6) | 69.8 | (67.5, 72.0) | 0.0 | (-2.5, -2.4) |
| Past month | 27.5 | (25.7, 29.4) | 25.2 | (23.0, 27.5) | -2.3 | (-4.5, -0.1)a |
| Alcohol | ||||||
| Lifetime | 88.1 | (86.5, 89.6) | 88.1 | (86.1, 89.8) | -0.1 | (-2.4, 2.3) |
| Past month | 57.1 | (54.8, 59.3) | 55.9 | (53.0, 58.9) | -1.1 | (-4.2, 1.9) |
| Marijuana | ||||||
| Lifetime | 52.8 | (50.6, 55.0) | 53.7 | (51.0, 56.4) | 0.9 | (-1.9, 3.7) |
| Past month | 2.7 | (2.0, 3.6) | 3.4 | (2.4, 4.6) | 0.7 | (-0.6, 1.9) |
| Gender and Age Group (Years) | Study | 1999 Percent (SE) |
2000 Percent (SE) |
2001 Percent (SE) |
|---|---|---|---|---|
| Total | NHIS | 23.7 (0.32) | 23.4 (0.32) | 22.9 (0.30) |
| NHSDA | 25.4 (0.39) | 24.7 (0.34) | 24.7 (0.35) | |
| 18 to 25 | NHIS | 28.6 (0.96) | 27.2 (0.95) | 27.8 (0.96) |
| NHSDA | 33.4 (0.47) | 32.4 (0.46) | 33.3 (0.46) | |
| 26+ | NHIS | 22.8 (0.32) | 22.7 (0.33) | 22.1 (0.29) |
| NHSDA | 24.1 (0.43) | 23.4 (0.39) | 23.2 (0.40) | |
| 18 to 20 | NHIS | 25.9 (1.60) | 24.7 (1.45) | 26.0 (1.47) |
| NHSDA | 33.0 (0.67) | 31.9 (0.69) | 32.0 (0.73) | |
| 21 to 25 | NHIS | 30.2 (1.18) | 28.8 (1.12) | 28.9 (1.13) |
| NHSDA | 33.7 (0.63) | 32.8 (0.56) | 34.2 (0.55) | |
| 26 to 34 | NHIS | 26.2 (0.70) | 25.7 (0.70) | 24.7 (0.63) |
| NHSDA | 29.5 (0.69) | 27.3 (0.55) | 28.2 (0.73) | |
| 35 to 49 | NHIS | 27.7 (0.57) | 27.6 (0.57) | 26.1 (0.51) |
| NHSDA | 29.3 (0.73) | 27.4 (0.67) | 28.8 (0.59) | |
| 50+ | NHIS | 16.9 (0.40) | 17.1 (0.39) | 17.4 (0.40) |
| NHSDA | 17.1 (0.69) | 18.3 (0.65) | 16.3 (0.62) | |
| Male | NHIS | 25.9 (0.49) | 25.8 (0.47) | 25.3 (0.44) |
| NHSDA | 28.1 (0.58) | 27.1 (0.52) | 27.1 (0.50) | |
| 18 to 25 | NHIS | 30.3 (1.41) | 28.9 (1.29) | 31.3 (1.35) |
| NHSDA | 36.5 (0.65) | 35.7 (0.65) | 36.6 (0.67) | |
| 26+ | NHIS | 25.1 (0.51) | 25.2 (0.48) | 24.2 (0.44) |
| NHSDA | 26.7 (0.67) | 25.6 (0.60) | 25.4 (0.58) | |
| Female | NHIS | 21.6 (0.38) | 21.2 (0.39) | 20.8 (0.39) |
| NHSDA | 23.0 (0.50) | 22.5 (0.47) | 22.5 (0.46) | |
| 18 to 25 | NHIS | 26.9 (1.23) | 25.5 (1.19) | 24.3 (1.24) |
| NHSDA | 30.4 (0.59) | 29.2 (0.57) | 30.1 (0.62) | |
| 26+ | NHIS | 20.7 (0.39) | 20.5 (0.40) | 20.2 (0.39) |
| NHSDA | 21.8 (0.56) | 21.5 (0.53) | 21.3 (0.52) |
| Gender and Age Group (Years) | Study | 1999 Percent (SE) |
2000 Percent (SE) |
2001 Percent (SE) |
|---|---|---|---|---|
| Total | NHIS | 62.6 (0.42) | 61.5 (0.43) | 62.7 (0.37) |
| NHSDA | 65.6 (0.47) | 65.3 (0.43) | 67.1 (0.37) | |
| 18 to 25 | NHIS | 63.6 (1.1) | 60.7 (1.09) | 64.7 (1.07) |
| NHSDA | 74.8 (0.48) | 74.5 (0.46) | 75.4 (0.41) | |
| 26+ | NHIS | 62.4 (0.42) | 61.6 (0.43) | 62.3 (0.38) |
| NHSDA | 64.0 (0.53) | 63.7 (0.49) | 65.7 (0.43) | |
| 18 to 20 | NHIS | 51.4 (1.85) | 47.4 (1.75) | 54.6 (1.82) |
| NHSDA | 69.2 (0.75) | 69.2 (0.68) | 69.8 (0.67) | |
| 21 to 25 | NHIS | 71.2 (1.21) | 69.2 (1.27) | 71.0 (1.16) |
| NHSDA | 78.9 (0.55) | 78.2 (0.55) | 79.3 (0.48) | |
| 26 to 34 | NHIS | 71.7 (0.78) | 70.4 (0.75) | 71.5 (0.67) |
| NHSDA | 74.7 (0.63) | 75.1 (0.57) | 76.5 (0.69) | |
| 35 to 49 | NHIS | 70.0 (0.62) | 68.2 (0.62) | 69.1 (0.55) |
| NHSDA | 70.7 (0.81) | 69.6 (0.71) | 71.8 (0.55) | |
| 50+ | NHIS | 51.1 (0.56) | 51.7 (0.59) | 52.4 (0.56) |
| NHSDA | 53.3 (0.97) | 53.6 (0.88) | 55.9 (0.81) | |
| Male | NHIS | 69.8 (0.52) | 68.0 (0.51) | 69.3 (0.47) |
| NHSDA | 70.5 (0.63) | 71.6 (0.58) | 72.0 (0.52) | |
| 18 to 25 | NHIS | 68.8 (1.46) | 66.0 (1.45) | 70.6 (1.47) |
| NHSDA | 78.4 (0.59) | 77.2 (0.60) | 78.3 (0.54) | |
| 26+ | NHIS | 70.0 (0.52) | 68.4 (0.51) | 69.1 (0.51) |
| NHSDA | 69.1 (0.73) | 70.6 (0.68) | 70.9 (0.60) | |
| Female | NHIS | 56.0 (0.54) | 55.5 (0.56) | 56.6 (0.48) |
| NHSDA | 61.1 (0.66) | 59.4 (0.58) | 62.7 (0.53) | |
| 18 to 25 | NHIS | 58.5 (1.49) | 55.4 (1.37) | 58.7 (1.45) |
| NHSDA | 71.3 (0.67) | 71.8 (0.59) | 72.6 (0.57) | |
| 26+ | NHIS | 55.6 (0.56) | 55.5 (0.58) | 56.2 (0.48) |
| NHSDA | 59.5 (0.75) | 57.4 (0.66) | 61.0 (0.61) |
20501
Table H.9 Percentages Reporting Lifetime, Past Year, and Past Month Use of Cigarettes Among 8th, 10th, and 12th Graders in the NHSDA and MTF: 1999 through 2001| Time Period, by Current Grade Level | Survey | |||||
|---|---|---|---|---|---|---|
| NHSDA (January to June) | MTF1 | |||||
| 1999 | 2000 | 2001 | 1999 | 2000 | 2001 | |
| Lifetime Use | ||||||
| 8th grade | 31.0c | 25.0 | 24.5 | 44.1 | 40.5 | 36.6 |
| 10th grade | 49.9a | 46.7 | 45.3 | 57.6 | 55.1 | 52.8 |
| 12th grade | 61.8a | 53.7 | 55.2 | 64.6 | 62.5 | 61.0 |
| Past Year Use | ||||||
| 8th grade | 19.0c | 13.9 | 12.9 | -- | -- | -- |
| 10th grade | 31.2 | 28.4 | 27.8 | -- | -- | -- |
| 12th grade | 46.3c | 34.8 | 35.9 | -- | -- | -- |
| Past Month Use | ||||||
| 8th grade | 9.4a | 6.9 | 6.9 | 17.5 | 14.6 | 12.2 |
| 10th grade | 20.0 | 18.4 | 18.3 | 25.7 | 23.9 | 21.3 |
| 12th grade | 34.0b | 26.8 | 27.2 | 34.6 | 31.4 | 29.5 |
20501
Table H.10 Percentages Reporting Lifetime, Past Year, and Past Month Use of Alcohol Among 8th, 10th, and 12th Graders in the NHSDA and MTF: 1999 through 2001| Time Period, by Current Grade Level | Survey | |||||
|---|---|---|---|---|---|---|
| NHSDA (January to June) | MTF1 | |||||
| 1999 | 2000 | 2001 | 1999 | 2000 | 2001 | |
| Lifetime Use | ||||||
| 8th grade | 34.6 | 31.8 | 32.3 | 52.1 | 51.7 | 50.5 |
| 10th grade | 58.8 | 56.9 | 58.1 | 70.6 | 71.4 | 70.1 |
| 12th grade | 72.3 | 71.4 | 74.3 | 80.0 | 80.3 | 79.7 |
| Past Year Use | ||||||
| 8th grade | 25.9 | 23.5 | 24.3 | 43.5 | 43.1 | 41.9 |
| 10th grade | 49.2 | 46.3 | 49.0 | 63.7 | 65.3 | 63.5 |
| 12th grade | 62.8 | 62.5 | 63.7 | 73.8 | 73.2 | 73.3 |
| Past Month Use | ||||||
| 8th grade | 9.1 | 9.1 | 10.0 | 24.0 | 22.4 | 21.5 |
| 10th grade | 23.4 | 23.1 | 24.3 | 40.0 | 41.0 | 39.0 |
| 12th grade | 38.6 | 37.1 | 39.9 | 51.0 | 50.0 | 49.8 |
| Substance Use, by Age | 2000 | 2001 | Year 2000 to 2001 Change | |||
|---|---|---|---|---|---|---|
| Percent | 95% CI | Percent | 95% CI | Percent | 95% CI | |
| Aged 12 or 13 | ||||||
| Lifetime alcohol use | 19.4 | (17.4, 21.5) | 19.4 | (17.2, 21.8) | 0.0 | (3.0, -3.0) |
| Past month alcohol use | 22.4 | (17.9, 27.6) | 20.4 | (15.7, 26.1) | -2.0 | (-9.3, 5.4) |
| Lifetime cigarette use | 15.5 | (13.7, 17.4) | 13.8 | (11.9, 16.0) | -1.7 | (-4.4, 1.0) |
| Past month cigarette use | 2.4 | (1.8, 3.4) | 2.0 | (1.3, 3.0) | -0.5 | (-1.5, 0.5) |
| Aged 14 or 15 | ||||||
| Lifetime alcohol use | 45.3 | (41.6, 48.9) | 44.1 | (40.9, 47.5) | -1.1 | (-5.7, 3.4) |
| Past month alcohol use | 28.4 | (22.4, 35.3) | 28.3 | (23.4, 33.7) | -0.1 | (-8.8, 8.6) |
| Lifetime cigarette use | 35.2 | (31.5, 39.0) | 33.9 | (30.7, 37.2) | -1.3 | (-6.0, 3.4) |
| Past month cigarette use | 8.2 | (6.3, 10.5) | 8.4 | (6.4, 11.0) | 0.3 | (-2.8, 3.4) |
| Aged 16 to 18 | ||||||
| Lifetime alcohol use | 69.7 | (66.1, 73.2) | 67.2 | (63.2, 71.0) | -2.5 | (-7.6, 2.5) |
| Past month alcohol use | 45.9 | (41.1, 50.7) | 44.3 | (39.5, 49.3) | -1.5 | (-8.1, 5.0) |
| Lifetime cigarette use | 57.2 | (53.6, 60.7) | 51.5 | (47.6, 55.5) | -5.6 | (-10.7, -0.6)a |
| Past month cigarette use | 24.6 | (21.7, 27.9) | 21.7 | (18.6, 25.1) | -3.0 | (-7.0, 1.1) |
| Aged 12 to 18 | ||||||
| Lifetime alcohol use | 47.3 | (45.0, 49.6) | 45.9 | (43.8, 48.1) | -1.3 | (-4.1, 1.4) |
| Past month alcohol use | 37.7 | (34.3, 41.3) | 36.5 | (33.1, 40.0) | -1.2 | (-5.7, 3.2) |
| Lifetime cigarette use | 38.0 | (36.0, 40.0) | 34.9 | (32.7, 37.2) | -3.1 | (-5.7, -0.5)a |
| Past month cigarette use | 12.9 | (11.6, 14.3) | 11.7 | (10.2, 13.4) | -1.2 | (-3.1, 0.7) |
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