Alcohol and Other Drug Use Among High School Students -- United States, 1990

Use of alcohol and other drugs is associated with the leading causes of death and injury (e.g., motor-vehicle crashes, homicides, and suicides) among teenagers and young adults; for example, nearly half of all deaths from motor-vehicle crashes in this age group involve alcohol use (1,2). This article presents self-reported data about the prevalence of alcohol, marijuana, and cocaine use among U.S. students in grades 9-12 during 1990.

The 1990 national school-based Youth Risk Behavior Survey (YRBS) is a component of the Youth Risk Behavior Surveillance System, which periodically measures the prevalence of priority health-risk behaviors among youth through comparable national, state, and local surveys (3). A three-stage sample design was used to obtain a representative sample of 11,631 students in grades 9-12 in the 50 states, the District of Columbia, Puerto Rico, and the Virgin Islands. Students were asked whether they had used alcohol, marijuana, and any form of cocaine during their lifetime and during the 30 days preceding the survey. Students also were asked whether they had had five or more drinks of alcohol on one occasion during the 30 days preceding the survey and how old they were when they first consumed alcohol or used marijuana or cocaine.

Of all students in grades 9-12, 88.1% had consumed alcohol in their lifetime, and 58.6% had consumed alcohol at least once during the 30 days preceding the survey (Table 1). Male students (62.2%) were significantly more likely than female students (55.0%) to have consumed alcohol during the 30 days preceding the survey. Students in grade 12 were significantly more likely to have had a drink of alcohol in their lifetime (92.4%) and to have had a drink of alcohol during the 30 days preceding the survey (65.6%) than were students in grade 9 (82.6% and 50.1%, respectively).

More than one third (36.9%) of all students had consumed five or more drinks of alcohol on at least one occasion during the 30 days preceding the survey (which was the survey definition for episodic heavy drinking) (Table 1). Male students (43.5%) were significantly more likely than female students (30.4%) to report heavy drinking on one or more recent occasions. The proportion of students who drank heavily on at least one occasion increased significantly by grade of students from 9th (27.7%) and 10th (35.7%) to 12th grade (44.0%).

Almost one third (31.4%) of all students had used marijuana at least once, and 13.9% had used marijuana during the 30 days preceding the survey (Table 1). Male students were significantly more likely to have used marijuana in their lifetime (35.9%) and to have used marijuana during the 30 days preceding the survey (16.9%) than were female students (27.0% and 11.1%, respectively). Students in grade 12 were significantly more likely to have used marijuana in their lifetime (42.2%) and to have used marijuana during the 30 days preceding the survey (18.5%) than were students in grade 9 (20.6% and 9.5%, respectively).

Of all students in grades 9-12, 6.6% had used cocaine at least once, and 2.1% had used cocaine during the 30 days preceding the survey (Table 1). Male students were significantly more likely to have used cocaine in their lifetime (8.1%) and to have used it during the 30 days preceding the survey (3.3%) than were female students (5.2% and 1.0%, respectively). Students in grade 12 were significantly more likely to have used cocaine in their lifetime (9.3%) and to have used cocaine during the 30 days preceding the survey (2.3%) than were students in grade 9 (3.6% and 1.1%, respectively).

For students in grades 9-12, initial use of alcohol, marijuana, or cocaine increased substantially with age. For example, among students in grades 9-12, more than one third (33.6%) had first consumed alcohol before age 12 and 92.0% had consumed alcohol for the first time before age 18 (Figure 1). Reported by: Div of Epidemiology and Prevention Research, National Institute on Drug Abuse, Alcohol, Drug Abuse, and Mental Health Administration; Div of Adolescent and School Health, National Center for Chronic Disease Prevention and Health Promotion, CDC.

Editorial Note

Editorial Note: Young adults may be less likely to develop serious alcohol and other drug problems if age at first use is delayed beyond childhood and adolescence (4). Therefore, the national health objectives for the year 2000 include efforts to delay by at least 1 year the age at which adolescents first use alcohol and marijuana (objective 4.5); reduce the proportion of youth aged 12-17 years who consumed alcohol or who used marijuana or cocaine to no more than 12.6%, 3.2%, and 0.6%, respectively (objective 4.6); and reduce the number of high school seniors involved in recent episodes of heavy drinking to no more than 28.0% (objective 4.7) (5). Current levels of alcohol, marijuana, and cocaine use and recent occasions of heavy drinking among adolescents must be reduced substantially to reach these objectives.

To reduce alcohol consumption and other drug use by students, primary and secondary schools should employ educational programs--optimally as part of quality school health education (objective 4.13) (5)--that provide students with factual information about the effects of alcohol and other drugs and teach skills to avoid their use. School policies that advocate substance-free campuses and provide referral to drug treatment and support groups can reinforce these programs (5).

The national health objectives to reduce the use of alcohol by youth also can be addressed through community enactment and enforcement of policies to reduce minors' access to alcoholic beverages (objective 4.16) (5). These policies may include restricting the sale of alcoholic beverages at recreational and entertainment events commonly attended by adolescents, increasing the price of alcoholic beverages, and imposing penalties and revoking licenses for the sale of alcoholic beverages to minors. Other key strategies include restricting the promotion of alcoholic beverages among youth (objective 4.17) (5) and reducing the legal blood alcohol concentration for minors to zero (objective 4.18) (5). A combination of these strategies and the coordinated efforts of local and state health and education officials, families, legislators, law-enforcement officials, media, and community agencies are essential to attaining the goal of reducing alcohol and other drug use among youth.

References

1. Perrine M, Peck R, Fell J. Epidemiologic perspectives on drunk driving. Surgeon General's workshop on drunk driving: background papers. Washington, DC: US Department of Health and Human Services, 1988.

2. Jessor R, Jessor SL. Theory testing in longitudinal research on marijuana use. In: Kandel DB, ed. Longitudinal research on drug use. Washington, DC: Hemisphere, 1978.

3. Kolbe LJ. An epidemiological surveillance system to monitor the prevalence of youth behaviors that most affect health. Health Education 1990;21:44-8.

4. Robins LN, Przybeck TR. Age of onset of drug use as a factor in drug and other disorders. In: Jones CL, Battjes RJ, eds. Etiology of drug abuse: implications for prevention. Washington, DC: US Department of Health and Human Services, Public Health Service, Alcohol, Drug Abuse, and Mental Health Administration, 1985. (NIDA research monograph no. 56).

5. Public Health Service. Healthy people 2000: national health promotion and disease prevention objectives--full report, with commentary. Washington, DC: US Department of Health and Human Services, Public Health Service, 1991; DHHS publication no. (PHS)91-50212.

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