SpeedyCeus

6. Youth Prevention-Related Measures

The National Survey on Drug Use and Health (NSDUH) includes questions for youths aged 12 to 17 about a number of risk and protective factors that may affect the likelihood that they will engage in substance use. Risk factors are individual characteristics and environmental influences associated with an increased vulnerability to the initiation, continuation, or escalation of substance use. Protective factors include individual resilience and other circumstances that appear to reduce the likelihood of substance use. Risk and protective factors include variables that operate at different stages of development and reflect different domains of influence, including the individual, family, peer, school, community, and societal levels (Hawkins, Catalano, & Miller, 1992). Interventions to prevent substance use generally are designed to ameliorate the influence of risk factors and enhance the effectiveness of protective factors.

This chapter presents findings for youth prevention-related measures collected in the 2007 NSDUH and compares these with findings from previous years. Included are measures of perceived risk from substance use (cigarettes, alcohol, and illicit drugs), perceived availability of substances, perceived parental disapproval of substance use, feelings about peer substance use, involvement in fighting and delinquent behavior, participation in religious and other activities, exposure to substance use prevention messages and programs, and parental involvement.

In this chapter, rates of substance use are compared for persons responding differently to questions reflecting risk or protective factors, such as the perceived risk of harm from using a substance. Because the NSDUH data for an individual are collected at only one point in time, it is not possible to determine causal connections from these data. However, a number of research studies of youths have shown that reducing risk factors and increasing protective factors can reduce rates of substance use (Botvin, Botvin, & Ruchlin, 1998). This report shows that marijuana use, cigarette use, and alcohol use among youths aged 12 to 17 decreased between 2002 and 2007, yet corresponding changes in individual risk and protective factors for the same period may or may not have occurred. There can be many reasons for this, such as the lack of or a weak causal connection, a lagged relationship between the occurrence of a risk factor and the change in drug use behavior, or that individual use is typically the result of multiple simultaneous risk factors rather than a single factor (Newcomb, Maddahian, & Bentler, 1986).

Perceptions of Risk

One factor that can influence whether youths will use tobacco, alcohol, or illicit drugs is the extent to which youths believe these substances might cause them harm. NSDUH respondents were asked how much they thought people risk harming themselves physically and in other ways when they use various substances in certain amounts or frequencies. Response choices for these items were "great risk," "moderate risk," "slight risk," or "no risk."

• The percentages of youths reporting binge alcohol use and use of cigarettes and marijuana in the past month were lower among those who perceived great risk in using these substances than among those who did not perceive great risk. For example, in 2007, 5.0 percent of youths aged 12 to 17 who perceived great risk from "having 5 or more drinks of an alcoholic beverage once or twice a week" reported binge drinking in the past month (consumption of five or more drinks of an alcoholic beverage on a single occasion on at least 1 day in the past 30 days); by contrast, past month binge drinking was reported by 12.9 percent of youths who saw moderate, slight, or no risk from having five or more drinks of an alcoholic beverage once or twice a week (Figure 6.1). Past month marijuana use was reported by 1.4 percent of youths who saw great risk in smoking marijuana once a month compared with 9.5 percent of youths who saw moderate, slight, or no risk.

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Figure 6.1 Past Month Binge Drinking and Marijuana Use among Youths Aged 12 to 17, by Perceptions of Risk: 2007

• Increases in the perceived risk of using a substance often are associated with decreases in the rate of current use of that substance. Looking over the 6-year period, the proportion of youths aged 12 to 17 who reported perceiving great risk from smoking one or more packs of cigarettes per day increased from 63.1 percent in 2002 to 68.8 percent in 2007 (Figure 6.2). The rate of past month cigarette smoking among youths aged 12 to 17 dropped from 13.0 to 9.8 percent during the same period. Percentages for both perceived risk of smoking one or more packs of cigarettes per day and smoking in the past month were similar in 2006 and 2007.

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Figure 6.2 Perceived Great Risk of Cigarette and Alcohol Use among Youths Aged 12 to 17: 2002-2007

⁺ Difference between this estimate and the 2007 estimate is statistically significant at the .05 level.

• The percentage of youths aged 12 to 17 indicating great risk in having four or five drinks nearly every day increased from 62.2 percent in 2002 to 65.2 percent in 2007, but the percentage remained unchanged between 2006 (64.6 percent) and 2007 (Figure 6.2). The rates of past month heavy alcohol use among youths aged 12 to 17 were about the same throughout the period from 2002 to 2007 (e.g., 2.5 percent in 2002, 2.4 percent in 2006, and 2.3 percent in 2007).
• The percentage of youths aged 12 to 17 perceiving great risk in having five or more drinks of an alcoholic beverage once or twice a week increased from 38.2 percent in 2002 to 39.4 percent in 2007, but remained stable between 2006 (39.4 percent) and 2007. Accordingly, the rate of past month binge alcohol use among youths decreased from 10.7 percent in 2002 to 9.7 percent in 2007, but the rate remained stable between 2006 (10.3 percent) and 2007.
• The percentage of youths aged 12 to 17 indicating great risk in smoking marijuana once a month increased from 32.4 percent in 2002 to 34.5 percent in 2007 (Figure 6.3). The percentage of youths aged 12 to 17 perceiving great risk in smoking marijuana once or twice a week also increased from 51.5 percent in 2002 to 54.7 percent in 2007. Both of these percentages of perceived great risk of use were similar between 2006 and 2007.

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Figure 6.3 Perceived Great Risk of Marijuana Use among Youths Aged 12 to 17: 2002-2007

Difference between this estimate and the 2007 estimate is statistically significant at the .05 level.

• Coincident with the increase in the percentage of youths who perceived great risk of marijuana use, the prevalence of lifetime, past year, and past month marijuana use among youths aged 12 to 17 decreased between 2002 and 2007. During the 6-year period, lifetime use of marijuana dropped from 20.6 to 16.2 percent, past year use declined from 15.8 to 12.5 percent, and past month use fell from 8.2 to 6.7 percent. Although lifetime use of marijuana decreased from 17.3 percent in 2006 to 16.2 percent in 2007, past year and past month marijuana use rates remained stable during the 2-year period.
• Between 2002 and 2007, the percentage of youths aged 12 to 17 perceiving great risk declined for the following substance use patterns: trying heroin once or twice (from 58.5 to 57.0 percent), using heroin once or twice a week (from 82.5 to 81.0 percent), trying LSD once or twice (from 52.6 to 51.2 percent), and using LSD once or twice a week (from 76.2 to 74.2 percent) (Figure 6.4). Over the same period, however, the percentage of youths aged 12 to 17 indicating great risk for using cocaine once a month (50.5 percent in 2002 and 49.6 percent in 2007) and using cocaine once or twice a week (79.8 percent in 2002 and 78.9 percent in 2007) remained statistically unchanged. Moreover, percentages for all of these perception of risk measures remained stable between 2006 and 2007.

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Figure 6.4 Perceived Great Risk of Use of Selected Illicit Drugs among Youths Aged 12 to 17: 2002-2007

Difference between this estimate and the 2007 estimate is statistically significant at the .05 level.

Perceived Availability

• In 2007, about half (49.1 percent) of the youths aged 12 to 17 reported that it would be "fairly easy" or "very easy" for them to obtain marijuana if they wanted some (Figure 6.5). One in seven (14.1 percent) indicated that heroin would be "fairly" or "very" easily available, and 14.4 percent reported so for LSD. Between 2002 and 2007, there were decreases in the perceived availability of marijuana (from 55.0 to 49.1 percent), crack (from 26.5 to 25.3 percent), LSD (from 19.4 to 14.4 percent), and heroin (from 15.8 to 14.1 percent). The perceived availability of cocaine declined from 25.9 percent in 2006 to 24.5 percent in 2007, but the perceived availability of marijuana, crack, LSD, and heroin did not change significantly during the 2-year period.

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Figure 6.5 Perceived Availability of Selected Illicit Drugs among Youths Aged 12 to 17: 2002-2007

Difference between this estimate and the 2007 estimate is statistically significant at the .05 level.

• The percentage of youths who reported that illicit drugs would be easy to obtain increased with age in 2007. For example, 20.6 percent of those aged 12 or 13 said it would be fairly or very easy to obtain marijuana compared with 50.9 percent of those aged 14 or 15 and 73.4 percent of those aged 16 or 17.
• In 2007, 14.5 percent of youths aged 12 to 17 indicated that they had been approached by someone selling drugs in the past month, which was down from the 16.7 percent reported in 2002 (Figure 6.6). The rate remained stable between 2006 (15.3 percent) and 2007.

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Figure 6.6 Approached in the Past Month by Someone Selling Drugs among Youths Aged 12 to 17: 2002-2007

Difference between this estimate and the 2007 estimate is statistically significant at the .05 level.

Perceived Parental Disapproval of Substance Use

• Most youths aged 12 to 17 believed their parents would "strongly disapprove" of their using substances. In 2007, 91.0 percent of youths reported that their parents would strongly disapprove of their trying marijuana or hashish once or twice; this was similar to the rate in 2006 (90.4 percent), but was higher than the rate in 2002 (89.1 percent). Most (89.6 percent) reported that their parents would strongly disapprove of their having one or two drinks of an alcoholic beverage nearly every day, which was the same as the rate in 2006 and similar to the 89.0 percent reported in 2002. In 2007, however, 92.1 percent of youths reported that their parents would strongly disapprove of their smoking one or more packs of cigarettes per day, which was higher than the 91.4 percent reported in 2006 and the 89.5 percent reported in 2002.
• Youths aged 12 to 17 who believed their parents would strongly disapprove of their using substances in certain amounts or frequencies were less likely to use that substance than were youths who believed their parents would somewhat disapprove or neither approve nor disapprove. For example, in 2007, past month cigarette use was reported by 7.2 percent of youths who perceived strong parental disapproval of their smoking one or more packs of cigarettes per day compared with 41.5 percent of youths who believed their parents would not strongly disapprove. Current marijuana use also was much less prevalent among youths who perceived strong parental disapproval for trying marijuana or hashish once or twice than among those who did not (4.6 vs. 28.1 percent, respectively).

Feelings about Peer Substance Use

• A majority of youths aged 12 to 17 reported that they disapprove of their peers using substances. In 2007, 89.7 percent of youths "strongly" or "somewhat" disapproved of their peers smoking one or more packs of cigarettes per day, which was similar to the rate of 89.1 percent in 2006, but higher than the 87.1 percent in 2002. In addition, 82.9 percent strongly or somewhat disapproved of peers using marijuana or hashish once a month or more, which was similar to the 82.8 percent reported in 2006, but was an increase from the 80.4 percent in 2002. Also, 86.6 percent of youths strongly or somewhat disapproved of peers having one or two drinks of an alcoholic beverage nearly every day, which was similar to the rate of 86.4 percent in 2006, but was higher than the 84.7 percent reported in 2002.
• In 2007, past month marijuana use was reported by 2.3 percent of youths aged 12 to 17 who strongly or somewhat disapproved of their peers using marijuana once a month or more compared with 27.7 percent of youths who reported that they neither approve nor disapprove of such behavior from their peers.

Fighting and Delinquent Behavior

• In 2007, 22.3 percent of youths aged 12 to 17 reported that, in the past year, they had gotten into a serious fight at school or at work; this was similar to the rate in 2006 (22.6 percent), but was higher than that in 2002 (20.6 percent). Almost one in six (15.4 percent) had taken part in a group-against-group fight, which was lower than the rate in 2006 (17.0 percent), but was similar to the rate in 2002 (15.9 percent). One in thirty (3.3 percent) had carried a handgun at least once, which was similar to the rates in 2006 (3.2 percent) and 2002 (3.3 percent). An estimated 2.9 percent had sold illegal drugs, which was similar to the rate of 3.3 percent in 2006, but was lower than the 4.4 percent rate in 2002. In 2007, 4.3 percent had, at least once, stolen or tried to steal something worth more than $50; this was similar to the rate in 2006 (4.8 percent), but lower than the rate in 2002 (4.9 percent). An estimated 7.3 percent had, in at least one instance, attacked others with the intent to harm or seriously hurt them, which was similar to the rates of 7.9 percent in 2006 and 7.8 percent in 2002.
• Youths aged 12 to 17 who had engaged in fighting or other delinquent behaviors were more likely than other youths to have used illicit drugs in the past month. For example, in 2007, past month illicit drug use was reported by 16.5 percent of youths who had gotten into a serious fight at school or work in the past year compared with 7.5 percent of those who had not engaged in fighting, and by 36.6 percent of those who had stolen or tried to steal something worth over $50 in the past year compared with 8.2 percent of those who had not engaged in such theft.

Religious Beliefs and Participation in Activities

• In 2007, 31.4 percent of youths aged 12 to 17 reported that they had attended religious services 25 or more times in the past year, which was similar to the rate in 2006 (31.7 percent) and the rate in 2002 (33.0 percent). In addition, 76.1 percent agreed or strongly agreed with the statement that religious beliefs are a very important part of their lives, which was similar to the 77.0 percent reported in 2006, but was lower than the 78.2 percent reported in 2002. Also, 35.1 percent agreed with the statement that it is important for their friends to share their religious beliefs, which was the same as the rate in 2006 and similar to the rate in 2002 (35.8 percent).
• Rates of past month use of illicit drugs, cigarettes, and alcohol (including binge alcohol) were lower among youths aged 12 to 17 who agreed with these statements than among those who disagreed. For example, in 2007, past month illicit drug use was reported by 7.4 percent of those who agreed that religious beliefs are a very important part of life compared with 16.3 percent of those who disagreed with that statement.

Exposure to Substance Use Prevention Messages and Programs

• In 2007, approximately one in eight youths aged 12 to 17 (11.3 percent) reported that they had participated in drug, tobacco, or alcohol prevention programs outside of school in the past year. This rate was similar to the 11.4 percent reported in 2006, but was lower than the rates reported in 2002 (12.7 percent) and 2003 (13.9 percent). The prevalence of past month binge alcohol use was lower among those who participated in these prevention programs outside of school (7.9 percent) than among those who did not (9.9 percent). However, the prevalence of past month use of illicit drugs, marijuana, or cigarettes was not significantly lower among those who participated in these prevention programs outside of school (9.4 percent, 6.2 percent, and 9.0 percent, respectively) than among those who did not (9.5 percent, 6.7 percent, and 9.9 percent, respectively).
• In 2007, 77.9 percent of youths aged 12 to 17 reported having seen or heard drug or alcohol prevention messages in the past year from sources outside of school, which was lower than the 79.4 percent reported in 2006 and the 83.2 percent reported in 2002 (Figure 6.7). The prevalence of past month use of illicit drugs was lower among those who reported having such exposure (9.2 percent) than among those who reported having no such exposure (10.6 percent).

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Figure 6.7 Exposure to Substance Use Prevention Messages and Programs among Youths Aged 12 to 17: 2002-2007

Difference between this estimate and the 2007 estimate is statistically significant at the .05 level.
¹ Estimates are from youths aged 12 to 17 who were enrolled in school in the past year.

• In 2007, 75.8 percent of youths aged 12 to 17 enrolled in school in the past year reported having seen or heard drug or alcohol prevention messages at school, which was lower than the 76.9 percent reported in 2006 and the 78.8 percent reported in 2002 (Figure 6.7). The prevalence of past month use of illicit drugs or marijuana was lower among those who reported having such exposure (8.7 percent and 6.0 percent for illicit drugs and marijuana, respectively) than among those who reported having no such exposure (12.0 percent and 9.1 percent, respectively).
• In 2007, 59.6 percent of youths aged 12 to 17 reported that they had talked at least once in the past year with at least one of their parents about the dangers of drug, tobacco, or alcohol use. This was similar to the 59.8 percent reported in 2006, but was higher than the 58.1 percent reported in 2002. The prevalence of past month use of illicit drugs, marijuana, cigarettes, or binge alcohol among those who reported having had such conversations with their parents (8.6 percent, 6.2 percent, 9.0 percent, and 9.3 percent, respectively) was lower than that among those who reported having no such conversations (10.9 percent, 7.3 percent, 11.0 percent, and 10.4 percent, respectively).

Parental Involvement

• Youths aged 12 to 17 were asked a number of questions related to the extent of support, oversight, and control that they perceived their parents exercised over them in the year prior to the survey. In 2007, among youths aged 12 to 17 enrolled in school in the past year, 79.5 percent reported that in the past year their parents always or sometimes checked on whether or not they had completed their homework, which was the same as the rate in 2006 and similar to the 78.4 percent reported in 2002. In addition, 80.9 percent reported that their parents always or sometimes provided help with their homework, which was similar to the rates of 79.8 percent in 2006 and 81.4 percent in 2002. Also, 70.4 percent reported that their parents limited the amount of time that they spent out with friends on school nights, which was higher than the 69.1 percent reported in 2006, but was similar to the 70.7 percent reported in 2002.
• In 2007, 87.8 percent of youths aged 12 to 17 reported that in the past year their parents made them always or sometimes do chores around the house, 86.2 percent reported that their parents always or sometimes let them know that they had done a good job, and 85.7 percent reported that their parents let them know they were proud of something they had done. All of these percentages in 2007 were similar to those reported in 2006 and remained statistically unchanged from the rates reported in 2002. In 2007, however, 39.7 percent of youths reported that their parents limited the amount of time that they watched television, which was similar to the rate in 2006 (39.4 percent), but was higher than the 36.9 percent reported in 2002.
• In 2007, past month use of illicit drugs, cigarettes, and alcohol (including binge alcohol) was lower among youths aged 12 to 17 who reported that their parents always or sometimes engaged in monitoring behaviors than among youths whose parents "seldom" or "never" engaged in such behaviors. For example, the rate of past month use of any illicit drug was 8.1 percent for youths whose parents always or sometimes helped with homework compared with 16.0 percent among youths who indicated that their parents seldom or never helped. Rates for current cigarette smoking were 8.5 and 16.3 percent for the two groups of youths, respectively, and rates of past month binge alcohol use were 7.9 versus 18.3 percent correspondingly.

That ends this section.  In the next section the survey continues (yes, it is a very long survey!) by addressing Substance Dependence, Abuse and Treatment.