Health Objectives for the Nation
Current Tobacco, Alcohol, Marijuana, and Cocaine Use
Among High School Students -- United States, 1990
Patterns of tobacco, alcohol, and other drug use usually are
established during youth, often persist into adulthood, contribute
substantially to the leading causes of mortality and morbidity (1),
and are associated with lower educational achievement and school
dropout (2-5). This report presents selected data on current use of
tobacco, alcohol, marijuana, and cocaine among 9th-12th grade
students from two components of the Youth Risk Behavior
Surveillance System (6): 1) the 1990 national school-based Youth
Risk Behavior Survey (YRBS) conducted during April-May 1990 and 2)
similar surveys conducted by departments of education in 22 states
and four cities during the same time period.
The national survey used a three-stage sample design to obtain
a probability sample of 11,631 students in grades 9-12 in the 50
states, the District of Columbia, Puerto Rico, and the Virgin
Islands. The 26 state and local sites used a variety of sampling
schemes: 14 drew probability samples from well-defined sampling
frames of schools and students, allowing computation of weighted
results of known precision; nine drew probability samples of both
schools and students, but either low overall response rates or
unavailable documentation precluded weighting the data or making
estimates of precision; and three used nonprobability samples of
either schools or students (Table 1).
For the state and local surveys, school response rates ranged
from 31% to 100%; student response rates ranged from 54% to 94%.
Sample sizes ranged from 378 to 5675 students. Students in most
samples were distributed evenly across grades and between genders.
The racial/ethnic characteristics of the samples varied
considerably (Table 1).
Among the state and local surveys, rates varied for current
tobacco, alcohol, and drug use during the 30 days preceding the
survey (Table 2): 9%-37% of students (median: 31%) reported smoking
at least one cigarette; 1%-20% (median: 11%) reported using
smokeless tobacco; 28%-64% (median: 54%) reported having at least
one drink of alcohol; 17%-47% (median: 35%) reported having five or
more drinks on one occasion; 3%-17% (median: 12%) reported using
marijuana at least once; and 1%-4% (median: 2%) reported using any
form of cocaine, including powder, crack, or freebase. At most
sites, more male than female students reported these behaviors. The
median prevalence estimates from the state and local surveys were
similar to the national prevalence estimates (Table 2).
Reported by: J Moore, Alabama State Dept of Education. D
Sandau-Christopher, State of Colorado Dept of Education. J Sadler,
District of Columbia Public Schools. G Davis, Georgia Dept of
Education. J Grosko, Kansas State Dept of Education. I Mudd,
Kentucky Dept of Education. T Dunn, Massachusetts Dept of
Education. A Jordan, Mississippi State Dept Bur of School
Improvement. J Owens-Nausler, Nebraska Dept of Education. B
Grenert, New Hampshire State Dept of Education. B Blair, New Mexico
State Dept of Education. A Sheffield, New York State Education
Dept. P Hunt, North Carolina Dept of Public Instruction. J
Reynolds, Oklahoma State Dept of Education. P Ruzicka, Oregon Dept
of Education. M Sutter, Pennsylvania Dept of Education. J Fraser,
South Carolina State Dept of Education. M Carr, South Dakota Dept
of Education and Cultural Affairs. E Word, Tennessee State Dept of
Education. L Lacy, Utah State Board of Education. L Zedosky, West
Virginia Dept of Education. B Nehls-Lowe, Wisconsin Dept of Public
Instruction. D Scalise, The School Board of Broward County; AN Gay,
The School Board of Dade County, Florida. D Chioda, Jersey City
Public School District, New Jersey. P Simpson, Dallas Independent
School District, Texas. A Blanken, Div of Epidemiology and
Prevention Research, National Institute on Drug Abuse, Alcohol,
Drug Abuse, and Mental Health Administration. Office on Smoking and
Health and Div of Adolescent and School Health, National Center for
Chronic Disease Prevention and Health Promotion, CDC.
Editorial Note
Editorial Note: Because the quality of the samples varied among the
state and local surveys, comparisons of data across sites should be
made with caution. Nonetheless, these results can be useful in
planning and evaluating broad national, state, and local
interventions and monitoring progress toward achieving National
Education Goals and health objectives. Goal 6 of the National
Education Goals (7) aims to have every school in the United States
free of drugs and violence and offer a disciplined environment
conducive to learning by the year 2000. The results presented in
this report will be incorporated in the first progress report on
the status of the National Education Goals to be released September
30, 1991.
Year 2000 national health objectives 3.5, 3.9, 4.5, 4.6, 4.7,
4.8, and 4.11 are to reduce the use of tobacco, alcohol, and other
drugs among youth (8). For example, objective 4.6 states that among
youth aged 12-17 the prevalence of alcohol use during the previous
30 days should be no more than 12.6%, that of marijuana use no more
than 3.2%, and that of cocaine use no more than 0.6%. Prevalence
rates from the national YRBS for 9th-12th grade students were four
times higher for alcohol and marijuana use and three times higher
for cocaine use than these objectives. Furthermore, most states and
cities that conducted a YRBS have not reached these national
objectives. To meet the National Education Goals and the national
health objectives, efforts to help youth reduce current use of
tobacco, alcohol, and other drugs will need to increase among
federal, state, and local education, health, and drug-control
agencies; families; media; legislators; relevant community
organizations; and youth themselves.
References
CDC. Results from the National Adolescent Student Health Survey.
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Jessor R, Jessor S. Problem behavior and psychosocial
development: a longitudinal study. New York: Academic Press, 1977.
Kolbe LJ, Green L, Foreyt J, et al. Appropriate functions of
health education in schools: improving health and cognitive
performance. In: Krasnegor NA, Arasteh JD, Cataldo MF, eds. Child
health behavior: a behavioral pediatrics perspective. New York:
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Dryfoos J. Adolescents at risk: prevalence and prevention. New
York: Oxford University Press, 1990.
Mensch BS, Kandel DB. Dropping out of high school and drug
involvement. Sociology of Education 1981;61:95-113.
Kolbe LJ. An epidemiological surveillance system to monitor the
prevalence of youth behaviors that most affect health. Health
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National Education Goals Panel. Measuring progress toward the
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strategies--discussion document. Washington, DC: National Education
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Public Health Service. Healthy people 2000: national health
promotion and disease prevention objectives. Washington, DC: US
Department of Health and Human Services, Public Health Service,
1991; DHHS publication no. (PHS)91-50212.
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