Research Spotlight: By age 21, about 1.56 million youth in the U.S. have reported using cigarettes, e-cigarettes, and binge drinking in the past 30 days

Published: January 20, 2022

Earlier exposure to tobacco and alcohol use increases the odds of substance abuse among youth and young adults. An important risk factor to consider for prevention is assessing the age of initiation of these substances. According to the 2019 National Youth Tobacco Survey (NYTS) data, e-cigarettes and cigar products were the most used tobacco products among adolescents in the United States, with 20.0% of middle school students and 5.3% of high school students using these products in the past 30 days. In addition, the 2017 National Survey on Drug Use and Health found that 5.3% of youth (aged 12–17) reported binge drinking in the past 30 days, which is a concern because alcohol is often a primary trigger for initiating tobacco use. Given that using both tobacco and alcohol are linked to long term health consequences, especially at a younger age, it is important to understand the age of when polysubstance use behavior begins.

The Population Assessment of Tobacco and Health (PATH) study has longitudinal national representation since 2013. Investigators at the University of Texas Health Science Center, School of Public Health estimated prospectively the age of initiation of two polysubstance use outcomes using the PATH study. Both outcomes include cigarette use and binge drinking over the past 30 days among youth who were 12–17 years old at the first wave of PATH participation. One outcome included e-cigarette use while the other outcome included cigar use. The study found that by age 21, 4.44% of youth or about 1.56 million U.S. youth are estimated to start using cigarettes, e-cigarettes, and binge drinking, and 1.98% of youth or about 700,000 U.S. youth are estimated to start using cigarettes, cigars, and binge drinking. Non-Hispanic white youth were reported to have the highest hazard of early age of initiation to both tobacco outcomes and binge drink compared to other ethnicities. Adolescence represents a period of critical growth and development during which neurobiological, physical, emotional, and social changes occur in youth, the early use of multiple substances has  negative health effects.

This study provides interventionists and the public with evidence to identify the most vulnerable populations at which education campaigns may be most effective to prevent youth from using multiple substances in the past 30 days. According to the CDC, some preventative strategies schools can implement include creating safe and supportive environments, connecting students to a supportive network, training for staff and having programs focused on positive youth development. In addition, the CDC states that the two key factors that protect youth from using high-risk drugs and from other health risk behaviors and experiences are fostering school connectedness and parent engagement in schools. Educating youth, parents, teachers and physicians on the age of initiation of polysubstance use is needed to reduce the burden and the impact of these substances on youth in our country.

CDC: https://www.cdc.gov/healthyyouth/substance-use/hrsu.htm

Link to publication: https://www.mdpi.com/1660-4601/18/24/12985