Teenagers are drinking less alcohol, smoking fewer cigarettes and trying fewer hard drugs, new federal survey data shows. But these public health gains have been offset by a sharp increase in vaping of marijuana and nicotine.
These diverging trend lines, published Wednesday, are among the findings in the Monitoring the Future survey — a closely watched annual study by the National Institute on Drug Abuse, or NIDA, of eighth, 10th and 12th graders. The survey shows that youth drug use and experimentation continue to undergo significant evolution.
Most troubling to public health experts in this year’s report were sharp increases in marijuana vaping. Of 12th graders surveyed, 14 percent said they had vaped marijuana in the last month, nearly double the 7.5 percent reported a year ago.
The percentage of teenagers who said they had vaped marijuana once or more over the last year essentially doubled during the past two years as well, rising to 7 percent for eighth graders, 19.4 percent for 10th graders and 20.8 percent for 12th graders.
The survey found that 3.5 percent of 12th graders and 3 percent of 10th graders report daily use, the first year the researchers had asked that question.
The data also echoed statistics that the government released in September about e-cigarettes, with a quarter of high school seniors reporting that they had vaped nicotine within the last month, along with one in four 10th graders.
“This is a very, very worrisome trend,” Dr. Nora Volkow, director of NIDA, said of the rise in both types of vaping among young people.
Vaping of marijuana was at the root of a public health crisis that unfolded this summer when more than 2,000 people across the country, many in their teens and 20s, became gravely ill with a lung infection that left many of them unable to breathe on their own. Most of the patients said they had vaped THC, the high-inducing ingredient in marijuana.
According to the Centers for Disease Control and Prevention, there have been 2,409 cases of hospitalization associated with vaping lung illness nationwide and 52 deaths. (Many of those who died were middle-aged or older, though one was 17.)
Public health experts have said the cause is not entirely clear but appears to stem from the way the lungs struggle to process certain oils used in black-market marijuana vaping devices; they have identified vitamin E acetate, an ingredient in some products, as a possible cause.
Though vaping of marijuana is on the rise, the overall rates of using the drug in all forms — smoking, vaping, edibles — were mixed. The rate of overall marijuana use held steady for high school students who reported using it once or more over the past year, but there was an uptick in daily use.
The Monitoring the Future survey this year did give public health experts a number of reasons to feel encouraged, as high school students reported declining use of many substances, including alcohol and tobacco, continuing a long-term trend.
Roughly 52 percent of high school seniors said they had used alcohol in the last year, along with 37.7 percent of 10th graders. Those figures have been dropping for years; in 2000, 73.2 percent of 12th graders said they had used alcohol in the last year as did 65.3 percent of 10th graders.
Cigarette use continued to drop, too. The portion of seniors who reported smoking in the last month fell to 5.7 percent, down from 13.6 percent five years ago.
Public health experts said that those declines — along with drops in the use of prescription painkillers like OxyContin and Vicodin — are the result of a multifaceted effort in the United States to discourage drug use, including stricter school penalties, smoking bans and general public awareness campaigns.
“There has been a whole lot of effort at the community level,” said Dr. Sion Kim Harris, a pediatrician and a co-director for the Center for Adolescent Substance Abuse Research at Boston Children’s Hospital. “There are some encouraging trends.”
On the flip side, she said, when it comes to vaping, young people may have gotten the wrong message: that it is not harmful. Silvia Martins, an associate professor of epidemiology at the Columbia University Mailman School of Public Health, noted that marijuana is increasingly marketed in states where it is legal to suggest the drug may have widespread health benefits, claims that are not backed up by science. The rise of marijuana vaping among young people, she said, “could be related to the fact it is seen as less harmful and less risky.”
More broadly, Dr. Martins and other experts said that the changes in teenage drug use may have a curious influence: technology.
The rise in vaping, they said, stems partly from the allure of the sleek electronic devices that deliver nicotine and marijuana, glamorized on social media and streaming videos; the gadgets are also relatively easy to conceal because they are designed to reduce smell and smoke. The popular Juul device, for instance, is often referred to as the iPhone of e-cigarettes.
“One of the reasons they are embracing these devices is because they are new technology. It resonates,” said Dr. Volkow of NIDA, the federal drug abuse institute.
But technology may also be partly responsible for the decline in the use of some other drugs, Dr. Martins and Dr. Volkow, among others, have hypothesized. The theory is that some teenagers are partying less because they are spending time stimulated by their devices, and communicating with one another over social media, rather than in gatherings where they might have encountered alcohol or drugs. Dr. Martins is in the middle of research to test that hypothesis.
Now Dr. Volkow said she hopes that teenagers will awaken to the fact that using marijuana regularly can be dangerous. “Less and less do kids feel it is harmful to smoke marijuana regularly,” she said, adding that she regrets that these teens are being misled by what she called “the freedom of misinformation.”
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