Is teen drug and alcohol use declining?
Teen substance use declined over time; vaping remained most common, with 33.8% of high schoolers in 2023, down 16.3 points from 2019.
Fewer teenagers are trying drugs or alcohol than they used to, according to the Centers for Disease Control and Prevention (CDC). In the 1990s, about 70% of high schoolers tried smoking cigarettes, the most popular substance at the time. By 2023, teen vaping was the most-tried, with one out of every three teens saying they’d vaped.
The CDC conducts the Youth Risk Behavior Surveillance System surveys with students in grades 9 through 12 every other year to track behaviors that can affect their health, including substance use.
Teen cigarette smoking dropped by 57 percentage points since its peak in 1995.
Percentage of high school drug or alcohol use by substance, 1991–2023
The substance with the largest drop in teen use was tobacco; between 1995 and 2023, cigarette smoking had a 56.9 percentage point drop from its peak. That year, 71.3% of high school students had at least tried a cigarette.
The second largest change was with alcohol, a 28.7 percentage point drop from 1991 (when 50.8% of teens said they currently drank alcohol) to 2023 (22.1%).
The least change? Marijuana usage, with a drop of 1.8 points (there were, however, fluctuations in use). Misused prescription pain medicine had the next-lowest change, a 2.4 point drop since 2017 (its first year of data. Cigarettes, alcohol, and marijuana have data going back to 1991).
What might have contributed to the decline in tobacco use?
What might have contributed to the decline in tobacco use?
The drop may be, in part, due to a series of lawsuits in the late 1990s. In November 1998, attorneys general from 51 states and territories settled a lawsuit with the R.J. Reynolds Tobacco Company about deceptive marketing practices.
Mississippi, Florida, Texas, and Minnesota also made separate settlements between 1997 and 1998 before the November 1998 settlement.
The Federal Trade Commission (FTC) had also charged the company with violations of federal law by marketing cigarettes to children via the Joe Camel mascot and other advertising practices. The settlement required R.J. Reynolds to end to all marketing targeting kids, pay over $200 billion to states through 2025, and contribute another $1.4+ billion for tobacco control and other charitable initiatives.
How many teenagers use drugs or alcohol?
About one out of every three high schoolers have tried vaping (also known as e-cigarettes), making it the most common substance use activity/substance in 2023. It was followed by marijuana (29.5%) and alcohol (22.1%).
The least-tried substances were tobacco (to smoke in cigarette form) (14.4%), prescription pain medicine (11.6%), and illicit drugs (9.9%).
Among illicit drugs, aerosol spray cans and other inhalants were the most commonly tried: 5.7% of high schoolers. Next were mushrooms or other hallucinogenic drugs (5.5%), ecstasy (2.7%), forms of cocaine (2.5%), methamphetamines (1.8%), and heroin (1.6%).
Is teen vaping on the rise?
No. While vaping is the most popular way to use substances among teens, its use has declined 16.3 percentage points since its 2019 peak (a high of 50.1%).
The Food and Drug Administration’s (FDA) 2024 annual survey of youth tobacco use reported that among sixth- through twelfth-graders who vaped, 87.6% reported using flavored e-cigarettes with fruit (62.8%), candy (33.3%) and mint (25.1%) being the most popular.
The survey also asked about specific e-cig brands. Young vapers were partial to:
- Elf Bar (36.1% of vapers)
- Breeze (19.9%)
- Mr. Fog (15.8%)
- Vuse (13.7%)
- JUUL (12.6%).
The study noted that Elf Bar consumption dropped by more than 20 percentage points in one year, and it has been subject to focused compliance and enforcement actions by the FDA since 2023.
Nearly 9 out of 10 youth who vaped reported using flavored products in 2024.
Percentage of youth who vape, by reported vaping product and brand preference, 2024
How many teens use marijuana?
Over a quarter of high school students (grades 9–12) — 29.5% — tried marijuana in 2023, up 1.7 points since the last CDC youth risk survey in 2021. Marijuana use peaked in 1999 when 47.2% of high school kids tried it.
Among high school teens who’ve tried marijuana, 57.6% stated that they're current users. That figure has been above 50% since 1993.
A smaller share of high schoolers who tried marijuana did so before the age of 13: 16.3% in 2023, the second-lowest percentage since the survey began in 1991.
In 2023, 57.6% of high schoolers who had tried marijuana reported current use.
Percentage of high schoolers who have tried marijuana that are current users, 1991–2023
How common is underage drinking?
In 2023, 22.1% of teenagers reported being current drinkers, or drinking alcohol at least once during the past 30 days before the CDC’s survey. Peak alcohol use was in 1995, when 51.6% of high school students said they currently drank alcohol.
Among youth who currently drink, 39.8% reported binge drinking (defined as 4 or more drinks within a few hours for females and 5 or more for males) and 10.0% reported sessions of 10 or more drinks.
About 40% of high schoolers who recently drank were binge drinkers.
Percentage of high schoolers who currently drink by amount of drinking, 2013–2023
Are there demographic trends in teenage drug and alcohol use?
Yes, there are some differences in teenage substance use by sex, sexual orientation and gender identity, and race or ethnicity.
Have more male or female teens tried drugs or alcohol?
In 2023, more female teens than male teens had used every substance the CDC survey measured, but that hasn’t always been the case. Through 2015, male teens generally used drugs or alcohol at higher rates than female teens for most substances. That began to shift in 2017; in 2017 and 2019 female teens used three out of six measured substances — alcohol and prescription pain medication in both years, and marijuana and vaping in one year each — more often than male teens did, and by 2023, female teens used all substances at higher rates.
Before 2017, male teens generally reported using drugs or alcohol more than female teens.
Gap between male and female drug or alcohol use rates, 1991–2023
Have more LBGTQ+ or heterosexual/cisgender youth tried drugs or alcohol?
A greater share of high school students identifying as LBGTQ+ have tried drugs or alcohol than their heterosexual or cisgender counterparts, for all substances. Vaping was the most popular for both groups. The largest percentage point difference was with marijuana — in 2023, LBGTQ+ teens had tried it at a rate that was 14.2 percentage points higher than their heterosexual peers. Underage drinking was the least different, with LBGTQ+ teens drinking alcohol at a rate of 4.5 points higher.
LBGTQ+ identifying teens reported using drugs or alcohol at higher rates for all substances.
Percentage of high school drug or alcohol use by substance and sexual/gender identity, 2023
Does teenage drug or alcohol use vary by race or ethnicity?
Teen vaping and marijuana use were more popular for every racial or ethnic identity, but the degree of use varied. American Indian or Alaska Native teens had the highest use rate for e-cigarettes (42.3%) and marijuana (41.0%), and Asian teens had the lowest rates for both substances, 17.5% and 17.6%.
American Indian or Alaska Native teens also had the highest use rates for cigarettes (23.0%) and illicit drugs (17.9%) while white teens had the highest rate of underage drinking (25.8%). Native Hawaiian or other Pacific Islander teens had the lowest rates for alcohol (11.5%), prescription pain medication (8.5%), and illicit drugs (6.2%). Black teens had the lowest cigarette smoking rate (7.8%).
Vaping and marijuana were reported as the two most used substances across all identities.
Percentage of high school drug or alcohol use by substance and race/ethnicity, 2023
How often have sexually active high school students tried drugs or alcohol?
High school students who were sexually active had substance use rates of at least 1.9 to 4.3 times that of students who weren’t sexually active, depending on the substance. The CDC survey asked high schoolers if they were sexually active and, if so, the sex of their partners. Among sexually-active teens, 69.3% of teens with partners of both sexes had tried vaping vs. 15.7% of kids who had no sexual contact.
The biggest delta was with marijuana — a 37.3 percentage point difference between teens who were not sexually active (11.7% had tried marijuana) and those who were active and in heterosexual relationships (49.0%).
Sexually active teens reported having higher rates of drug and alcohol use.
Percentage of high school drug or alcohol use by substance and sex of sexual partner, 2023
How many teens get treatment for drug and alcohol abuse?
In 2023, 35,910 minors aged 12 to 17 were admitted into a treatment facility, according to data from the Substance Abuse and Mental Health Services Administration (SAMHSA). Admissions fell 62.0% from 2013, when 104,059 young people were admitted.
In 2023, male youth made up 61.4% of admissions and female youth were 38.5%. By primary substance reported at admissions, marijuana or hashish led with 62.6%, followed by alcohol at 7.5%. In 21.3% of admissions, no specific substance was reported.
Youth substance use treatment admissions dropped 62% in 10-years.
Total youth admissions for substance use treatment, 2013–2023
If you or someone you know is experiencing alcohol or substance use disorders, call the SAMHSA National Helpline, 1-800-662-HELP (4357), a free, confidential, 24/7, year-round treatment referral and information service for individuals and families facing mental and/or substance use disorders.
Where does this data come from?
Where does this data come from?
The Youth Risk Behavior Surveillance System (YBRSS) is system of surveys conducted by the Centers for Disease Control and Prevention every two years since 1991. National YRBSS data are representative of all public and private school students in grades 9–12 in all 50 states and Washington, DC.
Among other topics, the CDC asked teens about substances they use, specifically:
- cigarettes (smoking and vaping),
- alcohol,
- misused prescription pain medicine,
- marijuana, and
- other illicit drugs (cocaine, inhalants, heroin, methamphetamines, ecstasy, or hallucinogens).
The CDC does not report on how many teens have ever tried alcohol, only those who currently consume it. Current use is defined as consumption of any substance at least one time in 30 days prior to the survey. For all other substances, there is also data on how many teens have tried them. Data for the full survey is available on the CDC website.
The stated intention of the YBRSS is to monitor adolescent heath behaviors over time to identify emerging issues and plan and evaluate youth programs to support heath. Substance use behaviors is one of four areas of focus:
- Student demographics: sex, sexual identity, race and ethnicity, and grade.
- Youth health behaviors and conditions: sexual, injury and violence, bullying, diet and physical activity, obesity, and mental health including suicide.
- Substance use behaviors: electronic vapor product and tobacco product use, alcohol use, and other drug use.
- Student experiences: parental monitoring, school connectedness, unstable housing, and exposure to community violence.
This article also references data from the Treatment Episode Data Set (TEDS) published by the Substance Abuse and Mental Health Services Administration (SAMHSA), an agency within the Department of Health and Human Services. TEDS reports on admissions to and discharges from treatment facilities, but not individual people. It does, however, track demographic information such as age, sex, race or ethnicity and employment status as well as information such as substances used, frequency, and number of previous admissions.
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