Teen drug use might drop as U.S. youth smoke less

(Reuters Health) - Two studies suggest that young people in the U.S. are smoking less than in the past, and this could be helping to reduce teen drug use as well, researchers say.

FILE PHOTO: Cigarette butts in an ashtray in Los Angeles, California, May 31, 2012. REUTERS/Jonathan Alcorn

One study published in Pediatrics examined survey data on tobacco use among middle school and high school students from 2011 to 2018 and found a drop in the proportion of youth who smoke as well as a decline in the number of daily cigarettes used by those who are current smokers.

A separate study in Tobacco Control tracked teen smoking from 2000 to 2018 and found a surge in the proportion of adolescents who had never even tried cigarettes. And never-smokers in this study were at least four times less likely to misuse drugs like opioids and amphetamines than teens who had tried smoking.

“Teens who have never smoked a cigarette have near-zero usage of these other drugs,” said Richard Miech of the University of Michigan in Ann Arbor, who led the Tobacco Control study.

Among high school seniors, the proportion who never smoked surged from 39% in 2001 to 76% in 2018, Miech and colleagues found. During this period, the proportion of never-smokers who used opioids or amphetamines remained relatively steady at about 1% to 3%.

Over this same time frame, however, drug use was much more common among high school seniors who had tried smoking at least once. Roughly 15% of teens who had tried smoking had also used amphetamines; opioid use in this group varied during the study and ranged from 3% to 18%.

“If the group of never-smokers grows - and they maintain their near-zero levels of use of other drugs - then they could bring down the overall levels of teen use of other drugs,” Miech said by email.

There are two main ways reducing cigarette use might also help curb drug use among teens, Miech said.

From a social perspective, kids who smoke are likely to become friends with other smokers, who can then introduce them to use of other drugs, Miech said.

At the same time, teens who get a taste of nicotine might experience changes in the brain that make them more receptive to use of other drugs, Miech added.

Some youth might be reducing cigarette use because they’re vaping, said Sunday Azagba, a researcher at the University of Utah in Salt Lake City and lead author of the Pediatrics study.

Azagba and colleagues looked at surveys that asked, among other things, how often teens who were current smokers used cigarettes or e-cigarettes in the previous 30 days.

Overall, the proportion of current smokers who were daily cigarette users dropped from 27% in 2011 to 18% in 2018. The proportion who smoked at least 10 days a month declined from 50% to 38%, and smoking on at least 20 days in a month fell from about 37% to 26%.

Light smoking - up to five cigarettes daily - became more common during the study period, while moderate smoking - six to ten daily cigarettes - declined.

Age at first cigarette use climbed among females and white students but fell among males.

Vaping, however, became more common. The proportion of youth who vaped daily rose from 9% to 22%.

“Despite overall decreases in cigarette use among youth, some youth, particularly males, continue to smoke heavily,” Azagba said by email.

“Prevention and cessation efforts should continue to target youth,” Azagba added. “Additionally, the high rates of dual-use suggest a need for education on the added risks of dual e-cigarette and cigarette use.”

SOURCE: Pediatrics, online February 3, 2020; and Tobacco Control, online January 15, 2020.