NATIONAL HOUSEHOLD SURVEY ON DRUG ABUSE: cigarette tables

1997 National Household Survey on Drug Abuse

Discussion

During 1997, about one-third of past year cigarette smokers, nearly one in six past year marijuana users, nearly one in six past year cocaine users, and about 7% of past year alcohol users reported three or more problems that are considered potential signs of dependence on each drug. These estimates translate to about 23 million past year cigarette smokers, about 3 million marijuana users, about 650,000 cocaine users, and about 10 million alcohol users who experienced three or more problems in the past year related to their use of these drugs.

More frequent or heavier users of each of these four drugs had notably higher rates of problems. Direct comparison of rates of problems, however, across drugs for more frequent or heavier users can be misleading because the measures of frequent or heavy use are not always comparable across drugs. In addition, as was discussed previously, reports of three or more drug-related problems should not be interpreted as being equivalent to a clinical diagnosis of dependence on these drugs. Nevertheless, people reporting multiple problems may be in need of services for their drug use.

The most frequently reported problems for past year users of marijuana and alcohol were spending a great deal of time getting or using the drug or getting over its effects, using the drug more often or in larger amounts than intended, and developing a tolerance for the substance. Among heavy cigarette smokers, the most frequently reported problem was wanting or trying to quit or cut down on using cigarettes but not being able to do so.

Among past year users of cocaine who were aged 12 or older, the most prevalent problem was the occurrence of psychological problems associated with cocaine use. This finding is consistent with a considerable body of literature on the psychological effects of cocaine intoxication and cocaine withdrawal (e.g., Anthony & Petronis, 1991; APA, 1994; Gawin & Ellingwood, 1998; Lowenstein et al., 1987; Post, 1975; Schottenfeld, Carroll, & Rounsaville, 1993). In comparison, the most commonly occurring problem among youths who had used cocaine in the past year was spending a great deal of time getting, using, or getting over the effects of cocaine. Nevertheless,more than one in five youths who were past year cocaine users reported psychological problems associated with their cocaine use. Because of the cross-sectional design of the NHSDA, however, it is not possible to distinguish between cocaine users whose psychological problems preceded the onset of cocaine use, those whose problems were a direct consequence of use (possibly in combination with other factors), and those whose problems followed the onset of cocaine use but were principally a consequence of one or more other behavioral or environmental factors.

Among past year users of marijuana, alcohol, and cigarettes, users in the younger age groups, and especially heavy users, tended to report higher rates of problems than did older users. For cocaine, however, there was no consistent relationship between age and the occurrence of problems. For marijuana, alcohol, and cigarettes, these findings may suggest that younger users may consider themselves to be less able to "manage" their use so as to reduce associated problems. Alternatively, psychological mechanisms, such as "denial," may not be as fully in place among younger users compared with older users, such that younger users may be more willing than older users to acknowledge the existence of problems. Neither of these hypotheses can be tested with the NHSDA data, however, because each would require a research design that repeatedly samples these behavioral and attitudinal measures in the same cohort over time.

Table 9.1 Percentage Reporting Components of Dependence in the Past Year Attributed to Use of Marijuana for the Total Population, Those Who Used at Least Once in the Past Year, and Those Who Used Once a Month or More Often in the Past Year, by Age Group: 1997


Problems in the Past Year Attributed to Marijuana Use¹	Age Group in Years				Total
	12-17	18-25	26-34	35+	Total
A. Total Population²
Wanted or tried to cut down but couldn't	2.9	3.0	1.2	0.2	1.0
Built up tolerance	4.7	5.6	1.3	0.5	1.7
Spent month or more on drug	5.7	6.1	2.5	0.8	2.3
Used drug more than intended	4.7	5.0	1.4	0.5	1.7
Reduced important activities	1.7	1.7	0.6	0.1	0.5
Caused psychological problems	2.9	2.9	1.0	0.2	1.0
Caused health problems	1.8	1.4	0.3	0.2	0.5
Any of the above problems	8.9	10.0	3.7	1.1	3.5
2 or more of the above problems	6.1	6.9	2.0	0.6	2.2
3 or more of the above problems	4.3	4.3	1.3	0.4	1.4
B. Used Marijuana at Least Once in the Past Year
(Unweighted n)	(1,309)	(1,350)	(466)	(264)	(3,389)
Wanted or tried to cut down but couldn't	18.7	13.5	10.6	5.1	11.4
Built up tolerance	29.9	25.2	11.4	10.4	18.8
Spent month or more on drug	35.8	27.4	21.9	18.0	25.1
Used drug more than intended	29.5	22.6	12.2	11.8	18.6
Reduced important activities	11.0	7.4	4.9	1.9	5.9
Caused psychological problems	18.3	13.0	9.4	4.8	10.8
Caused health problems	11.7	6.2	2.8	3.9	5.8
Any of the above problems	56.6	44.8	33.2	25.4	38.9
2 or more of the above problems	38.8	30.9	17.9	14.3	24.8
3 or more of the above problems	27.0	19.1	12.0	8.9	16.1
C. Used Marijuana on 12 or More Days in the Past Year
(Unweighted n)	(690)	(752)	(252)	(141)	(1,835)
Wanted or tried to cut down but couldn't	23.4	19.7	16.2	8.5	16.5
Built up tolerance	45.9	41.6	21.0	*	31.8
Spent month or more on drug	52.9	44.5	40.0	*	41.1
Used drug more than intended	44.5	34.7	22.9	*	30.0
Reduced important activities	16.9	11.9	9.2	2.2	9.5
Caused psychological problems	25.7	18.8	14.7	*	15.8
Caused health problems	17.2	9.9	4.6	*	9.2
Any of the above problems	74.0	65.2	53.7	*	57.9
2 or more of the above problems	56.7	49.0	32.8	*	40.7
3 or more of the above problems	42.3	32.3	23.1	*	27.6

Note 1: The definitions of these problems are different in number and kind from those used in the 1994 NHSDA and earlier years. Therefore, data in this table cannot be compared directly with Main Findings data prior to 1995.
Note 2: Questions asked were: In the past 12 months, indicate: (1) If you wanted or tried to stop or cut down on your use of that drug but found that you couldn't. (2) Whether you had built up a tolerance for the drug so that the same amount had less effect than before. (3) Whether you had a period of a month or more when you spent a great deal of time getting or using the drug, or getting over its effects. (4) Whether you have used that kind of drug much more often or in larger amounts than you intended. (5) Whether your use of the drug often kept you from working, going to school, taking care of children, or engaging in recreational activities. (6) Whether your use of the drug caused you to have any emotional or psychological problems-such as feeling uninterested in things, feeling depressed, feeling suspicious of people, feeling paranoid, or having strange ideas. (7) Whether your use of the drug caused you any health problems-such as liver disease, stomach disease, pancreatitis, feet tingling, numbness, memory problems, an accidental overdose, a persistent cough, a seizure or fit, hepatitis, an accidental overdose, or abscesses.

*Low precision; no estimate reported.

¹ Respondents with missing data on problems were coded as not having problems.
² Reports of past year drug-related problems were disregarded in the absence of indications of past year use on the marijuana answer sheet. The 1997 total population estimates may be somewhat lower than those reported in 1995 and 1996, which included all reports of drug-related problems in such estimates.

Source: Office of Applied Studies, SAMHSA, National Household Survey on Drug Abuse, 1997.

Table 9.2 Percentage Reporting Components of Dependence in the Past Year Attributed to Cocaine Use for the Total Population, Those Who Used at Least Once in the Past Year, and Those Who Used Once a Month or More Often in the Past Year, by Age Group: 1997


Problems in the Past Year Attributed to Cocaine Use¹	Age Group in Years				Total
	12-17	18-25	26-34	35+	Total
A. Total Population²
Wanted or tried to cut down but couldn't	0.3	0.7	0.4	0.2	0.3
Built up tolerance	0.4	0.6	0.3	0.1	0.3
Spent month or more on drug	0.6	0.7	0.4	0.2	0.3
Used drug more than intended	0.5	0.6	0.5	0.2	0.3
Reduced important activities	0.3	0.5	0.4	0.1	0.2
Caused psychological problems	0.5	0.8	0.5	0.2	0.3
Caused health problems	0.2	0.5	0.3	0.1	0.2
Any of the above problems	1.1	1.7	0.8	0.3	0.6
2 or more of the above problems	0.7	1.1	0.6	0.2	0.4
3 or more of the above problems	0.4	0.6	0.4	0.2	0.3
B. Used Cocaine at Least Once in the Past Year
(Unweighted n)	(202)	(300)	(155)	(83)	(740)
Wanted or tried to cut down but couldn't	14.0	16.7	13.7	13.8	14.6
Built up tolerance	17.2	15.4	9.1	12.9	13.0
Spent month or more on drug	29.1	16.8	12.6	17.5	17.4
Used drug more than intended	20.9	15.8	16.7	17.0	17.1
Reduced important activities	13.0	12.7	12.4	12.0	12.4
Caused psychological problems	21.5	20.5	14.9	17.3	18.0
Caused health problems	8.7	12.4	9.5	9.7	10.2
Any of the above problems	*	43.2	25.9	*	33.3
2 or more of the above problems	30.6	28.1	20.6	18.4	22.9
3 or more of the above problems	19.5	14.5	12.7	17.2	15.6
C. Used Cocaine on 12 or More Days in the Past Year
(Unweighted n)	(53)	(102)	(63)	(37)	(255)
Wanted or tried to cut down but couldn't	*	*	*	*	30.1
Built up tolerance	*	*	*	*	28.4
Spent month or more on drug	*	*	*	*	36.1
Used drug more than intended	*	*	*	*	36.2
Reduced important activities	*	*	*	*	27.1
Caused psychological problems	*	*	*	*	34.3
Caused health problems	*	*	*	*	20.9
Any of the above problems	*	*	*	*	57.5
2 or more of the above problems	*	*	*	*	*
3 or more of the above problems	*	*	*	*	35.6

*Low precision; no estimate reported.

¹ Respondents with missing data on problems were coded as not having problems.
² Reports of past year drug-related problems were disregarded in the absence of indications of past year use on the cocaine or crack cocaine answer sheet. The 1997 total population estimates may be somewhat lower than those reported in 1995 and 1996, which included all reports of drug-related problems in such estimates.

Source: Office of Applied Studies, SAMHSA, National Household Survey on Drug Abuse, 1997.

Table 9.3 Percentage Reporting Components of Dependence in the Past Year Attributed to Alcohol Use for the Total Population, Past Year Users, and Those Who Had Five or More Drinks on the Same Occasion on 5 or More of the Past 30 Days, by Age Group: 1997


Problems in the Past Year Attributed to Alcohol Use¹	Age Group in Years
	12-17	18-25	26-34	35+	Total
A. Total Population²
Wanted or tried to cut down but couldn't	4.2	7.1	5.3	3.2	4.2
Built up tolerance	6.3	16.5	7.3	3.5	6.1
Spent month or more on drug	6.7	15.6	10.1	5.9	7.9
Used drug more than intended	6.0	15.0	10.8	5.4	7.5
Reduced important activities	2.1	4.8	3.2	1.3	2.2
Caused psychological problems	2.9	5.5	3.1	2.0	2.7
Caused health problems	1.2	2.6	1.7	1.3	1.5
Any of the above problems	13.1	29.6	18.7	10.7	14.7
2 or more of the above problems	7.4	16.7	10.4	5.5	7.9
3 or more of the above problems	4.5	10.0	6.4	3.2	4.7
B. Any Alcohol Use in the Past Year
(Unweighted n)	(2,671)	(4,472)	(3,056)	(3,759)	(13,958)
Wanted or tried to cut down but couldn't	12.4	9.4	7.2	5.0	6.5
Built up tolerance	18.4	22.0	9.8	5.5	9.5
Spent month or more on drug	19.7	20.8	13.5	9.3	12.4
Used drug more than intended	17.8	19.9	14.5	8.4	11.8
Reduced important activities	6.3	6.4	4.3	2.1	3.4
Caused psychological problems	8.5	7.4	4.2	3.1	4.2
Caused health problems	3.6	3.4	2.2	2.0	2.3
Any of the above problems	38.7	39.4	25.0	16.7	22.9
2 or more of the above problems	21.8	22.3	13.9	8.5	12.4
3 or more of the above problems	13.3	13.3	8.6	5.0	7.4
C. Five or More Drinks on Each of 5 or More Occasions in the Past 30 Days
(Unweighted n)	(243)	(602)	(277)	(226)	(1,348)
Wanted or tried to cut down but couldn't	23.0	21.0	24.7	19.4	21.2
Built up tolerance	63.0	61.3	32.5	27.2	39.6
Spent month or more on drug	61.6	55.2	43.2	40.1	46.1
Used drug more than intended	60.9	51.8	44.4	34.2	42.8
Reduced important activities	21.6	19.7	8.0	7.9	11.9
Caused psychological problems	20.1	22.0	14.6	17.8	18.3
Caused health problems	12.4	9.7	8.7	8.0	8.9
Any of the above problems	77.4	81.5	64.2	62.8	69.0
2 or more of the above problems	68.8	63.5	46.2	41.6	50.1
3 or more of the above problems	52.9	44.0	32.9	23.9	33.0

*Low precision; no estimate reported.

¹ Respondents with missing data on problems are coded as not having problems.

² Reports of past year drug-related problems were disregarded in the absence of indications of past year use on the alcohol answer sheet. The 1997 total population estimates may be somewhat lower than those reported in 1995 and 1996, which included all reports of drug-related problems in such estimates.

Source: Office of Applied Studies, SAMHSA, National Household Survey on Drug Abuse, 1997.

Table 9.4 Percentage Reporting Components of Dependence in the Past Year Attributed to Cigarette Use for the Total Population, Past Year Users, and Those Who Currently Smoke a Pack or More a Day, by Age Group: 1997


Problems in the Past Year Attributed to Cigarette Use¹	Age Group in Years				Total
	12-17	18-25	26-34	35+	Total
A. Total Population²
Wanted or tried to cut down but couldn't	8.2	21.2	17.0	12.6	14.0
Built up tolerance	8.3	17.3	11.1	7.4	9.3
Spent month or more on drug	9.9	21.3	15.4	11.7	13.4
Used drug more than intended	8.3	18.7	14.5	10.3	11.8
Reduced important activities	1.9	2.8	2.5	1.4	1.8
Caused psychological problems	1.6	3.0	2.2	1.4	1.7
Caused health problems	3.0	6.4	4.5	3.5	4.0
Any of the above problems	14.0	29.5	23.5	17.7	19.8
2 or more of the above problems	10.5	23.6	17.5	13.1	14.9
3 or more of the above problems	7.8	18.2	13.1	9.0	10.8
B. Smoked Cigarettes at Least Once in the Past Year
(Unweighted n)	(1,929)	(2,601)	(1,646)	(1,851)	(8,027)
Wanted or tried to cut down but couldn't	31.0	46.1	45.0	42.5	42.7
Built up tolerance	31.3	37.7	29.4	24.9	28.6
Spent month or more on drug	37.3	46.5	40.9	39.5	40.8
Used drug more than intended	31.3	40.7	38.5	34.8	36.2
Reduced important activities	7.1	6.2	6.7	4.6	5.5
Caused psychological problems	6.0	6.6	5.8	4.6	5.3
Caused health problems	11.4	13.9	11.9	11.7	12.1
Any of the above problems	53.0	64.4	62.3	59.6	60.4
2 or more of the above problems	39.8	51.5	46.6	44.1	45.5
3 or more of the above problems	29.6	39.7	34.9	30.5	32.9
C. Currently Smoke About a Pack or More Per Day
(Unweighted n)	(120)	(480)	(471)	(786)	(1,857)
Wanted or tried to cut down but couldn't	63.6	67.5	63.7	54.5	57.6
Built up tolerance	78.4	61.6	49.4	33.0	39.6
Spent month or more on drug	82.6	71.2	62.0	49.6	54.6
Used drug more than intended	77.1	61.7	55.5	44.9	49.0
Reduced important activities	25.4	8.2	7.8	4.9	6.1
Caused psychological problems	*	7.0	6.7	4.4	5.3
Caused health problems	*	26.1	19.9	15.9	18.1
Any of the above problems	91.1	87.3	82.5	73.2	76.6
2 or more of the above problems	85.1	77.0	69.4	57.0	61.7
3 or more of the above problems	80.4	65.3	55.8	40.2	46.2

Note 1: The definitions of these problems are different in number and kind from those used in the 1994 NHSDA and earlier years. Therefore, data in this table cannot be compared directly with Main Findings data prior to 1995.
Note 2: Questions asked were: In the past 12 months, indicate: (1) If you wanted or tried to stop or cut down on your use of that drug but found that you couldn't. (2) Whether you had built up a tolerance for the drug so that the same amount had less effect than before. (3) Whether you had a period of a month or more when you spent a great deal of time getting or using the drug, or getting over its effects. (4) Whether you have used that kind of drug much more often or in larger amounts than you intended. (5) Whether your use of the drug often kept you from working, going to school, taking care of children, or engaging in recreational activities. (6) Whether your use of the drug caused you to have any emotional or psychological problems-such as feeling uninterested in things, feeling depressed, feeling suspicious of people, feeling paranoid, or having strange ideas. (7) Whether your use of the drug caused you any health problem-such as liver disease, stomach disease, pancreatitis, feet tingling, numbness, memory problems, an accidental overdose, a persistent cough, a seizure or fit, hepatitis, an accidental overdose, or abscesses.

*Low precision; no estimate reported.

¹ Respondents with missing data on problems are coded as not having problems.
² Reports of past year drug-related problems were disregarded in the absence of indications of past year use on the tobacco answer sheet. The 1997 total population estimates may be somewhat lower than those reported in 1995 and 1996, which included all reports of drug-related problems in such estimates.

Source: Office of Applied Studies, SAMHSA, National Household Survey on Drug Abuse, 1997.

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