The NHSDA includes an extensive set of risk and protective factors concerned with substance abuse prevention issues. Risk factors include those individual characteristics or social environments associated with an increased likelihood of substance use, while protective factors are related to a decreased likelihood of substance use, or nonuse. These factors derive from circumstances, influences, and perceptions at many levels such as the individual, peer, family, school, and community levels. A number of risk factors have been shown to be correlated with youth use of cigarettes, alcohol, and other illicit drugs. One goal of youth prevention programs has been to identify those factors and design programs that might affect them. Since individual attitudes and perceptions of substance use typically precede substance use, tracking risk and protective factors over time can provide an advance alert of upturns and downturns in actual use.
A recent report (SAMHSA, 2001b) based on the 1997 NHSDA data presented initial findings on a number of risk and protective factors for youth. A more comprehensive list of possible risk and protective factors was included in the 1999 NHSDA. A further analysis of those data is currently underway and will address issues of the relative change in these factors over time and their impact on levels of substance use. The section below presents some results from the 1999 and 2000 NHSDA surveys containing data on attitudes and beliefs about drug use, drug availability, parental disapproval, participation in substance abuse education programs, and the association of risk and protective factors with substance use.
Perceptions of Risk
For persons aged 12 and older, the perceived risks of using cigarettes and alcohol increased between 1999 and 2000, but perceptions of risk of using illicit drugs did not change. For cigarettes, the percentage who indicated there was a great risk of smoking one or more packs per day rose from 66.7 percent in 1999 to 69.3 percent in 2000. The increased perception of cigarette use risk in 2000 was consistent for all three age groups: 12 to 17, 18 to 25, and 26 and older (Figure 6.1).
The percentage reporting great risk of heavy drinking and binge drinking also rose in 2000 from 69.6 percent to 70.6 percent and from 45.1 to 47.1 percent, respectively. Perceived risk of binge drinking also rose significantly from 1999 to 2000 in both the 12 to 17 age group and the 26 and older age group. However, reported risks of using marijuana, cocaine, heroin and LSD were stable over the same period (Figure 6.2).
Among youths aged 12 to 17, the percentage reporting great risk of smoking a pack or more of cigarettes a day increased from 60.7 percent in 1999 to 64.1 percent in 2000. This increase was widespread in that it was statistically significant across a number of demographic subgroups of youth: ages 12 and 13, 14 and 15, and 16 and 17, both males and females, whites and Hispanics, and metropolitan and nonmetropolitan counties.
The percentage of youths aged 12 to 17 indicating a great risk of smoking marijuana once a month remained unchanged between 1999 and 2000 (37.2 percent in 1999 and 37.7 percent in 2000). This stability in perceived risk was consistent overall and for all age, race/ethnicity, gender, and nonmetropolitan subgroups among youth; however, youth in small metropolitan counties showed an increase from 36.3 percent in 1999 to 38.3 percent in 2000.
Availability
The percentage of persons aged 12 and older indicating that it was fairly or very easy to obtain a substance decreased between 1999 and 2000 for marijuana (56.9 to 54.8 percent), cocaine (32.3 to 30.4 percent), crack (30.9 to 29.0 percent), heroin (20.9 to 19.4 percent), and LSD (23.4 to 22.3 percent). These trends were consistent across all age groups: 12 to 17, 18 to 25 and 26 and older, except for LSD among persons aged 26 and older, which was stable (Figure 6.3).
The percentage of persons aged 12 and older who had been approached in the past month by someone selling drugs decreased slightly between 1999 and 2000 from 8.0 to 7.4 percent. This was primarily due to a decrease from 5.2 to 4.5 percent for persons aged 26 and older.
The percentage of youth indicating, "A lot of drug selling goes on in my neighborhood," increased between 1999 (24.8 percent) and 2000 (26.6 percent). The increases occurred among youth aged 16 and 17, both males and females, metropolitan and nonmetropolitan areas, and among whites.
Parental Disapproval
The percentage of youths aged 12 to 17 indicating their parents would "strongly disapprove" of their smoking one or more packs of cigarettes per day remained stable between 1999 (87.4 percent) and 2000 (87.8 percent). The percentage of youth who felt their parents would disapprove if they had one or two drinks of an alcoholic beverage nearly every day decreased from 89.5 in 1999 to 87.9 in 2000. The percentage reporting strong parental disapproval about trying marijuana or hashish once or twice dropped from 90.7 percent in 1999 to 89.5 percent in 2000.
Delinquent Behaviors Among Youths Aged 12 to 17
The percentage of youth who reported they had gotten into a serious fight at work or school in the past year dropped from 21.9 in 1999 to 17.9 in 2000. This decrease occurred among youths aged 14 to 17, both genders, whites, Hispanics, and metropolitan and nonmetropolitan counties. The percentage participating in a group-against-group fight one or more times also declined during the same period (from 17.1 to 15.0 percent).
The small percentage of youth reporting they had carried a handgun one or more times in the past year decreased from 3.6 percent to 2.9 percent in 2000. The percentage of youth that reported selling drugs in the past year remained steady during 1999 and 2000 at about 3.5 percent.
There was also a decline in the percentage of youth who reported having stolen or having tried to steal something worth $50 or more at least once in the past year. In 1999, this percentage was 4.8, while in 2000, the percentage fell slightly to 4.3 percent.
There was a drop in the percentage of youths aged 12 to 17 reporting that they had attacked someone with the intent to seriously hurt them during the past year. The percentage fell from 8.4 percent in 1999 to 7.5 percent in 2000.
Youth Exposure to Prevention Messages and Programs
A majority (81.9 percent) of youths aged 12 to 17 had either seen or heard a drug prevention message outside of school in the past year. A similar number had heard the out-of-school messages in both 2000 (81.9 percent) and 1999 (82.3 percent).
Among youths aged 12 to 17 who reported being enrolled in school during the past 12 months, 77.9 percent reported having been exposed to a drug message in school during that period. The percentage hearing anti-drug messages at school in 2000 was similar to the rate in 1999 (77.6 percent).
In 1999 and 2000, similar percentages of youth (about 58 percent) indicated that they had talked with a parent in the past year about the dangers of tobacco, alcohol, or drug use.
The percentage of youth who participated in a problem solving, communication, or self-esteem group in 2000 (18.9 percent) was slightly lower than the percentage for 1999 (20.1 percent). The percentage who had participated in a drug prevention program outside of school in 2000 (11.8 percent) was similar to the percentage that participated in 1999 (12.6 percent).
Association of Risk and Protective Factors with Substance Use Among Youth Aged 12 to 17
The difference in prevalence rate between youth who "agreed" and those who "disagreed" with the statement that, "A lot of drug selling goes on in my neighborhood," was significant. In 2000, 16.0 percent of youth who "agreed" with the statement had used an illicit drug in the past month, while 7.5 percent who "disagreed" with the statement had used an illicit drug in the past month.
Of the neighborhood factors considered in the 2000 NHSDA, the perception that "A lot of drug selling goes on in my neighborhood" had the strongest relationship to use of drugs. The prevalence rate in 2000 for past month use of any illicit drug among youth who "agreed" that a lot of drug selling went on in their neighborhood was more than twice as high as among youth who "disagreed" with the statement (16.0 percent vs 7.5 percent, respectively). The relative prevalence rate differences between the "agree" group and the "disagree" group were generally smaller for other neighborhood factors in the survey. For example, the prevalence rates for past month use of any illicit drug for respondents who "agreed" versus "disagreed" that "There is a lot of crime in my neighborhood" were 12.0 and 9.0 percent, respectively. Corresponding rates for other statements were: "People in neighborhood often help each other" (8.8 vs 13.1 percent), "There are a lot of street fights in my neighborhood" (14.1 vs 8.9 percent), "There are many empty or abandoned buildings in my neighborhood" (12.0 vs 9.4 percent), "People in their neighborhood often visit in each others homes" (9.2 vs 11.2 percent), "There is a lot of graffiti in my neighborhood" (11.7 vs 9.3 percent), and "People move in and out of their neighborhood often" (10.5 vs 9.4 percent).
As a group, the neighborhood factors in the survey showed a weaker association with youth substance use than did individual or family factors such as youth perceptions of whether their parents would "strongly disapprove" or "somewhat disapprove/neither approve nor disapprove" of various substance use behaviors. For example, in 2000, only 7.1 percent of youth who indicated that their "parents would `strongly disapprove' if they tried marijuana once or twice" had used an illicit drug in the past month. But 31.2 percent of youth in the other group (i.e., their parents did not strongly disapprove) reported use of some illicit drug in the past month. The smaller relative differences with the neighborhood variables is probably due to the fact that neighborhoods include various perceptions about the neighborhood as well as a mixture of individual youth substance use behaviors (Figure 6.4).
Youths indicating delinquent behaviors during the past year reported much higher levels of substance use than those who did not report such behavior. The highest ratio was for youth who had sold drugs. In 2000, about two-thirds (66.7 percent) of those who sold drugs reported having used some illicit drug themselves in the past month. By contrast, only 7.6 percent of those who said they had not sold drugs reported use of an illicit drug in the past month.
Trends in Substance Use by Risk and Protective Factors
Of the 87 to 88 percent of youth in 1999 and 2000 who thought that their parents would "strongly disapprove" of their smoking one or more packs of cigarettes per day, past month cigarette use fell during that period from 10.6 percent to 8.9 percent. For those youth who believed that their parents would either "somewhat disapprove" or "neither approve nor disapprove," there was no significant change in the prevalence rate of past month cigarette use from 1999 to 2000 (43.5 percent in 1999 and 45.9 percent in 2000) (Figure 6.5).
Among youth who characterized the risk of smoking a pack of cigarettes or more each day as a "great risk," rates of past month use of cigarettes decreased from 11.3 percent in 1999 to 9.9 percent in 2000. Even among youth who indicated only "moderate, slight, or no risk," past month cigarette use was lower in 2000 than in 1999 (19.8 percent and 20.7 percent, respectively). This difference is not statistically significant.
This page was last updated on June 03, 2008.
SAMHSA, an agency in the Department of Health and Human Services, is the Federal
Government's lead agency for improving the quality and availability of
substance abuse prevention, addiction treatment, and mental health
services in the United States.
