"In 2016, 71.8 percent of youths aged 12 to 17 who were enrolled in school in the past year reported having seen or heard drug or alcohol use prevention messages at school (Figure 10). This percentage was lower than the percentages in 2002 to 2013, but it was similar to the percentages in 2014 and 2015. In 2002, for example, 78.8 percent of adolescents who were enrolled in school reported exposure to substance use prevention messages at school.

"In 2016, 72.7 percent of youths aged 12 to 17 reported having seen or heard drug or alcohol use prevention messages in the past year from sources outside of school, such as posters, pamphlets, the radio, or television (Figure 10). The percentage in 2016 was lower than the percentages in 2002 to 2012, but it was similar to the percentages in 2013 to 2015."

"• Substantial differences were found in perceived availability of the various drugs. The percentage of 12th graders reporting it would be fairly easy or easy to get a drug varied from 16% or less for heroin and PCP to above 80% for alcohol, vaping devices, and an e-liquid with nicotine for vaping.

"• In general, the more widely used drugs are reported to be available by higher proportions of the age group, as would be expected (see Tables 9-7, 9 8, and 9-9). The substances with the highest levels of use in 2019, such as marijuana, alcohol, and e-liquids for vaping, also place in the top three in terms of perceived availability.

"• Older age groups generally perceive drugs to be more available. For example, in 2019, 35% of 8th graders said marijuana would be fairly easy or very easy to get (which we refer to as “readily available”), versus 66% of 10th graders and 78% of 12th graders. In fact, compared to 8th graders, the proportions of 12th graders indicating that drugs are available to them are two to four times as high for other illicit drugs included in the study. (An exception is tranquilizers, which are perceived to be about equally available in 8th and 12th grades, and have highest perceived availability in 10th grade.)

"• Higher availability among both the more widely used drugs and also older age groups is consistent with the notion that availability is largely attained through friendship circles. (Friends clearly are the leading source through which 12th graders obtain prescription drugs, as discussed above.) The differences among age groups may also reflect less willingness and/or motivation on the part of those who deal drugs to establish contact with younger adolescents.

"• Marijuana appears to be readily available to the great majority of 12th graders; in 2019, 78% reported that they think it would be very easy or fairly easy to get – far higher than the proportion who reported ever having used it (44%). Marijuana has the highest availability level of all illicit substances in this grade.

"• There is a considerable drop in availability after marijuana, alcohol, cigarettes, and vaping; the next most readily available class of drugs for 12th graders is amphetamines, with 39% saying these drugs would be very or fairly easy to get, followed by narcotics other than heroin (31%).

"• Between 16% and 30% of 12th graders perceived the following as readily available: MDMA (ecstasy, Molly) (24%), hallucinogens other than LSD (30%), cocaine (24%), LSD (28%), sedatives (barbiturates) (24%), cocaine powder (20%), steroids (19%), heroin (16%), and crack (17%).

"• Crystal methamphetamine (ice), tranquilizers, and PCP were reported as readily available by smaller proportions of 12th graders in 2019 (12%, 15%, and 11%, respectively).

"• In 8th grade the percentage who reported they could fairly or very easily get a vaping device was 49% and for e-liquids with nicotine it was 46%. The respective availability levels in 10th grade were 68% and 65%, and in 12th grade they were 83% and 82%.

"• The availability of a JUUL vaping device was asked for the first time of 8th and 10th grade students in 2019. Levels of availability were nearly identical for the more general category of a “vaping device.” In 8th grade the availability of JUUL as compared to a vaping device was 52% and 49%, respectively, and in 10th grade it was 69% and 68%, respectively. In both grades JUUL and vaping devices had higher availability levels than cigarettes.

"• In 2019, 43% of 8th graders, 58% of 10th graders, and 75% of 12th graders thought that cigarettes would be fairly easy or very easy for them to get if they wanted some.

"• The great majority of teens see alcohol as readily available: In 2019, 53% of 8th graders, 69% of 10th graders, and 84% of 12th graders said it would be fairly easy or very easy to get.

"• Drug availability levels are lowest in 8th grade. Even so, marijuana was described as readily available by 35% of 8th graders in 2019.

"• Because many inhalants – such as glues, butane, and aerosols – are universally available, we do not ask about their availability. See Table 9-9 for the full list of drugs included in the questions for 12th graders; a few of these drugs were not asked of the younger students (see Tables 9-7 and 9-8)."

"Compared to teens who have five to seven family dinners per week, those who have fewer than three family dinners per week are twice as likely to say they expect to try drugs (including marijuana and prescription drugs without a prescription to get high) in the future (17 percent vs. 8 percent)."

"• Youths aged 12 to 17 were asked several questions related to the extent of support, oversight, and control that they perceived their parents provided or exercised over them in the year prior to the survey interview. In 2012, among youths aged 12 to 17 who were enrolled in school in the past year, 70.3 percent reported that their parents limited the amount of time that they spent out with friends on school nights. This rate in 2012 was similar to the rate reported in 2011 (69.9 percent) and also in 2002 (70.7 percent). In 2012, 81.3 percent reported that in the past year their parents always or sometimes checked on whether or not they had completed their homework, and 80.6 percent reported that their parents always or sometimes provided help with their homework. Both of these rates reported in 2012 were similar to the rates in 2011 (81.1 and 80.4 percent, respectively). The rate in 2012 for parents checking on whether youths had completed their homework was higher than in 2002 (78.4 percent). However, the rate for parents providing help with homework in 2012 was similar to the rate in 2002 (81.4 percent)."

"• In 2012, past month use of illicit drugs and cigarettes and binge alcohol use were lower among youths aged 12 to 17 who reported that their parents always or sometimes engaged in supportive or monitoring behaviors than among youths whose parents seldom or never engaged in such behaviors. For instance, the rate of past month use of any illicit drug in 2012 was 7.6 percent for youths whose parents always or sometimes helped with homework compared with 18.1 percent among youths who indicated that their parents seldom or never helped. Rates of current cigarette smoking and past month binge alcohol use also were lower among youths whose parents always or sometimes helped with homework (5.1 and 5.9 percent, respectively) than among youths whose parents seldom or never helped (12.8 and 13.4 percent)."

"Exposure to early life stress, even to more severe forms such as physical and sexual abuse and emotional neglect, is common in the general population. The degree of risk for adult psychopathology tends to be correlated with the severity of childhood maltreatment and the number of childhood SLE [stressful life events]. An important causal pathway that links early life stress to the onset of psychiatric disorders is the altered homeostasis in the HPA [hypothalamicpituitary-adrenal] axis and the altered stress response circuitry that underlies many disorders including anxiety, depression, PTSD, and addiction. There appears to be a direct pathway from chronic stress exposure in prepubertal children via adolescent problem drinking to alcohol and drug dependence in early adulthood that is independent of family history. Of course, this can only occur in individuals exposed to the availability of alcohol or drugs. Early life stress may increase vulnerability to addiction through permanent effects on the expression of genes within the mesolimbic dopamine reward pathway. Early onset of problem drinking in stress-exposed children may exacerbate the deleterious effects on the developing brain. Since a large proportion of stress-exposed children do not go on to develop addiction, clearly resilience factors, including gene–environment interactions, are important. This review of the literature indicates that prevention should focus on early intervention in problem families to forestall maltreatment. Adolescence is a critically vulnerable time for the development of risky drinking habits, and this is an area where prevention, through the development of positive family, peer, and neighborhood-mediating factors, is vital. A holistic approach to the treatment of alcohol and drug dependence is essential since treatment is unlikely to be effective unless underlying impediments such as early life stress are recognized and addressed."

"Prior to 1981, daily use of cigarettes among 12th graders was generally inversely related to SES, with each successively higher SES group smoking less (Figure 5-12f). Between 1981 and 1991, this ordinal relationship diminished substantially because (a) the two highest SES groups showed some gradual increase in use; (b) the next two strata remained unchanged; and (c) the lowest SES group showed a decline in use, which brought it from the highest smoking stratum to the lowest (probably due to its racial composition, as will be discussed in the next section). The net result of this and other trends was a near elimination of the SES differences among 12th-grade students in daily cigarette smoking. From 1992 to 1997, all strata showed an increase in daily smoking.

"From 1997 to 2003, there were sharp declines in smoking in the two highest SES strata— with later and slower downturns in the other strata—once again opening up some differences by SES, though not as large as the differences that existed in the 1970s and 1980s. This time the lowest SES stratum is not at the top but rather down near the bottom of the rankings—again, likely because of its racial composition.

"It is possible that the introduction of the Joe Camel advertising campaign in 1988 helped account for the closing of the socioeconomic gap in the late 1980s, and that its termination in 1997 helped account for the re-emergence of that gap. We know that between 1986 and 1997, the rise in smoking was sharper among 12th-grade boys than 12th-grade girls, and the Camel brand was particularly popular among boys and those whose parents had higher than average education.72 So, the Joe Camel ad campaign appears to have been particularly effective with boys from more educated strata, raising the smoking rate of their SES strata and nearly eliminating the relationship between SES and smoking that existed before and after the years of the campaign for that brand."

"The extent of exposure to the ONDCP 'Above the Influence' campaign (RQ1) was assessed by cross-tabulating the measures of self-reported exposure to this campaign with each of the four treatment/control cells at the fourth wave of data collection, the point by which such exposure would have taken place for all study participants. Of youth in the control community/control school cell, 73% said they definitely had seen the ONDCP 'Above the Influence' campaign. The self-reported exposure to the ONDCP campaign was similar in the three treatment cells (68–79%).
"We can be confident that this exposure is in large measure due to actual exposure and not false recognition or youth providing what they may have believed to be a socially desirable response, as the percentage reporting they had definitely seen one of the two foils, or fake campaigns, was much less than the percentage reporting exposure to the ONDCP campaign. For example, in the control cell in which 73% of youth said they’d definitely seen the 'Above the Influence' campaign, 14.6% reported definitely seeing one foil and 20.2% claimed they definitely saw the other (false recognition of the two foils was highly correlated — 67% of those claiming recognition of the first foil also claimed recognition of the second). Similar differences were found in the other cells. These levels of false recognition are typical in response to survey questions about self-reported exposure that do not include actual images of an advertisement (see Shapiro (1994) for a discussion of false recognition of messages)."

"The NSPY [National Survey of Parents and Youth] did not find significant reductions in marijuana use either leading up to or after the Marijuana campaign for youth 12 to 18 years old between 2002 and 2003. Indeed there was evidence for an increase in past month and past year use among the target audience of 14- to 16-year-olds, although it appears that the increase was already in place in the last half of 2002, before the launch of the Marijuana Initiative. It will be worthwhile to track whether the nonsignificant decline from the second half of 2002 through the first half of 2003 is the beginning of a true trend. There was a significant decrease in lifetime marijuana use among youth 16 to 18 years of age from 2002 to 2003; however, since this significant decrease was not replicated in either the directly relevant past year or past month time periods, it is difficult to ascribe the change to the campaign."

"The community treatment parameter estimate was significant (?=?0.51, p=0.026), indicating that community-level treatment lowered the propensity to use marijuana at the last measurement occasion over and above the effect of the 'Above the Influence' campaign. There was no evidence that school-level treatment affected the marijuana use at the last measurement occasion. Neither the community-level nor the school-level treatment for the 'Be Under Your Own Influence' campaign provided evidence of an effect on the linear rate-of-change for marijuana use. In other words, while there was evidence of a significant effect of the community-based component of the 'Be Under Your Own Influence' campaign on post-test marijuana use, the strong and consistent effects of the prior campaign on both post-tests and reduced linear trajectory of marijuana use were not replicated."

"The younger and more often teens use marijuana, the more likely they are to engage in other substance use and the higher their risk of developing a substance use disorder. Among high school students, 7.5 percent used marijuana for the first time before the age of 13. CASA’s analysis of national data finds that the average age of initiation of marijuana use among high school students is 14.3 years old. Compared to those who began using marijuana after age 21, those who first used it before age 15 are:
• More likely to have ever smoked a cigarette (93.3 percent vs. 86.4 percent);
• More than twice as likely to have ever misused controlled prescription drugs (56.5 percent vs. 22.9 percent); and
• Two and a half times as likely to have ever used other illicit drugs (70.2 percent vs. 27.8 percent)."

"Teens also say they are seeing more peers in school smoking marijuana and more teens (73 percent) report having friends who smoke marijuana regularly (71 percent) – significantly higher than four years ago. Since 2008, there have also been significant declines in teen perceptions that they will lose respect, harm themselves, or mess up their lives if they use marijuana."

"An SRO [school resource officer] carries out some of the functions of a guidance counselor or social worker, such as mentoring or advising, but with arresting authority and license to carry a weapon in schools. In a national assessment of SRO programs, SROs reported that they spend approximately 20 hours per week on law enforcement activities, 10 hours on advising and mentoring, 5 hours on teaching (e.g. G.R.E.A.T. or D.A.R.E. programming⁹), and another 6 or 7 hours on other activities.¹⁰"

Drug Abuse Resistance Education (DARE)

A federally funded Research Triangle Institute study of Drug Abuse Resistance Education (DARE) found that "DARE's core curriculum effect on drug use relative to whatever drug education (if any) was offered in the control schools is slight and, except for tobacco use, is not statistically significant."

Dr. Dennis Rosenbaum, a professor at the University of Illinois at Chicago, completed a six-year study of 1,798 students and found that "DARE had no long-term effects on a wide range of drug use measures"; DARE does not "prevent drug use at the stage in adolescent development when drugs become available and are widely used, namely during the high school years"; and that DARE may actually be counter productive. According to the study, "there is some evidence of a boomerang effect among suburban kids. That is, suburban students who were DARE graduates scored higher than suburban students in the Control group on all four major drug use measures."

The GAO reported in 2006 that "From fiscal year 1998 through fiscal year 2006, Congress appropriated over $1.4 billion to support the campaign. For fiscal year 2007, the President’s budget requested $120 million for the campaign, an increase over the fiscal year 2006 appropriation, to purchase additional media time and space to increase the reach and frequency of the campaign’s messages, which would restore appropriations to their fiscal year 2005 level."

"In light of the fact that the phase III evaluation of the media campaign yielded no evidence of a positive outcome in relation to teen drug use and congressional conferees’ indications of their intentions to rely on the Westat study, Congress should consider limiting appropriations for the National Youth Anti-Drug Media Campaign beginning in the fiscal 2007 budget year until ONDCP is able to provide credible evidence of the effectiveness of exposure to the campaign on youth drug use outcomes or provide other credible options for a media campaign approach."

"GAO's [Government Accountability Office] review of Westat's evaluation reports and associated documentation leads to the conclusion that the evaluation provides credible evidence that the campaign was not effective in reducing youth drug use, either during the entire period of the campaign or during the period from 2002 to 2004 when the campaign was redirected and focused on marijuana use."