CA Strategic Plan
Recommendations
Public Support
Youth Involvement
& Development
Access to Care
Service Coordination
Families
Communities
Schools
Data
 
 
Outcome Areas
Injury Prevention
Mental Health and Suicide
Nutrition & Physical Activity
Alcohol, Tobacco
& Other Drugs
Teen Pregnancy & STI’s
Oral Health
Environmental
& Occupational Health
Out of Home Youth –
Resources on Mental Health
 
 
Alcohol, Tobacco and Other Drugs | Overview
 
   
Alcohol, tobacco & other drugs
 
This is Chapter 3, Outcome Area 4 of California's adolescent health strategic plan. To view the full plan, click here.

For the majority of adolescents, experimentation with tobacco, alcohol, and drugs represents a brief period of testing limits that is often characteristic of adolescence. For some teens, however, experimentation with alcohol and drugs leads to negative consequences including direct physiological harm, impaired judgment leading to risk-taking and violence, disengagement from school, and the support of illegal drug trafficking that has a profound effect on community life. In addition, adolescent substance use, particularly tobacco, can pave the way for adult addictions.

 
     
 
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Ninety percent of current adult smokers start smoking during adolescence. Long-term use of tobacco, alcohol, and other drugs can lead to serious illness and death, increased medical care utilization, and higher health care costs.103
 
     
  Data snapshot  
     
  Tobacco  
 

Figure 3.9

Between 1990 and 1993, when California’s tobacco control program (funded by Proposition 99) took effect, teen smoking prevalence (defined as smoking at least one cigarette within the past 30 days) remained relatively constant while it was increasing across the nation. However, between 1993 and 1995, teen smoking in California rose from 9.1% to 11.9%, after which it fell, reaching 6.9% in 1999 (Figure 3.9). The Monitoring the Future study puts smoking prevalence among California’s 10th grade students at 25.7%.104
 
     
 

Figure 3.10

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There are significant ethnic differences in tobacco use (Figure 3.10). Although white youth smoke more than any other ethnic group, recent data indicate that Latinos and Asians are approaching com-parable levels. Asian teens have had the greatest increase in tobacco use since 1990, whereas African Americans continue to have the lowest rates of tobacco use.
 
     
  Cigar and smokeless tobacco use are more common among whites and among males. The 1999 California Youth Risk Behavior Survey (YRBS) found that boys were twice as likely to have tried cigars as girls, 20% versus 9% respectively. Approximately 12% of white male adolescents reported smokeless tobacco use within the previous month.73  
     
  Alcohol and Illicit Drug Use  
 

Figure 3.11

Alcohol continues to be the most popular drug among California youth. The 1999-2000 California Student Substance Use Survey (CSS) found that 44% of students in 11th grade and 16% of those in 7th grade reported drinking alcohol within the past 30 days (Figure 3.11). These figures reflect a downward trend since the early 1990s. However, there has been little change in the percentage of youth who engage in binge drinking—five or more drinks within a two hour period during the preceding two weeks. This level of drinking has been reported by approximately one-quarter of 11th grade students and between 5% and 10% of 7th grade students since the early 1990s.23 Data from the California YRBS show similarly high levels of binge drinking (Indicator box). Drinking causes problems in daily life for some teens. For example, the CSS found that 6% of 11th grade students say they that drinking has hurt their school work or caused them to be arrested.
 
     
 

Table 3.3

Twenty percent of 7th grade students and 39% of 11th grade students report having used any illicit drug at least once in the past six months (Table 3.3).23 The reported use of illicit drugs in 1999-2000 is considerably lower than 1997-1998 levels after remaining fairly constant since the early 1990s. Marijuana remains the most commonly used illicit drug. Approximately one quarter of high school students responding to the 1999 YRBS reported using marijuana within the past 30 days (Indicator box) and the CSS found that almost 13% of students in 11th grade reported weekly use. However among younger adolescents, inhalants have rivaled or surpassed marijuana in terms of popularity during the 1990s.
 
     
  Data from the CSS can be used to calculate the proportion of adolescents who are high-risk illicit drug users. These are youth who, in the past six months, have engaged in: cocaine or crack use, frequent polydrug use (three or more times), weekly marijuana use, or high frequency use of other drugs. In 1999-2000, 11% of 9th and 21% of 11th grade students were classified as high-risk drug users.  
     
  Factors Related to Substance Use  
 

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According to the CSS, teens' reasons for using alcohol and drugs changed little during the 1990s. In 1999-2000, the reasons most commonly endorsed by 11th grade students were to have fun (67%), to see what it is like (57%), because friends are using (52%), and to avoid problems (47%). Only 36% reported using alcohol and drugs because they were bored or had nothing to do. Use of alcohol and drugs also is influenced by their availability. Significant percentages of 11th grade students believe that it is easy to obtain alcohol (81%), marijuana (78%), and methamphetamines (39%). One-third of the students responding to the 1999 California YRBS reported being offered, sold, or given an illegal drug on school property.73
 
     
  A review of the content of the most popular rental movies and songs from 1996 and 1997 found that of the 200 movies studied, alcohol appeared in 93%, tobacco in 89%, and illicit drugs in 22%.83 Slightly more than one-fourth (27%) of the 1,000 songs surveyed contained a direct reference to alcohol, tobacco, or illicit drugs (75% of Rap songs, 20% of Hot-100, 20% of Alternative Rock, 14% of Country Western, and 12% of Heavy Metal).  
     
  Examples of current efforts  
     
 
  • Proposition 99, which was approved by California voters in 1988, added an additional 25-cent tax to each pack of cigarettes, and has made an average of $74 million available each year to California’s Tobacco Control Program. The program implemented a major statewide anti-smoking media campaign beginning in the early 1990’s.
  • California’s Tobacco Control Program allocates funding to the California Department of Education for school-based Tobacco-Use Prevention Education (TUPE) programs, locally designed for students in grades four through twelve.
  • In 1994, California’s Tobacco Control Program developed the Operation Storefront campaign to stem the proliferation of tobacco advertising and promotion in communities.
  • The STAKE (Stop Tobacco Access to Kids Enforcement) Act prohibits the sale of or furnishing of tobacco to anyone under 18, requires retailers to check ID of anyone under 18 and post warning signs at sales counters, and authorizes $6,000 fines for violations.
  • Title IV-Safe and Drug-free Schools and Communities provides funding for age-appropriate drug and violence prevention and education programs for all K-12 students through linkages between schools and communities.
  • The California Mentoring Initiative (CMI), through the California Department of Alcohol and Drug Programs (ADP) was initiated in 1995. CMI works in partnership with many community-based organizations to reduce four major problem areas: alcohol/drug use, teen pregnancy, educational failure, and gangs and violence.
  • The California Friday Night Live (FNL) Program, funded by ADP, was established in 1984 to promote a teenage lifestyle free of alcohol and other drugs. FNL’s mission is to build partnerships for positive and healthy youth development which engage youth as active leaders and resources in their communities.
  • Club Live is a prevention program aimed at middle school students in California and is an extension of the successful FNL program. It assists students in developing alternatives to using alcohol, tobacco, and other drugs.
  • TEENWORK, INC., is a private agency working to provide a forum for youth to share ideas and discuss solutions to the critical issues facing teens today. Every year since 1984, California high school students spend seven months planning a training institute that focuses on substance use prevention and includes broader issues such as pregnancy, gangs, suicide, HIV/AIDS, and recovery. Special consideration is given to recruiting high-risk students. The discussions initiated through this process result in the implementation of programs and activities at the local level.
 
     
  Strategies to reduce teens’ use of alcohol, tobacco
& other drugs
 
     
  1. Raise awareness of the harms of substance use.  
 
  • Use educational strategies to help youth improve critical life and social skills, including decision making and refusal skills.
  • Distribute useful, relevant and effective information to targeted populations, such as policymakers, health providers, health plans, individuals, families, and communities to help them make wise decisions about strategies to prevent youth substance use.
 
     
  2. Combat advertising which promotes the use of alcohol, tobacco, or other drugs, especially advertising aimed at youth.  
 
  • Continue and intensify mass media campaigns, including Proposition 99 funded anti-tobacco advertisements, to counteract the image appeal of pro-tobacco messages aimed at children and youth.
  • Prohibit the sale or giveaway of tobacco products like caps, jackets, or gym bags that carry cigarette or smokeless tobacco product brand names or logos.
  • Negotiate with billboard companies to reduce the number of alcohol billboards. Encourage the federal government to address the expansion of alcohol advertising on television and radio stations.
 
     
  3. Limit youth access to alcohol, tobacco, and other drugs.  
 
  • Reduce youth access to tobacco and alcohol by licensing tobacco vendors; limiting vending machine sales and self-service displays to places where minors are not allowed, such as certain bars and nightclubs; and prohibiting the sale of single cigarettes.
  • Mobilize communities to counter drug activity, especially where youth might be present. Advocate for positive community-wide change through legal and regulatory initiatives, such as lowering legal blood alcohol limits for drivers, limiting bar hours, and restricting the number of alcoholic beverage outlets in any given area.
  • Establish hotel networks to intervene when underage youth attempt to rent rooms for parties.
 
     
  4. Provide substance-free environments and alternatives for youth.  
 
  • Encourage activities and initiatives that will change community standards and emphasize healthy lifestyles. Promote sobriety as a positive lifestyle choice.
  • Provide for the participation of targeted adolescent populations in activities that exclude alcohol, tobacco, and other drug use by youth.
 
     
  5. Improve substance treatment and promote harm-reduction approaches for adolescents’ unique needs.  
 
  • Develop sufficient resources to meet community needs for appropriate levels of treatment for youth, and special populations of adolescents.
    n Identify and remove barriers that inhibit adolescents from entering treatment.
  • Use relevant research to identify and incorporate key variables that contribute to successful treatment outcomes for youth.
  • Address the treatment needs of youth in the criminal justice system.
  • Improve assessment and early intervention strategies in schools, primary care, family planning, after-school programs, probation, and foster care.
  • Encourage the use of comprehensive harm reduction approaches. Promote the use of designated drivers and safe ride programs that provide free or low cost transportation to a safe destination (usually home).
 
     
  Additional resources  
     
  Preventing Tobacco Use Among Young People: A Report of the Surgeon General. U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, Atlanta, GA, 1994.  
     
  Reducing the Health Consequences of Smoking: 25 Years of Progress. A Report of the Surgeon General. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 1989.  
     
  Youth Smoking Trends in California Fact Sheet. California Department of Health Services, Tobacco Control Section, Sacramento, CA, 1998.  
     
  Seventh Biennial Student Substance Use Survey. Grades 7, 9 and 11. 1997-98. Austin, G. and Skager, R. Sacramento: California Department of Justice, Office of the Attorney General, 2000.  
     
  Toward a Tobacco-Free California: Renewing the Commitment 1997-2000. Tobacco Education and Research Oversight Committee, California Department of Health Services, Tobacco Control Section, January, 2000.
 
     
  A Model for Change: The California Experience in Tobacco Control. California Department of Health Services, Tobacco Control Section. October, 1998.  
     
  Preventing Drug Use Among Children and Adolescents: A Research Based Guide. National Institute on Drug Abuse. National Institutes of Health. 1997. http://www.nida.nih.gov  
     
  Drug Abuse Prevention for At-Risk Individuals. National Institute on Drug Abuse. National Institutes of Health. 1997. http://www.nida.nih.gov  
  Click here to view references