Adolescence is a period of significant developmental change when health patterns are being established. Decisions that youths make about tobacco, alcohol, and drug use can have both immediate and long-term health consequences for themselves, their families, and their communities. Adolescents’ attitudes about the risks associated with substance use are often closely related to their substance use, with an inverse association between drug use and risk perceptions (i.e., as the prevalence of risk perceptions decreases, the prevalence of drug use increases). As such, providing adolescents with credible, accurate, and age-appropriate information about the harm associated with substance use is a key component in prevention programming .
Although many factors may influence the initiation of drug or alcohol use, the perception of risk associated with these behaviors also varies by gender, age, and type of drug. Understanding the different patterns of risk perceptions that emerge during adolescent development may help to better target health communication messages and increase the effectiveness of prevention and intervention programs.
The National Survey on Drug Use and Health (NSDUH) asks persons aged 12 to 17 (i.e., adolescents) how much they think people risk harming themselves physically and in other ways when they use cigarettes, alcohol, and illicit drugs. Response choices are (1) no risk, (2) slight risk, (3) moderate risk, and (4) great risk. This issue of The NSDUH Report presents information on perceptions of great risk from using various substances; data are examined by age and gender. All findings are annual averages based on combined 2007 and 2008 NSDUH data.
Perceptions of Risk
For some substances, half or more of all adolescents perceived great risk associated with their use. For example, 69.3 percent of adolescents perceived great risk from smoking one or more packs of cigarettes per day, 57.4 percent perceived great risk from trying heroin once or twice, 50.9 percent perceived great risk from trying LSD once or twice, and 49.7 percent perceived great risk from using cocaine once a month (Figure 1). For other substances, however, the perception of risk was substantially less. Only 40.0 percent perceived great risk from having five or more drinks of alcohol once or twice a week, and just over one third (34.2 percent) perceived great risk from smoking marijuana once a month.
Perceptions of Risk by Gender
The most commonly abused substances by adolescents are tobacco products, alcohol, and marijuana. For all three, females were more likely than males to perceive great risk: smoking one or more packs of cigarettes per day (73.3 vs. 65.4 percent); having five or more drinks of alcohol once or twice a week (43.5 vs. 36.6 percent); and smoking marijuana once a month (36.4 vs. 32.1 percent) (Figure 2). Males, on the other hand, were more likely than females to perceive great risk from trying heroin once or twice (58.3 vs. 56.4 percent), and both genders had similar perceptions of risk associated with using cocaine once a month and trying LSD once or twice.
Perceptions of Risk by Age
The percentage of adolescents who perceived great risk from smoking one or more packs of cigarettes per day was stable across age groups (Figure 3). However, the percentage perceiving great risk from having five or more drinks of alcohol once or twice a week and the percentage perceiving great risk from smoking marijuana once a month decreased with age. For example, the percentage perceiving great risk from using marijuana once a month decreased from 42.7 percent among 12 or 13 year olds to 34.4 percent among 14 or 15 year olds and to 26.2 percent among 16 or 17 year olds. Conversely, the percentages perceiving great risk from using cocaine once a month, from trying heroin once or twice, and from trying LSD once or twice increased with age. For example, the percentage perceiving great risk from trying heroin once or twice increased from 46.7 percent among 12 or 13 year olds to 56.8 percent among 14 or 15 year olds and to 67.5 percent among 16 or 17 year olds.
Perceptions of Risk by Age and Gender
Perception of great risk generally followed the same age patterns within gender, with two exceptions. First, males aged 12 or 13 were more likely than those aged 14 or 15 and those aged 16 or 17 to have perceived great risk from smoking one or more packs of cigarettes per day, whereas the rate among females generally increased with age (although not all differences were statistically significant) (Figure 4). Second, the rate of perceived great risk from having five or more drinks of alcohol once or twice a week decreased steadily by age among males. In comparison, females aged 12 or 13 were more likely to perceive great risk than older females, but females aged 14 or 15 and those aged 16 or 17 had a similar rate of perception of great risk.
The data from NSDUH present a mixed message for those who are interested in preventing the initiation of substance use among our youths. Although the perception of the risk associated with cigarette use has reached 70.0 percent and is sustained across adolescent age groups, the same cannot be said of the perceptions of risk associated with alcohol and marijuana use. Perceptions of risk from using these drugs decrease as youths become more mature, making the initiation of their use more likely. On the other hand, as youths grow older, their perceptions of the risks associated with the use of heroin, cocaine, and LSD increase—although not to the same level as cigarette use. The multiplicity of factors that may influence these changes cannot be fully addressed through NSDUH data, but these findings may help to frame further prevention research work to better inform prevention programming.
Material adapted from Substance Abuse and Mental Health Services Administration by CFisher
Substance Abuse and Mental Health Services Administration, Office of Applied Studies. (November 23, 2009). The NSDUH Report: Perceptions of Risk from Substance Use among Adolescents. Rockville, MD
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