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To monitor substance use by Maryland adolescents over time, trend data from 1988 to 1998 are examined at all grade levels surveyed. Table 4.1 provides percentages of participating sixth, eighth, tenth, and twelfth graders who had used substances in the 30 days before they were surveyed. These data show the proportions of users in many of the substance categories have declined from 1996 to 1998, including alcohol use. For drugs other than alcohol, marijuana, or tobacco, there were some increases in use across grade levels.

Of all grades surveyed, sixth graders showed the greatest increase in use of substances from 1996 to 1998, with slight increases in use of thirteen different drugs. While the increase in the proportion of sixth graders who used a substance was sometimes quite small (less than half of a percentage point), for a few drugs, such as any form of alcohol, the percentage increase from 1996 was at least one percentage point (7.9% 1996 vs. 9.1% 1998). Sixth graders reported an increase in use of any drug other than alcohol and tobacco of 1.2 percentage points from 1996 levels (4.0% 1996 vs. 5.2% 1998).

Figure 4.1 graphically depicts the trends in sixth graders’ use of cigarettes, alcohol, and marijuana. From this figure, it can be seen that alcohol use among sixth graders has fluctuated somewhat over the 10-year period, with current use (9.1%) fairly close to use reported in 1988 (9.5%). Cigarette use is somewhat higher than in 1988 (4.2% 1998 vs. 3.6% 1988), however, sixth grader cigarette use has decreased since 1996. When compared to other drugs, marijuana has the largest percentage increase in use by sixth graders (1.2 percentage points) over the 10-year period.

Eighth graders were the only group of surveyed students by grade level that showed an increase in use of smokeless tobacco, up 0.5% from 1996 (Table 4.1). Eighth graders were more likely than their sixth and tenth grade counterparts to have decreased their use of substances from 1996 levels. Figure 4.2 shows the trends in eighth grader use of cigarettes, alcohol, and marijuana from 1988 to 1998. From this figure, it can be seen that use of all three substances increased between 1992 and 1994 and then began decreasing steadily through 1998. Despite these decreases, only alcohol use remains at a level somewhat similar to that found in 1988 (27.2% 1988 vs. 26.6%); cigarette use was somewhat higher than 1988 levels (11.3% 1988 vs. 14.8% 1998) while marijuana use had increased more considerably (3.5% 1988 vs. 10 percent 1998).

Like sixth graders, tenth graders in Maryland showed an increase in use across multiple substances when compared to 1996 survey data (Table 4.1). The largest of these increases was for use of crack with 1.8% of tenth graders reporting they had used the drug in 1996 and 3.3% of tenth graders reporting use in 1998. When compared to other grades, tenth graders showed increases between 1994 and 1996 and then from 1996 to 1998 for crack, other forms of cocaine, designer drugs, heroin, and needle use to inject drugs. While percentages of youth who used these substances were low (3.6% or less), the continuing growth over the 4 year period is noteworthy.

Fewer tenth graders reported using alcohol in 1998 (42.9%) than in 1988 (50.5%) (Figure 4.3). Overall, alcohol use among tenth graders has decreased, although there was an increase in 1994, followed by decreases through the present survey. Cigarette use remained relatively constant from 1988 through 1992, with an increase in reported use in 1994. Among tenth graders, cigarette use continues to decrease from 1994 levels of use. For marijuana use, the percentages of tenth graders using the drug has almost doubled between 1988 (12.5%) and 1998 (22.7%).

Compared to their younger counterparts, twelfth graders were the most likely group of students to have decreased their use of any substance from 1996 levels. Twelfth graders only reported an increase in their use of designer drugs from 1996 levels; this increase represented less than half a percentage point. While the decrease in substance use appears to be a positive indicator, twelfth graders had increased their use of eleven substances between 1994 and 1996, making the decrease in 1998 an important finding. From Figure 4.4, it can be seen that use of alcohol between the 1990 and 1996 has remained relatively constant. Use of alcohol by twelfth graders decreased from 52.4% in 1996 to 48.4% in 1998, almost 12 percentage points less than was reported in 1988 (60.2%). Cigarette use among twelfth graders has remained relatively stable over the 10-year period, with a small increase in use (24.1% 1988 vs. 28.6% 1998). For marijuana use, a larger number of twelfth graders used marijuana in 1998 (24.2%) than in 1988 (15.1%). While marijuana use decreased between 1988 and 1990, use of the drug steadily increased from 1990 through 1996.

When use of drugs other than alcohol, tobacco, or marijuana is considered by grade level, several trends become apparent. First, there were slight increases from 1996 to 1998 in use of PCP, crack, other forms of cocaine, steroids, heroin, and use of needles to inject drugs, in sixth, eighth, and tenth graders. There was also an increase from the 1996 survey in barbiturates/ tranquilizers use by sixth and tenth graders. Designer drugs increased in use in all but the eighth grade between 1996 and 1998. Tenth graders increased their use of narcotics and methamphetamines from 1996 to 1998; the use of methamphetamines represented an increase of almost 1 percentage point. While use of these drugs still represents a small proportion of youth (less than 4% at each grade level), the increase in use between 1996 and 1998 suggests that the use of "hard" drugs is becoming more common since the trend is consistent across grades and multiple categories of drugs.

Age at first use is an important measure in examining trends over time. In this section, changes between 1996 and 1998 are highlighted for each of three substances¾ alcohol, cigarettes, and marijuana.

For alcohol, 1998 data indicated that fewer surveyed twelfth graders started drinking beer/wine/wine coolers at age 10 or younger than in 1996. Analysis indicates there was a decrease of 2.2 percentage points from 1996 in the number of twelfth graders who had ever used beer/wine and began drinking these beverages at age 10 or less. The percentage of twelfth graders who began drinking liquor at age 10 or less also decreased from 1996 levels, but to a lesser extent (0.8 percentage points). One trend important to note was for Hispanic twelfth graders, there was increase in the number of youth who began drinking at age 10 or less, representing an increase of 5.5 percentage points for beer/wine and 5 percentage points for liquor.

Survey results from 1998 indicate there was a decrease (2.5 percentage points) in the number of twelfth graders who reported first smoking cigarettes at age 10 or younger. Male twelfth graders who had ever used cigarettes increased by 4 percentage points from 1996 levels for those who first used cigarettes at age 10 or younger. When race/ethnicity is considered, Asian twelfth graders were the only racial/ethnic group that showed an increase in the percentage of youth who had first used cigarettes at age 10 or younger (who had ever smoked). The increase seen in the Asian population was substantial¾ an increase of 9.3 percentage points from the 1996 survey.

For marijuana, there was an increase in the percentage of twelfth graders who used marijuana before they were 15 years old. Of those who had ever used marijuana, 40.9% first used marijuana between the ages of 13 and 14 in 1998 while only 33.1% had done so in 1996 (a difference of 7.8 percentage points). For first use at 11 to 12 years of age, the increase from 1996 was 1.5 percentage points, and for first use at 10 years of age or younger, the increase represented 0.6 percentage points. The increase was found in both males and females, with the exception of 10 or younger (no increase in number of twelfth grade females who first used marijuana at age 10 or younger). When age at first use is viewed by race/ethnicity, the largest gains in use of marijuana at a young age was in the Asian population. There was an increase of 2.7 percentage points in the number of twelfth graders who were Asian who first used marijuana at age 10 or younger. This statistic is particularly noteworthy as there were no Asians (or very few) who indicated they had first used marijuana at age 10 or younger in the 1996 survey. For first using marijuana between the ages of 11 and 12 years of age, Asian, African American, and White twelfth graders all showed an increase in use from that recorded in 1996. The largest gain was in Asians (5.7 percentage points), followed by Whites (2.6 percentage points), and then African Americans (0.6 percentage points). The number of Hispanic youth who first used marijuana between the ages of 11 and 12 decreased by 4.4 percentage points from that reported in 1996.

The National Institute on Drug Abuse conducts an annual survey, Monitoring the Future, that addresses substance use by youth across the country. Data from the survey provide long-term trend information as well as current use rates for alcohol, tobacco, and other drugs at the national level. The MAS is modeled on the Monitoring the Future survey as a way of determining how closely Maryland youth match their national peers in use of various types of drugs. Figures 4.5 and 4.6 present comparisons between Maryland and the nation on the most frequently used substances by twelfth graders.

Figure 4.5 demonstrates that Maryland twelfth graders used alcohol less than their peers nationally (65.6% vs. 73.8%). Maryland twelfth graders also used marijuana slightly less than other twelfth graders nationally (37.0% vs. 37.8%). For crack and LSD, Maryland twelfth graders had a slightly higher percentage of students who had used these drugs in the last year than twelfth graders nationally.

*Maryland students were surveyed in December of 1998
National responses represent students surveyed in the Spring of 1999

*Maryland students were surveyed in December of 1998
National responses represent students surveyed in the Spring of 1999

When use within the last 30 days is considered, Maryland twelfth graders were less likely to have used alcohol and cigarettes than twelfth graders nationally (Figure 4.6). Maryland twelfth graders were more likely to have used crack or LSD than their peers nationally. Table 4.2 indicates that across grade levels, fewer Maryland youth at the eighth, tenth, and twelfth grade used cigarettes in the last 30 days than their peers nationally. A higher percentage of Maryland adolescents used marijuana, crack, and LSD in the last 30 days than their national peers; their use rate, however, did not differ any more than 4 percentage points from national rates. It is interesting to note that more of Maryland’s eighth and tenth graders used alcohol than their national peers while the proportion of Maryland’s twelfth graders who used alcohol was less than twelfth graders nationally.

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