Purpose: To examine if the record declines in adolescent substance use after the onset of the COVID-19 pandemic resulted from reduced levels of initiation, defined as any lifetime use.
Methods: We analyzed data from the nationally representative, cross-sectional, annual Monitoring the Future surveys of eighth, 10th, and 12th grade students from 2019 to 2022. Measures included past 12-month use of cannabis, nicotine vaping, and alcohol as well as self-reported grade of initiation of each substance. Analyses are based on randomly selected subsamples of students who received questions on both prevalence and grade of first use, resulting in a total sample size of 96,990 students.
Results: Levels of the past 12-month substance use were markedly lower after the onset of the pandemic, in 2021 and 2022. In eighth and 10th grade, levels were at least one-third lower for cannabis and nicotine vaping and 13%-31% lower for alcohol. In 12th grade, the decreases ranged from 9% to 23%. Lower levels of initiation in seventh grade in 2020-2021 accounted for half or more of the overall prevalence decreases in eighth grade in 2021- 2022. Lower levels of initiation in ninth grade in 2020-2021 accounted for 45% or more of the overall prevalence decreases in 10th grade in 2021-2022. Declines in 12th grade substance use prevalence were not consistently linked to lower initiation in earlier grades.
Discussion: Much of the declines in overall prevalence of adolescent substance use after the onset of the COVID-19 pandemic trace back specifically to declines in substance use initiation in seventh and ninth grades.
Keywords: Adolescents; Alcohol; Cohorts; Marijuana; Pandemic; Trends; U.S. population; Vaping.
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