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November 23, 2009

Perceptions of Risk from Substance Use among Adolescents

In Brief
  • Only 40.0 percent of adolescents 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
  • Females were more likely than males to perceive great risk from smoking one or more packs of cigarettes per day, from having five or more drinks of alcohol once or twice a week, and from smoking marijuana once a month; males were more likely than females to perceive great risk from trying heroin once or twice
  • The percentage of adolescents who perceived great risk from smoking one or more packs of cigarettes per day was stable across age groups; however, the perceptions of risk associated with having five or more drinks of alcohol once or twice a week and smoking marijuana once a month decreased with age, while the perceptions of risk increased with age for cocaine use, heroin use, and LSD use

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.1

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.


Figure 1. Perception of Great Risk from Substance Use among Persons Aged 12 to 17: 2007 and 2008
This is a bar graph comparing perception of great risk from substance use among persons aged 12 to 17: 2007 and 2008. Accessible table located below this figure.

Figure 1 Table. Perception of Great Risk from Substance Use among Persons Aged 12 to 17: 2007 and 2008
Risk Percent
Smoking One or More Packs of Cigarettes Per Day 69.3%
Trying Heroin Once or Twice 57.4%
Trying LSD Once or Twice 50.9%
Using Cocaine Once a Month 49.7%
Having Five or More Drinks of Alcohol Once or Twice a Week 40.0%
Smoking Marijuana Once a Month 34.2%
Source: 2007 and 2008 SAMHSA National Surveys on Drug Use and Health (NSDUHs).


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.


Figure 2. Perception of Great Risk from Substance Use among Persons Aged 12 to 17, by Gender: 2007 and 2008
This is a bar graph comparing perception of great risk from substance use among persons aged 12 to 17, by gender: 2007 and 2008. Accessible table located below this figure.

Figure 2 Table. Perception of Great Risk from Substance Use among Persons Aged 12 to 17, by Gender: 2007 and 2008
Risk Male Female
Smoking One or More Packs of Cigarettes Per Day 65.4% 73.3%
Trying Heroin Once or Twice 58.3% 56.4%
Trying LSD Once or Twice 50.8% 50.9%
Using Cocaine Once a Month 49.6% 49.8%
Having Five or More Drinks of Alcohol Once or Twice a Week 36.6% 43.5%
Smoking Marijuana Once a Month 32.1% 36.4%
Source: 2007 and 2008 SAMHSA National Surveys on Drug Use and Health (NSDUHs).


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.


Figure 3. Perception of Great Risk from Substance Use among Persons Aged 12 to 17, by Age Group: 2007 and 2008
This is a bar graph comparing perception of great risk from substance use among persons aged 12 to 17, by age group: 2007 and 2008. Accessible table located below this figure.

Figure 3 Table. Perception of Great Risk from Substance Use among Persons Aged 12 to 17, by Age Group: 2007 and 2008
Risk 12 or 13 14 or 15 16 or 17
Smoking One or More Packs of Cigarettes Per Day 69.7% 68.8% 69.3%
Having Five or More Drinks of Alcohol Once or Twice a Week 43.3% 39.5% 37.4%
Smoking Marijuana Once a Month 42.7% 34.4% 26.2%
Using Cocaine Once a Month 42.8% 49.0% 56.5%
Trying Heroin Once or Twice 46.7% 56.8% 67.5%
Trying LSD Once or Twice 44.4% 49.9% 57.4%
Source: 2007 and 2008 SAMHSA National Surveys on Drug Use and Health (NSDUHs).


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.


Figure 4. Perception of Great Risk from Substance Use among Persons Aged 12 to 17, by Gender and Age Group: 2007 and 2008
This is a bar graph comparing perception of great risk from substance use among persons aged 12 to 17, by gender and age group: 2007 and 2008. Accessible table located below this figure.

Figure 4 Table. Perception of Great Risk from Substance Use among Persons Aged 12 to 17, by Gender and Age Group: 2007 and 2008
Risk Gender 12 or 13 14 or 15 16 or 17
Smoking One or More Packs of Cigarettes Per Day Male 67.3% 64.5% 64.5%
Smoking One or More Packs of Cigarettes Per Day Female 72.1% 73.4% 74.3%
Having Five or More Drinks of Alcohol Once or Twice a Week Male 40.7% 37.2% 32.3%
Having Five or More Drinks of Alcohol Once or Twice a Week Female 45.9% 41.9% 42.7%
Source: 2007 and 2008 SAMHSA National Surveys on Drug Use and Health (NSDUHs).


Discussion

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.



End Note
1 Palmgreen, P., & Donohew, L. (2006). Effective mass media strategies for drug abuse prevention campaigns. In Z. Sloboda & W. J. Bukoski (Eds.), Handbook of drug abuse prevention (pp. 27-43, Part II, Handbooks of Sociology and Social Research series). New York: Springer US.


Suggested Citation
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.

The National Survey on Drug Use and Health (NSDUH) is an annual survey sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA). The 2007 and 2008 data used in this report are based on information obtained from 44,979 persons aged 12 to 17. The survey collects data by administering questionnaires to a representative sample of the population through face-to-face interviews at their place of residence.

The NSDUH Report is prepared by the Office of Applied Studies (OAS), SAMHSA, and by RTI International in Research Triangle Park, North Carolina. (RTI International is a trade name of Research Triangle Institute.)

Information on the most recent NSDUH is available in the following publication:

Office of Applied Studies. (2009). Results from the 2008 National Survey on Drug Use and Health: National findings (DHHS Publication No. SMA 09-4434, NSDUH Series H-36). Rockville, MD: Substance Abuse and Mental Health Services Administration. Also available online: http://oas.samhsa.gov.

The NSDUH Report is published periodically by the Office of Applied Studies, Substance Abuse and Mental Health Services Administration (SAMHSA). All material appearing in this report is in the public domain and may be reproduced or copied without permission from SAMHSA. Additional copies of this report or other reports from the Office of Applied Studies are available online: http://oas.samhsa.gov. Citation of the source is appreciated. For questions about this report, please e-mail: shortreports@samhsa.hhs.gov.

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This page was last updated on September 29, 2009.