Cigarette, Cigar, and Marijuana Use Among High School Students — United States, 1997–2013

October 16, 2015 / Vol. 64 / No. 40

MMWR Introduction

CDC analyzed data from the 1997–2013 national Youth Risk Behavior Surveys (YRBS) among U.S. non-Hispanic white (white), non-Hispanic black (black), and Hispanic students in grades 9–12 to examine trends in the prevalence of current 1) exclusive cigarette or cigar use, 2) exclusive marijuana use, and 3) any use of the three products. CDC further examined the prevalence of current marijuana use among current users of cigarettes or cigars. During 1997–2013, significant linear decreases occurred in exclusive cigarette or cigar use; however, significant linear increases occurred in exclusive marijuana use. Any cigarette, cigar, or marijuana use significantly decreased overall and among all sex and racial/ethnic subgroups during the study period, whereas marijuana use among cigarette or cigar users increased significantly among all sex and racial/ethnic subgroups. Significant nonlinear trends in exclusive marijuana use and marijuana use among cigarette or cigar users also were identified among black and Hispanic students. Increased exclusive marijuana use and use of marijuana among cigarette or cigar users could undermine success in reducing tobacco use among youths. Closer collaboration between public health professionals to address prevention of tobacco and marijuana use might be beneficial in the development of evidence-based policies and programs to prevent tobacco and marijuana use.

Reducing current use of cigarette, cigar, and marijuana among U.S. youth might be achieved through multifaceted, targeted implementation of evidence-based program and policy interventions, in concert with active engagement of multiple stakeholders, including parents, schools, communities, and the media. Enhanced and sustained tobacco and marijuana use surveillance can help in monitoring trends and patterns of use, including the measurement of progress toward achieving Healthy People 2020 objectives related to the use of these substances among youth. Policy and programmatic efforts may benefit from approaches that focus on reducing the use of tobacco and marijuana among youth.