Many Youth Discontinue Use of Alcohol, Tobacco, and Other Drugs by the Time They Leave High School

"'Noncontinuation' refers to not using a drug in the prior 12 months after having used it at some earlier time in one’s life. In other words, the noncontinuation rate is the percent of lifetime users who did not report using the drug in the past 12 months (or in the case of cigarettes, in the past 30 days). These rates and the changes in them over the years are shown in Table 6-5a for lifetime users; in Table 6-5b the noncontinuation rates are based on 12th graders who are “experienced users” (i.e., used the drug 10 or more times in their lifetime). An important caution is that these estimates are based on students who have ever used specific drugs, and the estimates can vary substantially from year to year for drugs with lower prevalence and thus small numbers of cases.

"• The noncontinuation rate for nicotine vaping in 2022 was 30%, similar to where it was in 2021 at 31%. This level represents more than a doubling since 2019, when it was 14%. Since 2019 the prevalence of nicotine vaping plateaued and then began to decline. These results suggest that in recent years the decline in adolescent nicotine vaping partly stems from the increasing percentage of adolescents who discontinued use after initiating use.

"• Noncontinuation had to be defined differently for cigarettes because respondents are not asked to report on their cigarette use in the past year. The noncontinuation rate is thus defined as the percentage of those who say they ever smoked in their lifetime who also reported not smoking at all during the past 30 days rather than the past year. In 2022 noncontinuation of cigarettes continued its long term increase and was at 76%, a level second only to 2021 when it was 77%.

"• Noncontinuation of smokeless tobacco was near its highest recorded level in 2022 at 69%. One possibility is that nicotine vaping is displacing teen use of cigarettes and smokeless tobacco, a hypothesis that warrants close consideration.

" The noncontinuation rate for marijuana vaping has more than doubled in the past four years, from 12% in 2019 to 25% in 2022. Part of the reason for these increased rates may be the outbreak of vaping related lung injury in 2020, which was linked to marijuana vaping. Since 2019 the prevalence of marijuana vaping has plateaued after marked increases in 2018 and 2019. As with nicotine vaping, these results suggest that in recent years the decline in adolescent marijuana vaping partly stems from the increasing percentage of adolescents who discontinued use after initiating use.

"• Marijuana use overall—that is, without the question specifying any specific method of use—has one of the lowest rates of noncontinuation of all drugs (Table 6-5a). In 2022, the noncontinuation rate was only 20%, and has hovered in a narrow window between 18% and 26% over the last two decades.

"During the 1990s, marijuana noncontinuation rates fell by half, from a high of 35% in 1991 to a low of 17% in 1995, indicating that the substantial increase in prevalence during this period represented not only an increase in youth adopting marijuana use, but also sharply lower levels of users desisting from it. Previous to 1992, noncontinuation had gradually increased since the early 1980s, and with these higher rates of noncontinuation came a decrease in marijuana prevalence during those same years."