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Thursday, 14 June 2012

Good news and bad news on what youth are smoking and drinking

Our friends to the south are very more diligent in collecting information on the health and wellbeing of their population.   Canada has much to learn and emulate.   A report released last week is based on an ongoing youth risk behaviour surveillance study.  The study comprises work from the national surveillance program, 43 state surveys and 21 large urban school area surveys  US behaviour youth survey.  Are you envious yet?   The down side, is the report rarely puts data into a temporal context.   Just like with patients, it is measuring changes that are critical to management of the population’s health.

The study and the Canadian comparators are rich information and worth using as a benchmark for surveys in provinces and regions. 

Work in both countries confirms something most would have suspected.  Regular tobacco use behaviour in US youth has reached a relative low at 10.2% daily use in the last 30 days with any tobacco smoking use at 18.1%.  This is good news.  On the other hand, marijuana use in the last 30 days was at 23.1%.   Officially, marijuana use has become more prevalent than tobacco. 

Lest we forget the third of the major psychoactive substances, alcohol.   Consumption being illegal for youth under 21 in the US with provinces at either 18 or 19 years of age. US youth use of alcohol in the previous 30 days was the highest of the three substances at 38.7%. Alcohol consumption by youth seems to be decreasing amongst this US population .

Within Canada we have the Youth smoking survey 2010-2011 Youth smoking survey 2010-2011 which shows tobacco use at  10% use in past 30.  This survey also asks about alcohol and drug use with rates reported at 45% use of alcohol in the last year, and this is also appears to be decreasing.  Past year cannabis use reported at 21% and also supposedly decreasing.   Note that question format and time frames make comparison to the US survey difficult but suggestive that youth in both countries have similar risk profiles.

The Canadian drug and Alcohol Use Monitoring Survey provides some information on youth (ages 15-24) CDAUMS  but does not provide directly comparable statistics to the US youth behavioural survey .   Cannabis consumption in the past year – 25.1%.   Alcohol consumption in past 30 days – 52.3%.   Noting that these numbers would at least appear consistent with the youth survey data given a slightly different age group.

Here rests the public health dilemma.   We have different approaches to efforts to control and regulate tobacco, alcohol and marijuana, the former being legal, the later still considered a criminal offense to have possession of. Alcohol supposed not legal for consumption for youth.    Relative success has occurring through concerted efforts to reduce tobacco and alcohol, yet efforts to control marijuana use are limited by lack of information, lack of legitimacy and significant illicit profit compared to regulated substances like tobacco and alcohol.  

While marijuana may not have the same health risks associated with its use, it is not something to be promoted or encouraged – but controlled.  

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