Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Dr, Room 4E514, MSC 9765, Bethesda, MD 20892-9765. Email:
National Cancer Institute, Bethesda, Maryland.
Prev Chronic Dis. 2018 May 31;15:E69. doi: 10.5888/pcd15.170345.
This study statistically ranked states' performance on adolescent substance use related to cancer risk (past-month cigarette smoking, binge alcohol drinking, and marijuana use).
Data came from 69,200 adolescent participants (50 states and the District of Columbia) in the National Survey on Drug Use and Health (NSDUH) and 450,050 adolescent participants (47 states) in the Youth Risk Behavior Surveillance System (YRBSS). Adolescents were aged 14 to 17 years. For 2011-2015, we estimated and ranked states' prevalence of adolescent substance use. We calculated the ranks' 95% confidence intervals (CIs) using a Monte Carlo method with 100,000 simulations. Spearman correlations examined consistency of ranks.
Across states, the prevalence of cigarette smoking was 4.5% to 14.3% in NSDUH and 4.7% to 18.5% in YRBSS. Utah had the lowest prevalence (NSDUH: rank = 51 [95% CI, 47-51]; YRBSS: rank = 47 [95% CI, 46-47]), and states' ranks across surveys were correlated (r = 0.66, P < .001). The prevalence of binge alcohol drinking was 5.9% to 14.3% (NSDUH) and 7.1% to 21.7% (YRBSS). Utah had the lowest prevalence (NSDUH: rank = 50 [95% CI, 40-51]; YRBSS: rank = 47 [95% CI, 47-47]), but ranks across surveys were weakly correlated (r = 0.38, P = .01). The prevalence of marijuana use was 6.3% to 18.7% (NSDUH) and 8.2% to 27.1% (YRBSS). Utah had the lowest prevalence of marijuana use (NSDUH: rank = 50 [95% CI = 33-51]; YRBSS: rank= 46 [95% CI, 46-46]), and ranks across surveys were correlated (r = 0.70, P < .001). Wide CIs for states ranked in the middle of each distribution obscured statistical differences among them.
Variability emerged across adolescent substance use behaviors and surveys (perhaps because of administration differences). Most states showed statistically equivalent performance on adolescent substance use. Adolescents in all states would benefit from efforts to reduce substance use, to prevent against lifelong morbidity.
本研究通过统计分析评估了各州在青少年与癌症风险相关的物质使用方面的表现（过去一个月的吸烟、狂饮和使用大麻）。
数据来自国家药物使用与健康调查（NSDUH）的 69200 名青少年参与者（50 个州和哥伦比亚特区）和青年风险行为监测系统（YRBSS）的 450050 名青少年参与者（47 个州）。青少年年龄在 14 至 17 岁之间。对于 2011-2015 年，我们估计并对各州青少年物质使用的流行率进行了排名。我们使用蒙特卡罗方法（Monte Carlo method）和 100000 次模拟计算了排名的 95%置信区间（CIs）。Spearman 相关性检验用于检验排名的一致性。
在各州中，吸烟的流行率在 NSDUH 中为 4.5%至 14.3%，在 YRBSS 中为 4.7%至 18.5%。犹他州的流行率最低（NSDUH：排名=51[95%CI，47-51]；YRBSS：排名=47[95%CI，46-47]），并且两个调查的排名具有相关性（r=0.66，P<.001）。狂饮酒精的流行率在 NSDUH 中为 5.9%至 14.3%，在 YRBSS 中为 7.1%至 21.7%。犹他州的流行率最低（NSDUH：排名=50[95%CI，40-51]；YRBSS：排名=47[95%CI，47-47]），但调查间的排名相关性较弱（r=0.38，P=0.01）。大麻使用的流行率在 NSDUH 中为 6.3%至 18.7%，在 YRBSS 中为 8.2%至 27.1%。犹他州大麻使用的流行率最低（NSDUH：排名=50[95%CI=33-51]；YRBSS：排名=46[95%CI，46-46]），并且调查间的排名具有相关性（r=0.70，P<.001）。处于每种分布中间的各州排名的宽置信区间掩盖了它们之间的统计学差异。
青少年物质使用行为和调查之间存在差异（可能是由于管理方面的差异）。大多数州在青少年物质使用方面表现出统计学上等同的水平。所有州的青少年都将受益于减少物质使用的努力，以预防终生发病。
