National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland.
Kelly Government Solutions, Rockville, Maryland.
JAMA Netw Open. 2023 Jan 3;6(1):e2254566. doi: 10.1001/jamanetworkopen.2022.54566.
Information about national substance use trends among youths and adults after mid-March 2020 is limited due to constraints on surveillance during the COVID-19 pandemic.
To evaluate whether substance use prevalence in the early part of the pandemic (2020) differed from the prepandemic periods of 2018 to 2019 and 2016 to 2018.
DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study was a repeated analysis of 2016 to 2020 data from a nationally representative sample of youths and adults in the Population Assessment of Tobacco and Health (PATH) Study. Participants were representative of the US civilian noninstitutionalized population. Household residents age 13 years or older were interviewed in person from 2016 to 2019 and via telephone in 2020.
Age, calendar year.
Past 30-day self-reported use of any tobacco, any alcohol, binge drinking, cannabis, and any other illegal or misused prescription drugs.
The overall nationally representative 2020 sample included 7129 youths (ages 13-17 years), 3628 young adults (ages 18-20 years), and 8874 adults (ages ≥21 years). Comparing 2018 to 2019 with 2020 among youths, prevalence of all substances used declined (eg, cannabis use declined in those aged 16-17 years from 14.9% to 7.6%; absolute difference, -7.3 percentage points [95% CI -8.8 to -5.8 percentage points]). Among young adults, prevalence of all substances other than any alcohol decreased significantly (eg, tobacco use declined from 37.8% to 22.8%; absolute difference, -15.1 percentage points [95% CI -16.8 to -13.3 percentage points]). In adults ages 21 to 24 years, any tobacco use declined from 39.0% to 30.9% (absolute difference, -8.2 percentage points [95% CI, -10.6 to -5.7 percentage points]), and alcohol use increased from 60.2% to 65.2% (absolute difference, 5.0 percentage points [95% CI, 2.3 to 7.7 percentage points]). Among adults aged 25 years or older, any tobacco use declined from 39.0% to 30.9% (absolute difference, -8.2 percentage points [95% CI, -10.6 to -5.7 percentage points]), cannabis use increased from 11.3% to 12.4% (absolute difference, 1.2 percentage points [95% CI, 0.3 to 2.0 percentage points]), and other substance use declined from 5.8% to 3.7% (absolute difference, -2.1 percentage points [95% CI, -2.9 to -1.4 percentage points]).
In this cross-sectional study, substance use decreased between 2019 and 2020 among those aged 13 to 20 years; consistent declines were not seen in older persons other than tobacco use reductions, and cannabis use increased among adults ages 25 years and older. While social changes during the COVID-19 pandemic could have affected substance use, findings should be interpreted with caution due to differences in data collection methods in 2016 to 2019 and 2020.
由于 COVID-19 大流行期间监测受限，有关青少年和成年人在 3 月中旬之后的全国物质使用趋势的信息有限。
评估大流行早期（2020 年）的物质使用流行率是否与 2018-2019 年和 2016-2018 年的流行前期有所不同。
设计、地点和参与者：本横断面研究是对全国代表性青少年和成年人人群进行的人口评估烟草与健康（PATH）研究 2016-2020 年数据的重复分析。参与者代表美国非机构化的平民人口。2016-2019 年通过个人访谈对年龄在 13 岁及以上的家庭居民进行调查，2020 年通过电话进行调查。
年龄，日历年份。
过去 30 天内自我报告的任何烟草、任何酒精、狂饮、大麻和任何其他非法或滥用处方药物的使用情况。
总体上，具有全国代表性的 2020 年样本包括 7129 名青少年（年龄 13-17 岁）、3628 名青年成年人（年龄 18-20 岁）和 8874 名成年人（年龄≥21 岁）。与 2018-2019 年相比，2020 年青少年中所有物质的使用流行率均下降（例如，16-17 岁人群中使用大麻的比例从 14.9%降至 7.6%；绝对差异，-7.3 个百分点[95%置信区间：-8.8 至-5.8 个百分点]）。在青年成年人中，除任何酒精以外的所有物质的使用流行率均显著下降（例如，烟草使用从 37.8%降至 22.8%；绝对差异，-15.1 个百分点[95%置信区间：-16.8 至-13.3 个百分点]）。在 21-24 岁的成年人中，任何烟草使用从 39.0%降至 30.9%（绝对差异，-8.2 个百分点[95%置信区间：-10.6 至-5.7 个百分点]），而酒精使用从 60.2%增加到 65.2%（绝对差异，5.0 个百分点[95%置信区间：2.3 至 7.7 个百分点]）。在 25 岁及以上的成年人中，任何烟草使用从 39.0%降至 30.9%（绝对差异，-8.2 个百分点[95%置信区间：-10.6 至-5.7 个百分点]），大麻使用从 11.3%增加到 12.4%（绝对差异，1.2 个百分点[95%置信区间：0.3 至 2.0 个百分点]），其他物质的使用从 5.8%降至 3.7%（绝对差异，-2.1 个百分点[95%置信区间：-2.9 至-1.4 个百分点]）。
在这项横断面研究中，2019 年至 2020 年间，13 至 20 岁人群的物质使用量下降；在 25 岁及以上的成年人中，除了烟草使用量减少外，其他年龄段的物质使用量没有持续下降，大麻使用量增加。虽然 COVID-19 大流行期间的社会变化可能会影响物质使用，但由于 2016-2019 年和 2020 年数据收集方法的差异，结果应谨慎解释。
