Substance Use Rates
Our Youth, Our Future has been measuring rates of substance use among Native adolescents attending schools on or near reservations for many years. Consistently, Native adolescents have reported the highest levels of substance use compared with other US racial/ethnic groups. The harm associated with high rates of use and early initiation for Native youths include increasing rates of use in early and later adulthood, higher risk of developing a substance use disorder, and more alcohol-related problems, including alcohol-attributable death.
During the early years of the COVID-19 pandemic, substance use rates dropped significantly. As time passes, it is important to continue to measure rates to see whether rates increase back to their pre-COVID-19 levels or continue at the lower rates.
Table 1: Prevalence of nicotine product use for reservation-area American Indian youth, 2021-2022
| Grades in School | |||
|---|---|---|---|
| Lifetime | 8 | 10 | 12 |
| Cigarettes | 8.9% | 16.4% | 21.6% |
| Vaping Nicotine | 19.9% | 29.9% | 38.8% |
| Smokeless Tobacco | 5.1% | 8.9% | 11.6% |
| Past month | 8 | 10 | 12 |
| Cigarettes | 2.1% | 4.1% | 5.5% |
| Vaping Nicotine | 9.7% | 17.4% | 20.2% |
| Smokeless Tobacco | 0.7% | 1.8% | 2.5% |
| Daily | 8 | 10 | 12 |
| Cigarettes | 1.2% | 2.3% | 2.4% |
| Vaping Nicotine | 1.5% | 6.9% | 7.0% |
| Smokeless Tobacco | 3.4% | 4.6% | 12.3% |
Nicotine Product Use
Tobacco use in any form by youth is especially concerning, as it leads to immediate and long-term damage. Although rates of cigarette smoking among youth have declined over several decades, a sharp rise in e-cigarette smoking occurred less than a decade ago.
Table 1 shows the prevalence of nicotine product use among the 2021-2022 sample of reservation-area American Indian youth.
Alcohol Use
Alcohol and cannabis are the most used substances (not including nicotine) among youth nationally. Table 3 presents the percentage of American Indian reservation-area 8th, 10th and 12th grade students who reported having used alcohol in their lifetimes, in the last 12 months and in the last 30 days and the percentage reporting binge drinking (having 5 or more drinks in a row in the last 2 weeks).
Table 3: Prevalence of alcohol use for reservation-area American Indian youth, 2021-2022
| Grades in School | |||
|---|---|---|---|
| Alcohol use | 8 | 10 | 12 |
| Lifetime alcohol use | 24.7% | 31.6% | 46.3% |
| 12-month alcohol use | 13.8% | 21.2% | 32.5% |
| 30-day alcohol use | 7.6% | 9.3% | 18.9% |
| Drunkenness | 8 | 10 | 12 |
| Lifetime drunkenness | 9.7% | 17.5% | 33.4% |
| 12-month drunkenness | 7.6% | 13.8% | 24.9% |
| 30-day drunkenness | 3.9% | 6.4% | 13.8% |
| Binge Drinking | 8 | 10 | 12 |
| 5+ drinks in a row in last 2 weeks | 3.4% | 4.6% | 12.3% |
Table 5: Prevalence of cannabis use for reservation-area American Indian youth, 2021-2022
| Grades in School | |||
|---|---|---|---|
| Cannabis use | 8 | 10 | 12 |
| Lifetime cannabis use | 22.3% | 35.9% | 46.2% |
| 12-month cannabis use | 16.0% | 27.4% | 36.8% |
| 30-day cannabis use | 10.9% | 18.9% | 26.4% |
| Daily cannabis use | 2.5% | 6.1% | 11.0% |
Cannabis Use
Cannabis is often the most used substance among Native youth that live on a reservation. Table 5 presents the percentage of American Indian reservation-area 8th, 10th and 12th grade students who reported having used cannabis in their lifetimes, in the last 12 months, in the last 30 days, and daily.
2016 Substance Use Rates for Native Youth on Reservations
Table 3: Prevalence of alcohol use for reservation-area American Indian youth, 2021-2022
| Grades in School | |||
|---|---|---|---|
| Alcohol use | 8 | 10 | 12 |
| Lifetime alcohol use | 24.7% | 31.6% | 46.3% |
| 12-month alcohol use | 13.8% | 21.2% | 32.5% |
| 30-day alcohol use | 7.6% | 9.3% | 18.9% |
| Drunkenness | 8 | 10 | 12 |
| Lifetime drunkenness | 9.7% | 17.5% | 33.4% |
| 12-month drunkenness | 7.6% | 13.8% | 24.9% |
| 30-day drunkenness | 3.9% | 6.4% | 13.8% |
| Binge Drinking | 8 | 10 | 12 |
| 5+ drinks in a row in last 2 weeks | 3.4% | 4.6% | 12.3% |
Table 2: Comparison of nicotine product use: 2003 - 2004 to 2021 - 2022
| Grades in School | ||||||
|---|---|---|---|---|---|---|
| 8 | 10 | 12 | ||||
| Lifetime | 2003-4 | 2021-22 | 2003-4 | 2021-22 | 2003-4 | 2021-22 |
| Cigarettes | 59% | 8.9% | 70% | 16.4% | 72% | 21.6% |
| Smokeless tob. | 27% | 5.1% | 25% | 8.9% | 29% | 11.6% |
| 8 | 10 | 12 | ||||
| Cigarettes | 13% | 1.2% | 15% | 2.3% | 16% | 2.4% |
| Smokeless tob. | 5% | 0.3% | 2% | 0.5% | 5% | 1.4% |
