Trends in single, dual, and poly use of alcohol, cigarettes, and marijuana among US high-school students: 1991–2017

Objectives. To evaluate trends in patterns (single, dual, or poly) of current use of alcohol, cigarettes, and marijuana (ACM) among youths in the United States. Methods. I used data from the 1991–2017 Youth Risk Behavior Surveys (n = 203 663) to report average annual percentage change (AAPC) and linear trends of single, dual, and poly use of ACM among youths. Results. From 1991 to 2017, the prevalence of marijuana-only use increased from 0.6% to 6.3% (AAPC = 7.4) while the prevalence of use of alcohol only or cigarettes only significantly declined. Dual use of alcohol and marijuana increased from 3.6% to 7.6% (AAPC = 2.4), while dual use of alcohol and cigarettes declined from 11.8% to 1.7% (AAPC = –7.5). The prevalence of poly use of ACM declined from 9.4% to 4.4%. There is an enlarged disparity in use of marijuana only by race/ethnicity with an increase of 11.5% among non-Hispanic Blacks and an increase of 8.1% among Hispanics, compared with an increase of 3.4% among non-Hispanic Whites. Conclusions. The use patterns of ACM among youths have changed with a surge in use of marijuana only, especially among racial/ethnic minorities.