Substance Use among 12th Grade Aged Youths by Dropout Status

In the United States, about 75 percent of youths who enter public high school as freshmen eventually graduate from high school in 4 years (or average freshman graduation rate).¹ This is an important public health issue because, in general, adults who do not graduate from high school tend to have lower paying jobs than those who do and thus are at greater risk for living in poverty, lacking health insurance, and suffering from poor health.^2,3,4 Moreover, high school dropouts typically have higher rates of substance use than high school graduates.⁵

The National Survey on Drug Use and Health (NSDUH) asks respondents about their age, current school enrollment status, last grade completed, and age when they last attended school. For this report, these respondent characteristics are used to identify 12th grade aged youths and whether they have dropped out of school. Youths aged 16 to 18 are categorized into three groups:

This issue of The NSDUH Report focuses on the first two of these groups, which are collectively referred to as "12th grade aged youths"; comparisons of past month (current) substance use between 12th grade students and 12th grade aged dropouts are provided. All findings in this report are annual averages from the 2002 to 2010 NSDUH data.

Nearly one in seven (13.2 percent) 12th grade aged youths had dropped out of school, with males having been more likely than females to have dropped out (14.7 vs. 11.6 percent).⁷ About one quarter of Hispanic and American Indian or Alaska Native 12th grade aged youths (23.0 and 25.5 percent, respectively) had dropped out of school compared with 12.6 percent of youths of two or more races, 12.1 percent of black or African American youths, 11.2 percent of white youths, and 1.5 percent of Asian youths.

Twelfth grade aged youths who had dropped out of school were more likely than similarly aged youths who were still in school to engage in current cigarette use, alcohol use, binge alcohol use, marijuana use, nonmedical use of psychotherapeutic drugs, and use of any illicit drugs (Figure 1).⁸ For example, 56.8 percent of dropouts were current cigarette users compared with 22.4 percent of those still in school, and 27.3 percent of dropouts were current marijuana users compared with 15.3 percent of those still in school.

Current substance use rates among 12th grade aged male dropouts were higher than the rates among similar aged males who were still in school (Figure 2). For example, 60.1 percent of male dropouts were current cigarette users compared with 23.8 percent of males who were still in school, and 32.0 percent of male dropouts were current marijuana users compared with 17.9 percent of males who were still in school.

Figure 2. Past Month Substance Use among 12th Grade Aged Male Youths, by Dropout Status: 2002 to 2010

Figure 2 Table. Past Month Substance Use among 12th Grade Aged Male Youths, by Dropout Status: 2002 to 2010

Substance	Dropouts	In School
Cigarettes*	60.1%	23.8%
Alcohol*	46.9%	37.1%
Binge Alcohol*	38.7%	27.5%
Any Illicit Drug*	35.8%	20.5%
Marijuana*	32.0%	17.9%
Nonmedical Use of Prescription-Type Drugs*	9.6%	5.5%

* Difference between 12th grade students and 12th grade aged youths who had dropped out of school is significant at the .05 level. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2002 to 2010 (revised March 2012).

Current substance use rates among 12th grade aged female dropouts were generally higher than the rates for similar aged females who were still in school (Figure 3). One exception was current alcohol use, for which there was no statistical difference between the rates among female dropouts and females who were still in school (34.2 and 33.4 percent, respectively).

Current substance use rates by dropout status varied among racial groups. For both white and black youths, rates of current substance use were consistently higher among 12th grade aged dropouts than among those who were still in school (Figures 4 and 5). For example, current cigarette use was more than 2 times higher among white dropouts than among white students (69.3 vs. 26.6 percent) and more than 4 times higher among black dropouts than black students (50.3 vs. 11.5 percent). By contrast, the substance use rates between 12th grade aged Hispanic dropouts and those who were still in school did not differ significantly, with the exception of cigarette use, for which dropouts were more likely than those still in school to be current users (38.0 vs. 18.4 percent) (Figure 6).⁹

Dropping out of high school is related to a number of negative socioeconomic and health outcomes. This report shows that one in seven 12th grade aged youths had dropped out of high school and that 12th grade aged dropouts (with a few exceptions) had higher rates of current substance use (e.g., cigarettes, alcohol, binge alcohol, marijuana, nonmedical use of psychotherapeutic drugs, any illicit drugs) than similar aged peers who were still in school. Substance use is a public health problem that is preventable. Thus, prevention efforts targeted to adolescents generally and to those at risk of dropping out of high school more specifically might improve the educational, employment and financial, and health outcomes of many youths.