Alcohol is the substance abused most frequently by adolescents, followed by marijuana and tobacco. In the past month, 35 percent of high school seniors reported drinking some alcohol, 21 percent reported using marijuana, and 11 percent reported smoking cigarettes.
More adolescents drink alcohol than smoke cigarettes or use marijuana. Within the past month, more than three out of 10 high school seniors report drinking some alcohol and one in six have engaged in “binge drinking” daily in the past two weeks. Drinking endangers adolescents in multiple ways including motor vehicle crashes, the leading cause of death for this age group., One in five adolescents has ridden in a car with a driver who had been drinking. Genetic factors and life stressors influence adolescents’ alcohol abuse, but parents and guardians can help by monitoring adolescents’ activities and keeping channels of communication open.
Cigarette smoking among adolescents has declined dramatically in the last 15 years. Today, most adolescents do not smoke, but about one in 10 has smoked within the past month and the use of smokeless tobacco increased between 2008 and 2010, but has declined steadily since 2010. Tobacco use harms nearly every organ in the body, and more than five million children under 18 will die prematurely of smoking-related illnesses. Multiple factors influence whether an adolescent becomes a regular smoker, including genetics and having parents or peers who smoke.[8-10] Many adolescents start trying tobacco products at a young age, so prevention efforts in schools, in communities, and in homes, can help and should begin early.
Illicit drug use—which includes the abuse of illegal drugs and/or the misuse of prescription medications or household substances—is something many adolescents engage in occasionally, and a few do regularly. By the 12th grade, about half of adolescents have abused an illicit drug at least once. The most commonly used drug is marijuana but adolescents can find many abused substances, such as prescription medications, glues, and aerosols, in the home. Many factors and strategies can help adolescents stay drug free: Strong positive connections with parents, other family members, school, and religion; having parents present in the home at key times of the day; and reduced access in the home to illegal substances.
 U.S. Department of Transportation. (2014). Young Drivers. DOT HS 812 019. Washington, DC. Retrieved February 12, 2016, from http://www-nrd.nhtsa.dot.gov/Pubs/812019.pdf
 Centers for Disease Control and Prevention. (2016). Youth Risk Behavior Surveillance-United States, 2015. Morbidity and Mortality Weekly Report, 65(6). Retrieved August 25, 2016, from http://www.cdc.gov/healthyyouth/data/yrbs/pdf/2015/ss6506_updated.pdf
 Brody, G. E., Beach, S. R. H., Philibert, R. A., Chen, Y.-f., & Murry, V. M. (2009). Prevention effects moderate the association of 5-HTTLPR and youth risk behavior initiation: Gene x environment hypotheses tested via a randomized prevention design. Child Development, 80(3), 645-661.
 Centers for Disease Control and Prevention. (2014). Health effects of cigarette smoking. Retrieved February 12, 2016, from http://www.cdc.gov/tobacco/data_statistics/fact_sheets/health_effects/effects_cig_smoking/
 U.S. Department of Health and Human Services. (2014). The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health. Retrieved on August 29, 2016, from http://www.surgeongeneral.gov/library/reports/50-years-of-progress/full-report.pdf
 Mays, D., Gilman, S. E., Rende, R., Luta, G., Tercyak, K. P., & Niaura, R. S. (2014). Parental Smoking exposure and adolescent smoking trajectories. Pediatrics, 133(6), 983-991.
 Singh, T., Arrazola, R. A., Corey, C. G., et al. (2016) Tobacco Use Among Middle and High School Students — United States, 2011–2015. Morbidity and Mortality Weekly Report, 65(14), 361–367. Retrieved August 29, 2016, from http://www.cdc.gov/mmwr/volumes/65/wr/mm6514a1.htm
 Haas, S. A., & Schaefer, D. R. (2014). With a little help from my friends? Asymmetrical social influence on adolescent smoking initiation and cessation. Journal of Health and Social Behavior, 55(20), 126-143.
 National Institute on Drug Abuse. (2003). Preventing drug use among children and adolescents. Bethesda, MD: National Institute on Drug Abuse. Retrieved February 12, 2016, from http://www.drugabuse.gov/sites/default/files/preventingdruguse.pdf