Alcohol is the substance abused most frequently by adolescents, followed by marijuana and tobacco. In the past month, 39 percent of high school seniors reported drinking some alcohol, almost 23 percent reported using marijuana, and 16 percent reported smoking cigarettes.
More adolescents drink alcohol than smoke cigarettes or use marijuana.  Within the past month, almost four out of 10 high school seniors report drinking some alcohol and more than one in five 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., Nearly one in four 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 ten has smoked within the past month and the use of smokeless tobacco increased between 2008 and 2010, but has remained fairly steady since 2010. Tobacco use harms nearly every organ in the body, and more than six million children born between 1983 and 2000 will die in adulthood of smoking-related illnesses. Multiple factors influence whether an adolescent becomes a regular smoker, including genetics and having parents or peers who smoke.,, 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 twelfth 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.
 Hoyert, D.L. & Xu, J. (2012). Deaths: final data from 2011. National Vital Statistics Reports; 61(6). Hyattsville, MD: National Center for Health Statistics. Retrieved October 10, 2014, from http://www.cdc.gov/nchs/data/nvsr/nvsr61/nvsr61_06.pdf
 U.S. Department of Transportation. (2013).Young Drivers. DOT HS 812 019. Washington, DC. Retrieved October 17, 2014, from http://www-nrd.nhtsa.dot.gov/Pubs/812019.pdf
 Centers for Disease Control and Prevention. (2014). Youth Risk Behavior Surveillance-United States, 2013. Morbidity and Mortality Weekly Report, 63(4). Retrieved October 17, 2014, from http://www.cdc.gov/mmwr/pdf/ss/ss6304.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 October 17, 2014, from http://www.cdc.gov/tobacco/data_statistics/fact_sheets/health_effects/effects_cig_smoking/
 Hahn, E. J., Rayens, M. K., Chaloupka, F. J., Okoli, C. T. C., & Yang, J. (2002). Projected smoking-related deaths among U.S. youth: A 2000 update. ImpacTeen Research Paper Series, No. 22. Retrieved October 17, 2014, from http://www.impacteen.org/generalarea_PDFs/Hahn_researchpaper22_May2002.pdf
 Gilman, S. E., Rende, R., Boergers, J., Abrams, D. B., Buka, S. L., Clark, M. A., et al. (2009). Parental smoking and adolescent smoking initiation: An intergenerational perspective on tobacco control. Pediatrics, 123(2), e274-e281.
 Whitten, L. (2009). Studies link family of genes to nicotine addiction. NIDA Notes, 22(6). Retrieved October 17, 2014, from http://www.nida.nih.gov/NIDA_notes/NNvol22N6/Studies.html
 O’Loughlin, J. O., Karp, I., Koulis, T., Paradis, G., & DiFranza, J. (2009). Determinants of first puff and daily cigarette smoking in adolescents.American Journal of Epidemiology, 170(5), 585-597.
 National Institute on Drug Abuse. (2003). Preventing drug use among children and adolescents. Bethesda, MD: National Institute on Drug Abuse. Retrieved October 17, 2014, from http://www.drugabuse.gov/sites/default/files/preventingdruguse.pdf