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REMARKS BY: Donna E. Shalala, Secretary of Health and Human Services PLACE: National Household Survey Press Conference, Washington, D.C. DATE: August 31, 2000

Heading for Home


I'm pleased to join General McCaffrey this morning to announce the results of the 1999 National Household Survey. Last year, I optimistically told you that in the fight against illicit drug use we may have finally turned the corner. Well this year's survey definitely shows that we've not only turned the corner- we're heading for home plate.

According to national trend data, the decline in illicit drug use among young people ages 12 to 17 that began in 1997 has continued through 1999-while illicit drug use among the overall population remained flat. Among teens, there has been a consistent, downward trend from 11.4 percent in 1997 to 9.9 percent in 1998 to 9.0 in 1999-a statistically significant decline. More of our young people are obviously getting the message that drugs are not the stuff of dreams, but the stuff of nightmares. Marijuana use among youths ages 12 to 17-still the drug of choice for this age group-also decreased from 9.4 percent in 1997 to 7.0 percent in 1999.

The pattern was the same for cigarette use. Among teens, cigarette use decreased from 19.9 percent in 1997 to 15.9 percent in 1999. For the very first time, the survey also captured which cigarette brands were most popular among adolescents. More than half of white and Hispanic youth smokers reported Marlboro as their usual brand-while nearly three-quarters of African-American teen smokers reported that Newport is their first choice. Despite the declining numbers, all of us-parents, teachers, the government, media-still need to do more to help our young people see through the tobacco companies' smokescreen of deceit.

We also need to intensify our efforts to protect our children from the threat of alcohol. Current alcohol use among 12 to 17 year olds was 19.0 percent in 1999. And binge drinking-or drinking five or more drinks on the same occasion-was 7.8 percent.

The survey also found that the current use of cocaine, inhalants, hallucinogens and heroin for the 12 and older population remained stable-while the rates of smokeless tobacco use significantly decreased from 3.1 percent in 1998 to 2.2 percent in 1999.

These national trends from the Household Survey are generally consistent with the results from other recent CDC and NIH surveys. Both Monitoring the Future and the Youth Risk Behavior Survey have shown a leveling or declining trend in illicit drug, marijuana and cigarette use among adolescents since 1996 or 1997-after a period of increases since the beginning of the decade. In a separate study being released today, the annual Drug Abuse Warning Network report found that the number of emergency room visits for drug-related causes decreased 11 percent for youth age 12 to 17 from 1998 to 1999.

All of this is very good news. But let me be clear: We have a long way to go. To paraphrase the poet, we have miles to go in our journey to a drug free America. We have miles to go when 14.8 million Americans were current users of illicit drugs in 1999. And we have miles to go if even a single young person is letting his or her dreams-and life-go up in a cloud of marijuana or cigarette smoke.

That's why, in 1996, I challenged my department to develop a whole new approach to fighting substance abuse. I wanted our efforts to be based on science, with measurable outcomes, and designed to help community and state leaders formulate targeted programs. As a result, we have greatly expanded the 1999 National Household Survey. The previous surveys were generated by interviewers and self-administered paper questionnaires. They used a sample size of 18,000. And they were only able to generate national estimates.

The newly designed survey is fundamentally different. It is an interactive, bilingual, computer-based questionnaire. It expands the sample size almost four-fold to nearly 70,000 persons. And-perhaps most important-it can provide national, state and sub-population substance use estimates. Of course, because of the changes in methodology, national estimates from the expanded survey cannot be compared to data from prior surveys. That's why we kept both surveys in place this year to give us reliable trend data.

But this new survey will provide parents, governors-and future administrations- with a better, more powerful tool. It will draw a more accurate picture of substance abuse in America than ever before available. It will establish a new baseline for better year-to-year calculations and comparisons of future trends-trends that will take a few years to develop. It will help states and communities to better target their substance abuse strategies. It will allow for better analysis of our progress in reducing substance use among specific age groups, racial and ethnic minorities, and those in rural areas. And it will help us to further improve our partnerships with states and communities by better targeting several of our key programs.

Our "State Incentive Grant for Community-Based Action" will now require applicants to select one or two key state estimates from the Household Survey as a baseline of substance use-and to identify a goal to be achieved within three years. This will allow states to better manage and direct their resources. Additionally, in Fiscal Year 2001, the Targeted Capacity Expansion Grant program will give preference to those tribal and local government applicants who propose to address problem areas identified by the National Household Survey. This will help communities cultivate a substance abuse treatment system that is responsive to current and emerging needs.

The snapshot of substance use that was developed from the new survey has already provided us with considerable information that invites further investigation. For example, of the ten states with the highest rates of illicit drug use in the population 12 and older, six were in the western region-while eight of the ten states with the lowest rates were within the southern region. Eight of the ten states with the highest rates of binge drinking for those 12 and older were in the northern or midwestern region-while seven of the nine states with the lowest rates were again in the southern region. Additionally, four of the ten states with the highest rates of cigarette use among those 12 and older were in the southern region-and six were in the midwestern region. I must caution, however, that within regions there was considerable variation. Also- because of the margin of error-simply ranking the states would not provide the most accurate picture.

I am sending letters-today-to all 50 governors and DC Mayor Williams to apprise them of the substance use estimates for their respective jurisdictions-and to ensure that they understand that states have complete access to our information. Later this year, HHS will also be issuing a series of four reports- including ones on alcohol dependency and youth tobacco use-based on the information gleaned from the new survey. We know that the newly designed National Household Survey will help us to continue to move in the right direction.to remove any roadblocks along the way.and to provide the best mileposts of our progress in the fight against illicit drugs.

Of course, as we use this powerful new tool, at HHS we're expanding our efforts to reduce tobacco, alcohol and illicit drug use among young people. These include developing a program for female Hispanic adolescents based on our highly successful Girl Power! campaign-and generating new materials to help Spanish-speaking parents talk with their children about drugs. We're also working to specifically reduce marijuana use among America's youth through our comprehensive Marijuana Initiative, which was started in 1995. And today, I'm pleased to announce that we're issuing an updated version of our free publication, "Keeping Youth Drug Free," which is targetd to parents of young teens.

For all we've done, we're still not satisfied with where we are in this fight. We're going to keep pushing ahead until we're all the way home. But protecting our children from drugs isn't a job for government alone. We need a bipartisan commitment to target our resources. We need parents-the single most important factor in protecting children from trying drugs-to sit down with their children, early and often, and tell them that drugs are a one-way ticket to no where. And we need coaches, clergy, media and everyone involved in our children's lives to keep up a steady drumbeat of anti-drug messages echoing from every corner of society. The task may seem daunting-but it's not impossible. It just takes all of us-all of us helping our young people move in the right direction.

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