STATEMENT OF CHERYL G. HEALTON, DrPH, President and Chief Executive Officer, American Legacy Foundation, and JOSEPH A. CALIFANO, JR., Chairman and President, The National Center on Addiction and Substance Abuse (CASA) at Columbia University

In 1994, The National Center on Addiction and Substance Abuse (CASA) at Columbia University issued its report, Cigarettes, Alcohol, Marijuana: Gateways to Illicit Drug Use, a statistical analysis which found that teens who smoked cigarettes were 12 times likelier to use marijuana and more than 19 times likelier to use cocaine.

Similar analyses have also been conducted by a number of distinguished researchers, including Denise Kandel, PhD (1992).
In recent years, scientists have found evidence that sheds light on this statistical relationship: studies at the University of Cagliari in Italy, Cumplutense University in Madrid, and Scripps Research Institute in California reveal that marijuana affects levels of dopamine (the substance that gives pleasure) in the brain in a manner similar to nicotine, heroin and cocaine.

Dr. Nora Volkow, Director of the National Institute on Drug Abuse, has stated that “cigarette smoking may also facilitate consumption of other drugs.”

As a smoked drug, cigarettes initiate teens into the sensation of inhaling a drug and desensitize them to the feeling of smoke entering their lungs.

These findings--and their implications for American teenagers--led us to examine how prevalent marijuana was in the life of teenage smokers.

As a result, The National Center on Addiction and Substance Abuse (CASA) at Columbia University and the American Legacy Foundation included in CASA’s 2003 back to school survey of 12- to 17-year olds--the CASA National Survey of American Attitudes on Substance Abuse VIII: Teens and Parents--questions regarding the extent to which marijuana is part of the life of a teenage smoker.

This report on the results of this survey by CASA and the American Legacy Foundation finds that marijuana is pervasive in the life of a teenage cigarette smoker.

Teens who smoke nicotine cigarettes are 14 times likelier to try marijuana, six times likelier to be able to buy marijuana in an hour or less and 18 times likelier to report that most of their friends smoke marijuana.

Among teens who are repeat marijuana users, 60 percent tried cigarettes first. The findings indicate that reducing teen smoking can be a singularly effective way to reduce teen marijuana use.

There is a powerful message for the Administration and Congress in these findings: the media and public service awareness campaigns to prevent teen drug use--such as the National Youth Anti-Drug Media Campaign of the White House Office of National Drug Control Policy and that of the Partnership for a Drug-Free America--should devote a significant amount of their energy and time to discourage cigarette smoking among teens.

President George W. Bush last year committed to reduce illegal drug use by 10 percent over two years and 25 percent over five years.

He can only achieve such dramatic declines by sharp reductions in marijuana use. This report suggests one powerful way to help the administration attain its stated goal.

We urge the administration to take advantage of this opportunity and educate the nation on the dangers of tobacco use.

There is also a powerful message for parents in these findings: to the extent that biological activation and desensitization play a role, preventing teen initiation of cigarette use can significantly reduce teen involvement with other drugs--especially drugs that are typically smoked, such as marijuana.

This underscores--for parents, teachers, policymakers and anyone else concerned with the welfare of American children--the importance of intervening to end teen cigarette smoking in order to prevent other drug use.

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Introduction

For eight years, CASA has been engaged in the unprecedented undertaking of surveying attitudes of teens and those who most influence them--parents, teachers and school principals.

While other surveys seek to measure the extent of substance abuse in the population, the CASA National Survey of American Attitudes on Substance Abuse VIII: Teens and Parents probes substance-abuse risk and identifies factors that increase or diminish the likelihood that teens will abuse tobacco, alcohol or illegal drugs.

We regard this effort as a work in progress and strive to refine it each year.

This year, for the first time, working with the American Legacy Foundation, CASA asked a series of questions to examine statistical associations between teen cigarette smoking and teen marijuana use.

The troubling findings:

• Teens who smoke cigarettes are 14 times likelier than those who do not to try marijuana.

• Among teens who admit to having tried marijuana, those who do not smoke cigarettes are likelier to have tried marijuana only once.

• Teens who have tried marijuana and are current cigarette smokers are 60 percent likelier to be repeat (as opposed to one-time) marijuana users.

• Teens who are current cigarette smokers are six times likelier than those who have never smoked cigarettes to report that they can buy marijuana in an hour or less.

• Fifty-five percent of teens who are current cigarette smokers report more than half their friends use marijuana, compared with only three percent of those who have never smoked cigarettes.

• Among teens who are repeat marijuana users, 60 percent tried cigarettes first.

• Seventy-seven percent of teens believe that a teen who smokes cigarettes is more likely to use marijuana.

From the Report on Teen Cigarette Smoking and Marijuana Use [30 pages]