Attachments D R

2020 NSDUH, Supporting Statement
Attachment D – Question & Answer Brochure

Answers

If you have more questions
about NSDUH, please call
1-800-848-4079
or visit our Web site at
http://nsduhweb.rti.org

For more information on SAMHSA or
RTI International, contact:
NSDUH National Study Director
SAMHSA
Center for Behavioral Health
Statistics and Quality
5600 Fishers Lane, Room 15E09A
Rockville, MD 20857
www.samhsa.gov

to your questions

The National Survey on Drug Use and Health (NSDUH) provides up-todate information on alcohol, tobacco, and drug use, mental health and
other health-related issues in the United States. NSDUH is directed by the
Substance Abuse and Mental Health Services Administration (SAMHSA),
part of the U.S. Department of Health and Human Services (DHHS).
The study is being conducted by RTI International, a nonprofit research
organization.

National Survey
on Drug Use
and Health

NSDUH National Field Director
RTI International
3040 Cornwallis Road
Research Triangle Park, NC 27709
www.rti.org

RTI International is a trade name of Research Triangle Institute.
v. 01.18

What Is the National Survey on
Drug Use and Health?

Sponsored by the U.S. Department of Health and Human
Services and the Substance Abuse and Mental Health Services
Administration. Conducted by RTI International.

NSDUH began in 1971 and is conducted every year. This year almost
70,000 people from across the United States will be interviewed for this
important study.
Information from NSDUH is used to support prevention and treatment
programs, monitor substance use trends, estimate the need for treatment
facilities and assist with the creation of government policy.

Answers to Your Important Questions about the National Survey on Drug Use and Health
Why Should I Participate?
You are important! Your household was one
of only a few in this area selected for this
study, and no other household or person
can take your place.
Every person who is chosen and completes
the full interview will receive $30 in cash at
the end of the interview in appreciation for
their help.
If chosen for an interview, you will represent
the residents of your community and help us
gather important information that is needed
to make sound policy decisions.
Your participation also provides vital
information to researchers and local, state
and federal agencies to design education,
treatment and prevention programs and
receive funding to support these efforts.

What if I Do Not Smoke, Drink
or Use Drugs?
In order to know the percentage of people
who smoke, drink or use drugs, we also
need to know how many people do not.

The responses of people who do not use
these substances are just as important as the
responses of people who do.

All information collected for this study will be
kept confidential and used only for statistical
purposes, as required by federal law – the
Confidential Information Protection and
Statistical Efficiency Act of 2002 (CIPSEA).

While some questions ask about drug
knowledge and experience, other questions
ask about a number of health-related topics
relevant for all people. You do not need to
know anything about drugs to answer the
questions.

What Is the Substance Abuse
and Mental Health Services
Administration?

How Was I Chosen?
Household addresses, not specific people,
are randomly selected through scientific
methods. Once a household has been
selected, it cannot be replaced for any
reason. This assures that NSDUH accurately
represents the many different types of
people in the United States.
A professional RTI interviewer will visit your
household to ask several general questions
that only take a few minutes to answer.
Afterwards, one or possibly two members of
your household may be asked to complete
the full interview. It is possible that no one
in your household will be chosen for the
interview.

Your household has been chosen at random, but no one
else can take your place. Your participation matters!

What Will Happen During the
Interview?
An interviewer will conduct the interview
with each selected person using a laptop
computer. No prior computer skills are
necessary.
Participants will answer most of the
interview questions in private, entering their
responses directly into the computer. For
other questions, the interviewer will read the
questions aloud and enter the participant’s
responses into the computer.
The interview takes about one hour to
complete. Persons who complete the full
interview will receive $30 at the end of the
interview as a token of our appreciation.

SAMHSA is an agency in the U.S. Department
of Health and Human Services (DHHS).
SAMHSA was created to improve the lives
of people with or at risk for mental and
substance use disorders.
NSDUH is used to help this mission by
gathering data on substance use, problems
related to substance use, and mental health
problems in the United States. The numbers
of people who use various substances, or
have problems related to substance use or
mental health, are important for planning
treatment and prevention services.
SAMHSA selects a qualified survey research
organization to administer NSDUH.
RTI International, a nonprofit research
organization, is under contract with SAMHSA
to conduct NSDUH.

2020 NSDUH, Supporting Statement
Attachment R – NSDUH Highlights and
Newspaper Articles

SELECTED HIGHLIGHTS from the

2017 National Survey on Drug Use and Health
Tobacco Use
•

An estimated 48.7 million
Americans reported current use
(during the past month) of
cigarettes in 2017, which is 17.9
percent of the population aged 12
and older. Of these, 27.8 million
were daily cigarette smokers.

•

The graph to the right illustrates
past month cigarette use among
people aged 12 or older.

Alcohol Use

Past Month Cigarette Use among People Aged 12 or Older,
by Age Group: Percentages, 2002 - 2017

+ Difference between this estimate and the 2017 estimate is statistically significant at the .05 level.

Past Month Alcohol Use among People Aged 12 or Older,
by Age Group: Percentages, 2002 - 2017

•

Slightly more than half of all
Americans aged 12 or older, 51.7
percent or an estimated 140.6
million persons, were current
drinkers in the 2017 survey, which
is higher than the 136.7 million
persons (50.7 percent) reported in
2016. The graph on the left
displays past month alcohol use by
age group.

•

Although consumption of alcoholic
beverages is illegal for those under
21 years of age, 19.7 percent of
this age group (7.4 million) were
current drinkers in 2017.

+ Difference between this estimate and the 2017 estimate is statistically significant at the .05 level.

Illicit Drug Use
•

An estimated 30.5 million Americans were current users of illicit drugs in 2017, meaning
they used an illicit drug at least once during the 30 days prior to the interview. This
estimate represents 11.2 percent of the population 12 years old or older.

•

Marijuana is the most commonly used illicit drug, with an estimated 26.0 million current
users, or 9.6 percent of the population 12 years old or older, which is higher than the 2016
rate of 8.9 percent. In 2017, an estimated 6.0 million (2.2 percent) misused prescriptiontype psychotherapeutic drugs in the past month.

Major Depressive Episode in the Past Year among Adults Aged 18 or
Older, by Age Group: Percentages, 2005 – 2017
Mental Health
•

In 2017, an estimated
17.3 million adults, or
7.1 percent of the
population aged 18 or
older, had at least one
major depressive episode
(MDE) in the past 12
months. Among adults,
the percentage having
MDE in the past year
varied by age, as shown
in the graph to the right.
+ Difference between this estimate and the 2017 estimate is statistically significant at the .05 level.

•

Adolescents aged 12 to 17 with past year MDE were more likely than those without MDE to
have used an illicit drug in the past year (29.3 vs. 14.3 percent). Youths with past year MDE
were more likely to be users of illicit substances, as shown in the graph below.
Past Year Illicit Drug Use among Youths Aged 12 to 17, by Past Year Major Depressive Episode
(MDE) Status: Percentages, 2017

Substance Abuse and Mental Health Services Administration. (2018). Key Substance Use and Mental Health Indicators in
the United States: Results from the 2017 National Survey on Drug Use and Health (HHS Publication No. SMA 18-5068,
NSDUH Series H-53).

Recent articles about the National Survey on Drug Use and Health
From U.S. News & World Report, September 7, 2018 (online)

Study: Marijuana Use Has Doubled Among Middle-Aged Adults
By ALEXA LARDIERI

Marijuana use among middle-aged adults has doubled over the last decade.
According to a study published in Drug and Alcohol Dependence, 9 percent of adults aged 50 to 65 have
used the drug at least once in the last year, and 2.9 percent of adults aged 65 and older have done the
same – twice as many as the 4.5 percent of those 50-65 and far more than the 0.4 percent of those 65 and
older who said the same 10 years prior.
Researchers looked at the survey responses of 17,608 adults aged 50 and older from the 2015 and 2016
administrations of the National Survey on Drug Use and Health and compared it to similar information
from 2006 and 2007 – a period that has seen major changes in legal and social acceptance of the drug.
Asked if they had used it in the past month, 5.7 percent of middle-aged adults and 1.7 percent of older
adults in the recent survey said they had used the drug. Additionally, adults aged 50 to 65 were more
likely than older adults to have tried marijuana at some point in their lives – 55 percent compared to 22
percent.
Along with marijuana use, researchers discovered that the use of alcohol, nicotine and cocaine and the
misuse of prescription medications, such as opioids and sedatives, within the last year were higher among
marijuana users than nonusers.
Benjamin Han, author and assistant professor at New York University School of Medicine, told CNN that
the study found "high rates of unhealthy substance use" among adults who use marijuana.
According to the study, 5 percent of middle-aged marijuana users had alcohol-use problems, 9 percent
were nicotine-dependent and 3.5 percent had abused opioids. Among older adults, 1.5 percent had
alcohol-use problems, 3.5 percent were nicotine-dependent and 1.2 percent had abused opioids.
Although additional unhealthy substance use seems to be correlated to marijuana use, Joseph Palamar,
author and associate professor in the Department of Population Health at NYU Langone Medical Center,
told CNN that most of these adults "are not first-time users" of the drug. Although use is rising, Palamar
doesn't think people "need to worry about millions of older people trying weed for the first time."
"At least not yet," he said.

Article available online at: usnews.com/news/health-care-news/articles/
2018-09-07/study-marijuana-use-has-doubled-among-middle-aged-adults
Copyrighted 2018. U.S. News & World Report. 292361:1218BC

From CNN, February 28, 2018 (online)

1 in 14 women still smokes while pregnant, CDC says
By JAQUELINE HOWARD

About one in 14 pregnant women who gave birth in the
United States in 2016 smoked cigarettes during her
pregnancy, according to a report released Wednesday.
The findings, gathered by the Centers for Disease Control and
Prevention's National Center for Health Statistics, revealed
that 7.2% of all expectant mothers smoked -- but that the
percentage of pregnant smokers varied widely from state to
state.
The prevalence of smoking was highest in West Virginia,
where 25.1% of women reported smoking at any time during
pregnancy, and lowest in California, where 1.6% reported
smoking.

"Despite the well-understood risk to mother and child, still,
about one of every 14 women in the United States smoked
during pregnancy," said Patrick Drake, senior author of the
report and a demographer at the CDC's National Center for
Health Statistics.
"These levels do vary widely by state, maternal age, race and
Hispanic origin, and education, but any amount of smoking
during pregnancy is too much," he said.
In 2011, about 10% of women in the US reported smoking
during their last three months of pregnancy, and of those
women who smoked, 55% quit during pregnancy, according
to data from the CDC's Pregnancy Risk Assessment and
Monitoring System.
(Continued on next page)

Recent articles about the National Survey on Drug Use and Health
From CNN, February 28, 2018 (online)

1 in 14 women still smokes while pregnant, CDC says
(Continued from front)

Smoking while pregnant puts a baby at risk for certain birth
defects. It also can cause a baby to be born too early or to
have low birth weight and can raise the risk of stillbirth or
sudden infant death syndrome, according to the CDC.
A spotlight turned on West Virginia
The new report is based on birth certificate data from the
CDC's National Vital Statistics System.
After analyzing the data, the researchers found that the
prevalence of smoking during pregnancy was lower than the
overall national rate in 19 states, including California, Utah,
Texas, Hawaii, New Jersey, Nevada, Arizona, New York and
Connecticut, and in the District of Columbia.
Those states and D.C. each had a prevalence of less than 5%,
much lower than the national 7.2%. Thirty-one states had a
prevalence higher than the national rate. West Virginia
topped the list, followed by Kentucky, Montana, Vermont and
Missouri.
"Women in West Virginia smoked during pregnancy more than
five times as often as women in the states with the lowest
prevalence," Drake said.
The researchers also found that prevalence of smoking
during pregnancy varied by age and race. The prevalence was
highest among women 20 to 24 at 10.7%, followed by women
15 to 19 at 8.5% and 25 to 29 at 8.2%.
The prevalence also was highest among non-Hispanic
American Indian or Alaska Native women at 16.7%, followed
by non-Hispanic white women at 10.5%, non-Hispanic black
women at 6%, Hispanic women at 1.8% and non-Hispanic
Asian women at 0.6%.
"Non-Hispanic white women were almost twice as likely to
smoke during pregnancy as non-Hispanic black women and
about six times as likely as Hispanic women," Drake said.
The prevalence of smoking also varied by education. Women
with a high school diploma or GED had the highest prevalence
at 12.2%, and the prevalence decreased with increasing
education, dropping to 7.9% among those with some college
or an associate's degree.
Among those with less than a high school diploma, the
prevalence was 11.7%.
The report had some limitations, one being that the data on
smoking during pregnancy were self-reported.
Since most women might be less likely to admit that they
smoked cigarettes while pregnant, the prevalence of smoking
could be under-reported, said Dr. Robyn Horsager-Boehrer,
professor and chief of obstetrics and gynecology at the
University of Texas Southwestern's William P. Clements Jr.
University Hospital.
"With the birth certificate data, it's easy to use it for things like
birth weights, potentially the presence of anomalies, things
that are a little bit more objectively recorded during the
course of a delivery," said Horsager-Boehrer, who was not
involved in the new report.

"But in this case, this is the mom being asked about her use of
cigarettes during pregnancy, and I do worry a little bit about a
bias toward under-reporting," she said. "In some cases, even
though a patient may come and report that she is not smoking,
you walk into a room, and you can smell the smoke on her
clothes or on her hair. They may not be aware that their
presence is kind of contrary to what they're reporting.“
'We still need very aggressive education campaigns'
The prevalence of cigarette smoking during pregnancy across
the US came as no surprise to Dr. Haywood Brown, professor
of obstetrics and gynecology at Duke University School of
Medicine, who was not involved in the new report.
"West Virginia and Kentucky have always had one of the
highest prevalence of smoking, and it's consistent," Brown
said, adding that education campaigns could help reverse the
prevalence of smoking during pregnancy.
The perceived risk of smoking declined in the United States
between 2006 and 2015, according to a separate study
published Monday in the journal Drug and Alcohol
Dependence.
That study included data from the National Survey on Drug Use
and Health suggesting that, in 2006, 73.89% of people
surveyed said cigarette smoking posed a great health risk, but
in 2015, that percentage dropped to 72.89%.
We still need very aggressive education campaigns in highsmoking-prevalence states, particularly in where there's rural
access-to-care issues," said Brown, who was not involved in
that study.
"We still have a serious issue with infant mortality -prematurity and infant mortality are clearly linked to cigarette
smoking, as is low birth weight -- and when you begin to explain
these things to patients, it really does appear to make a
difference to them," he said.
Brown pointed out that some of the states in the new CDC
report with the highest prevalence of smoking during
pregnancy also tend to have high rates of infant mortality. A
CDC data brief released in January showed that, between
2013 and 2015, West Virginia and Kentucky had infant
mortality rates higher than the overall national rate.
"The linkages between smoking and infant mortality and
prematurity are real," Brown said.
Yet for many patients, pregnant or not, quitting smoking
remains difficult, Horsager-Boehrer said. On the other hand,
she added, pregnancy can provide an opportunity for many
women to overcome their nicotine addiction once and for all.
"Pregnancy gives us an opportunity because people are
frequently coming for multiple visits. So there's a lot more
support, I think, during pregnancy than at any other time that
somebody might want to stop smoking, and there's a lot of
motivation," she said.
Article available online at: cnn.com/2018/02/28/health/
pregnant-cigarettes-smoking-cdc-study/index.html

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