"• The annual average rate of past month cigarette use in 2012 and 2013 among women aged 15 to 44 who were pregnant was 15.4 percent (Figure 4.5). The rate of current cigarette use among women aged 15 to 44 who were pregnant was lower than that among women who were not pregnant (24.0 percent). This pattern was also evident among women aged 18 to 25 (21.0 vs. 26.2 percent for pregnant and nonpregnant women, respectively) and among women aged 26 to 44 (11.8 vs. 25.4 percent, respectively). Rates of current cigarette use in 2012-2013 among pregnant women aged 15 to 44 were 19.9 percent in the first trimester, 13.4 percent in the second trimester, and 12.8 percent in the third trimester.
"• The annual average rates of current cigarette use among women aged 15 to 44 who were not pregnant decreased from 30.7 percent in 2002-2003 to 24.0 percent in 2012-2013 (Figure 4.5). However, the prevalence of cigarette use among pregnant women in this age range did not change significantly during the same time period (18.0 percent in 2002-2003 and 15.4 percent in 2012-2013)."

"• In 2013, as in prior years, the rate of current illicit drug use among persons aged 12 or older was higher for males (11.5 percent) than for females (7.3 percent). Males were more likely than females to be current users of several different illicit drugs, including marijuana (9.7 vs. 5.6 percent), cocaine (0.8 vs. 0.4 percent), and hallucinogens (0.7 vs. 0.3 percent).
"• In 2013, the rate of current illicit drug use was higher for males than females aged 12 to 17 (9.6 vs. 8.0 percent). This represents a change from 2012, when the rates of current illicit drug use were similar among males and females aged 12 to 17 (9.6 and 9.5 percent, respectively), and reflects a decrease in the rate of current illicit drug use among females from 2012 to 2013. Likewise, in 2013, the rate of current marijuana use was higher for males than females aged 12 to 17 (7.9 vs. 6.2 percent), which is a change from 2012 when the rates of current marijuana use for males and females were similar (7.5 and 7.0 percent).
"• The rate of current marijuana use among males aged 12 to 17 declined from 9.1 percent in 2002 to 6.9 percent in 2006, then increased between 2006 and 2011 (9.0 percent) (Figure 2.11). The rate decreased from 2011 to 2012 (7.5 percent) and remained stable in 2013 (7.9 percent). Among females aged 12 to 17, the rate of current marijuana use decreased from 7.2 percent in 2002 and 2003 to 6.2 percent in 2013."

"• An estimated 6.4 percent, or 7.3 million, of full-time workers reported use of marijuana during the past month (Tables 2.2 and 2.3).
"• Adults aged 26 to 34 were only about half as likely as 18- to 25-year-olds to be past month marijuana users (8.0 vs. 15.9 percent). Past month use of marijuana was lower with increasing age (Table 2.2).
"• The prevalence of past month marijuana use was higher for males than females (7.9 vs. 4.3 percent, respectively) (Table 2.2).
"• An estimated 11.0 percent of workers reporting two or more races used marijuana during the past month. This was higher than among non-Hispanic white adults (6.9 percent). Fewer Hispanic adults (4.6 percent) reported past month marijuana use than non-Hispanic white adults who reported two or more races (Table 2.2).
"• Higher educational attainment and higher family income were associated with a lower prevalence of current marijuana use (Table 2.3)."

"Cannabis use has increased globally, particularly in Asia since 2009. Although epidemiological data is not available, experts from the region report a perceived increase in use. The regions with a prevalence of cannabis use that is higher than the global average continue to be West and Central Africa (12.4 per cent), Oceania (essentially Australia and New Zealand, 10.9 per cent), North America (10.7 per cent) and Western and Central Europe (7.6 per cent). Cannabis use in North America and in most parts of Western and Central Europe is considered to be stable or declining."

"• In 2013, there were 601,000 persons aged 12 or older who had used cocaine for the first time within the past 12 months; this averages to approximately 1,600 initiates per day. This estimate was similar to the number in 2008 to 2012 (ranging from 623,000 to 724,000). The annual number of cocaine initiates in 2013 was lower than the estimates from 2002 through 2007 (ranging from 0.9 million to 1.0 million).
"• The number of initiates of crack cocaine ranged from 209,000 to 353,000 in 2002 to 2008 and declined to 95,000 in 2009. The number of initiates of crack cocaine has been similar each year since 2009 (e.g., 58,000 in 2013).
"• In 2013, most (81.9 percent) of the 0.6 million recent cocaine initiates were aged 18 or older when they first used. The average age at first use among recent initiates aged 12 to 49 was 20.4 years. The average age estimates have remained fairly stable since 2002."

"• In 2018 the proportion of 12th graders who favor legalization of marijuana was 48%, about the same as the record of 49% set in the previous year. Support for legalization has been steadily and rapidly increasing since 2008, when it was near 30%. Prior to 2008, support followed a U-shape curve, in which support levels near 30% were present at the beginning of the survey, in 1975, then dipped by half to a nadir of 15% in 1986-88, only to redouble and return to around 30% by 1995, where it hovered for a decade before rising considerably.

"• The proportion of 12th grade students who favor treating marijuana use as a crime is at the lowest level ever recorded by the survey (11%), and its trend is a mirror image of the pattern seen for support of marijuana legalization. Back around 1990 as many as 50% thought its use should be a crime.

"• Given that the percentage of 12th grade students who support legalization has never exceeded 50% in the 44 years of this study, some of the greater tolerance for marijuana use among adults²¹ apparently develops after the high school years.

"• The recent trend toward greater tolerance of marijuana use is also seen in the proportion of 12th grade students who support the sale of marijuana to adults, conditional on its use being legalized. In 2018 this proportion was 55%, the same level as in 2017 and the highest level ever recorded by the study (Table 8-8). In past years, support had reached a nadir of 38% in 1989, and then gradually increased to present levels, with a decade-long plateau between 1995 and 2005.

"• It is likely that the growing number of states that have legalized recreational marijuana use for adults plays a role in the increasing tolerance of marijuana use among 12th grade students, who may interpret increasing legalization as a sign that marijuana use is safe and state-sanctioned.

"• In 2018, 9% of 12th graders predicted they would use marijuana if it were legally available (Table 8-8). This is the second highest level recorded for this measure, with the record of 10% set last year. The percentage who predicted they would try marijuana if it were legal reached a historic high in 2018, at 16%. The percentage who reported they would not use marijuana even if it were legal significantly declined to 45%, a record low. Previous to 2018 these outcomes had been fairly similar for all graduating classes. The slight shifts that did occur were attributable mostly to the changing proportions of 12th graders who had actually used marijuana."

"• Table 8-8 lists the proportions of 12th graders in 2018 who favor various legal consequences for marijuana use. The proportion who believe it should be entirely legal was 48%, near the record high set the previous year of 49%. As the percentage favoring legality increased, the percentage believing marijuana use should be a crime decreased and in 2018 was 11%, the lowest level recorded by the survey, having fallen from a peak of 53% in 1990.

"• Asked whether they thought it should be legal to sell marijuana if it were legal to use it, about two in three (66%) said “yes,” very near the historic high of 67% set the previous year. However, about 83% of those answering “yes” (55% of all respondents) would permit sale only to adults. A small minority (11%) favored the sale to anyone, regardless of age, while 19% said that sale should not be legal even if use were made legal, and 15% said they “don’t know.” Thus, while the majority subscribe to the idea of legal sale, if use is allowed, the great majority agree with the notion that sale to underage people should not be legal.

"• Most 12th graders felt that they would be little affected personally by the legalization of either the sale or the use of marijuana. Nearly half (45%) of the respondents said that they would not use the drug even if it were legal to buy and use, while others indicated that they would use it about as often as they do now (16%) or less often (1%). Only 9% said they would use it more often than they do at present, while 16% thought they would try it. Another 13% said they did not know how their behavior would be affected if marijuana were legalized. Still, this amounts to 25% of all 12th graders, or about one in four, who thought that they would try marijuana, or that their use would increase, if marijuana were legalized.

"• A study of the effects of decriminalization by several states during the late 1970s, based on MTF data, found no evidence of any impact on the use of marijuana among young people, nor on attitudes and beliefs concerning its use.¹⁸ However, it should be noted that decriminalization falls well short of the full legalization posited in the questions here. Moreover, the situation today is very different from the one in the late 1970s, with more peer disapproval and more rigorous enforcement of drug laws, at least until recently. Some more recent studies suggest that there might be an impact of decriminalization, because “youths living in decriminalized states are significantly more likely to report currently using marijuana.”¹⁹ One study using MTF data shows that prevalence of marijuana use among 12th grade Californian students significantly increased in the two years after decriminalization went into effect in 2011, and youth attitudes also became significantly more permissive.²⁰ As more states approve full legalization of recreational use for adults (as has occurred in California, Massachusetts, Michigan, Nevada, Maine, Colorado, Washington, Oregon, Alaska, Vermont, and Washington, DC), it seems quite possible that attitudes about, and use of, marijuana will change. Declines in perceived risk and disapproval of marijuana would seem the most likely attitudinal changes, and such changes may well lead to increased use among youth."

"Updating the previous global estimates, the United Nations Office on Drugs and Crime (UNODC) estimates that in 2011 a total of 14.0 million (range: 11.2 million to 22.0 million) people injected drugs worldwide, which corresponds to 0.31 per cent (range: 0.24-0.48 per cent) of the population aged 15-64.14 The current global estimates are lower than the previous ones of 15.9 million people, and primarily reflect the fact that many countries have revised their earlier estimates downward, based on behavioural surveillance data. However, many countries have also reported an increase in the prevalence of injecting drug use and in the number of people who inject drugs.
"Changes over time in national, regional and global estimates of injecting drug use may result from a number of factors, such as improvements in the methodology or coverage of behavioural surveillance (e.g., Georgia, Italy and South Africa), additional countries undertaking behavioural surveillance for the first time (Kenya and Seychelles) or changes in patterns of drug use, including injecting drug use (Australia and Brazil). Such factors have contributed to the overall reduced global estimates of people who inject drugs. Notable increases in the estimated number of people who inject drugs have been reported from Pakistan, the Russian Federation and Viet Nam, while countries reporting a considerable reduction include Brazil, Indonesia, South Africa, Thailand and the United States."

"Use of ATS, excluding 'ecstasy', remains widespread globally, and appears to be increasing. Although prevalence estimates are not available from Asia and Africa, experts from these regions continue to report a perceived increase in the use of ATS. While the use of ATS was already a problem in East and South-East Asia, there are reports of increasing diversion of precursor chemicals, as well as increased seizures and manufacture of methamphetamine, combined with an increase in its use. Current data from the drug use survey in Pakistan, for instance supports this assessment. Use of ATS is emerging in Pakistan, with a reported annual prevalence of 0.1 per cent among the general population.³ High levels of ATS use are reported in Oceania (2.1 per cent in Australia and New Zealand), Central and North America (1.3 per cent each) and Africa (0.9 per cent), while the estimated annual prevalence of ATS use in Asia (0.7 per cent) is comparable with the global average."