Federal Survey Reveals Declining Substance Use and Improved Mental Health Among U.S. Youth
核心洞察
The 2025 National Survey on Drug Use and Health shows significant declines in tobacco, alcohol, marijuana, and illicit drug use among adolescents aged 12–17 and young adults aged 18–25.
Fewer adolescents reported major depressive episodes (搜索), serious thoughts of suicide, making a suicide plan, and attempting suicide compared to prior years.
Public health experts attribute the positive trends to reduced risky behaviors, increased supervised screen time, and effective public health messaging about substance dangers.
The latest National Survey on Drug Use and Health (NSDUH), released Monday by the Substance Abuse and Mental Health Services Administration (搜索) (SAMHSA), reveals promising trends in youth mental health and substance use across the United States. The annual survey, which tracks data from 2021 to 2025, shows broad declines in tobacco, alcohol, and drug use among adolescents and young adults, alongside improvements in key mental health indicators.
Among adolescents aged 12 to 17, the survey documented fewer reporting past-month use of tobacco, alcohol, marijuana, and binge drinking. Over the past year, this age group also showed declines in illicit drug use, marijuana use, initiation of alcohol drinking, vaping or marijuana, and substance, alcohol, or drug use disorders. Young adults aged 18 to 25 demonstrated similarly favorable trends, with reductions in past-month use of nicotine products, tobacco, cigarettes, alcohol, and binge drinking, as well as declines in past-year use of illicit drugs and prescription stimulants or opioids.
Mental health metrics also improved. Adolescents saw declining trends for major depressive episodes (搜索), and fewer reported serious thoughts of suicide, making a suicide plan, and attempting suicide.
Despite these gains, significant challenges remain. Nearly 20% of adolescents surveyed reported moderate or severe anxiety (搜索) symptoms in the previous two weeks, compared with approximately 7% of adults over age 18. Overall, more than half of people aged 12 and older used an illicit drug, drank alcohol, used tobacco, or vaped nicotine in the previous month—including 44% who drank alcohol, 16% who used a tobacco product, 10% who vaped nicotine, and 16% who used an illicit drug.
“Nearly 45 million people still have substance use disorder (搜索) and still not nearly enough people are getting treatment,” said Robyn Oster, policy director for the Partnership to End Addiction. “It’s still well over 80% of people who needed it did not get substance use treatment in the past year, let alone quality treatment.”
Shifting Patterns in Youth Behavior
Public health specialists point to several factors driving the favorable trends. Daniel Kruger, a research associate professor at the University at Buffalo, State University of New York, noted that American teenagers are engaging in less risky behavior overall—including crime, dangerous driving, and unprotected sexual behavior—which correlates with reduced substance use.
“There’s sort of like a delay in adulthood,” Kruger said. “In other words, they’re driving at older ages, moving out of the house at older ages. So, there’s just sort of like a longer period of adolescent development, a longer period where people are still in the orbit of their parents compared to previous generations.”
Kruger also highlighted the role of changing social environments, with teenagers and young adults spending more time online and less time in unstructured, unsupervised settings where substance use typically occurs.
The Role of Public Health Messaging
Experts credit decades of public health campaigns about the dangers of smoking and emerging evidence linking alcohol to several types of cancer as contributing factors. Denise Hien, distinguished professor at Rutgers University and director of the Rutgers Center of Alcohol and Substance Use Studies, suggested that adults are absorbing these messages and modeling healthier behaviors for younger generations.
“We’re seeing it in the youth, who of course have parents who are being influenced by the public health messaging and the science,” Hien said. “So, I think there’s a number of reasons why we’re seeing those declines, but those kind of influences, familial and also public health, are probably filtering down into the youth.”
Emerging Concerns: Vaping and Cannabis
While traditional substance use declines, the survey identified shifting consumption patterns. From 2021 to 2025, the percentage of those aged 12 and older who used marijuana in the past year increased from 19% to 21.2%. Nicotine vaping among the same age group rose from 8.3% in 2022 to 10.1% in 2025.
“The trends are starting to shift,” Hien said. “What we’re seeing is higher vaping and higher cannabis use. So it’s almost like maybe there’s a replacement.” She added that teenagers and young adults “may perceive alcohol and nicotine as dangerous, but cannabis and vaping is not. The perception is it’s not as harmful.”
Anti-vaping advocates have raised concerns that e-cigarettes in kid-friendly flavors have driven increased use among youth and young adults, while the legalization of recreational marijuana in more states has made the drug more widely available.