Monday, November 30, 2009

Wild in the Streets! Vermont Health Department's Verdict on Youth

Some excerpts from a recent press release from the Vermont Department of Health:

Youth Risk Behavior Survey Shows Changing Perceptions of Unhealthy Behaviors

Fewer young Vermonters (8th to 12th graders) believe tobacco and
marijuana are harmful than they did two years ago, according to the
2009 Youth Risk Behavior Survey, a survey of more than 11,000 students conducted every two years by the Vermont Departments of Health and Education. . . .

The 2009 survey results revealed that 67 percent of Vermont students
perceived great risk of harm from smoking tobacco, compared to 72
percent in 2007. Forty-two percent of students perceived great risk of
harm from regular marijuana use in 2009, compared to 51 percent in
2007.

By contrast, actual smoking rates among young people in Vermont –
which peaked at 38 percent in 1995 has steadily declined to 16 percent
in 2009. A primary reason, according to Cimaglio, was a sustained,
comprehensive public health effort that was supported by Vermonters
statewide.

“The Health Department celebrates the youth smoking rate being cut in
half during the past 14 years as a major public health victory,”
Cimaglio said. “It’s one of the main reasons we’re routinely ranked
among the healthiest states in the nation.”

Marijuana use in Vermont is among the highest in the nation with 22
percent of students surveyed reporting that they smoked marijuana in
the past 30 days. This percentage has remained nearly unchanged since
2005. Alcohol use has also held steady with 36 percent reporting
consumption in the past 30 days, and 20 percent reporting that they
binged, or had five or more drinks in a row. . . .

The Youth Risk Behavior Survey measures the prevalence of behaviors
that contribute to the leading causes of death, disease and injury
among young people. The survey is conducted by the Vermont Departments
of Health and Education with 144 schools participating. Survey data is
collected and the results have been reported every two years since
1993.

And here's what's wrong with it:

The claim that "fewer young Vermonters . . . believe tobacco and
marijuana are harmful than they did two years ago" is simply not
supported by the report cited by the Vermont Department of Health.

The report purports to be a summary of the results from the Health
Department's 2009 Youth Risk Behavior Survey. The survey contained
108 questions. Here are questions 98 and 100, apparently relied upon
for the assertion quoted above:

98. How much do you think people risk harming themselves (physically
or in other ways), if they smoke one or more packs of cigarettes per
day?
a. No risk
b. Slight risk
c. Moderate risk
d. Great risk

100. How much do you think people risk harming themselves (physically
or in other ways), if they smoke marijuana regularly?
a. No risk
b. Slight risk
c. Moderate risk
d. Great risk

Here are the details the Health Department provided to support its
claim that Vermont's youth are growing more indifferent to the dangers
of tobacco and marijuana: "The 2009 survey results revealed that 67
percent of Vermont students perceived great risk of harm from smoking
tobacco, compared to 72 percent in 2007. Forty-two percent of students
perceived great risk of
harm from regular marijuana use in 2009, compared to 51 percent in 2007."

Note how the news release fails to report how many Vermont youth said
(in response to questions 98 and 100) that there was at least SOME
risk (slight, moderate or great) in using tobacco or marijuana. Thus
it is possible that a GROWING number of Vermont youth, rather than a
decreasing number, are acknowledging that there's at least a moderate
risk of harm in using tobacco or marijuana.

Please do not misunderstand: I am not advocating a stance of public
indifference to tobacco or marijuana use among young people. I don't
use either substance myself and I would be extremely unhappy if my
kids started using them. (The eldest just turned 8, so by any measure
they are a few years away from being vulnerable.) My anti-tobacco
bona fides are strong: I played a key role in causing the Hanover
Consumer Cooperative Society, whose flagship store is across the
street from Hanover High School, to stop selling tobacco as of January
1, 2009. One of my kids has cystic fibrosis. So every time I see
anyone smoking, especially a young person, I fight the urge to stop
them and shout: You were blessed with a perfectly healthy pair of
lungs -- how dare you defile them?

Nevertheless, we should not make important public policy decisions
based on scare tactics and misleading data.

And we should stop demonizing young people. Maybe we should give them
credit -- or at least give credit to those with the persistence to
slog through 108 extremely personal questions -- for a nuanced and
realistic approach to the dangers of substances it is illegal for them
to possess. It is quite possible that students reserved the rating of
"great risk" for the harm about which they were queried BETWEEN
questions 98 and 100. Question 99 asked about how harmful it would be
to drink one or two alcoholic beverages nearly every day. (Note that
the Health Department's press release did NOT focus on how students
answered this particular question.) However much we don't want our
kids smoking cigarettes or marijuana, can't we agree it would be even
MORE dangerous for them to abuse alcohol, particularly when so many
teenagers are driving these days?

Even more troubling is that the Health Department chose not to
highlight the fact that, responses to queries about perception aside,
the survey shows that tobacco and marijuana use by young people is
clearly becoming LESS of a problem. Here are two quotes straight from
the Health Department's report: "Overall, 36% of students have tried
marijuana, down from 48% in 1997." "Overall, 28% of students reported
ever having smoked a whole cigarette, down from a high of 59% in
1997." (To be fair, the Department's news release did mention the
declining use of tobacco, way down toward the bottom.)

It is, of course, arguable that the whole survey is a bunch of
blarney. Most of us grownups would howl in protest if the government
handed us 108 questions asking us to disgorge details about our sexual
behavior, eating habits, drug use and other highly personal stuff. I
don't know how we expect our kids to suffer this kind of intrusion, or
why we assume there is anything of statistical signifiance in the
responses of those with sufficient docility to succumb to the survey.

In any event, lots of things about our culture and society are in
flux. But one constant appears to be a tendency in some quarters to
claim that the youth of America are running wild in the streets, even
when the evidence, such as it is, runs straight to the contrary.

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