Vaping, Alcohol and Drugs in the Teen Years

It can feel like everyone is vaping, drinking or trying weed. The numbers say otherwise. Most US teens do not use these substances, and teen use remains relatively low.^1,2 Still, the teen years are when many people first get offered something, and the products keep changing: flavored vapes, nicotine pouches and "hemp" THC products sold in gas stations and online.

This page gives you the facts without scare tactics. It covers how substances affect mood, sleep and the growing brain, how to handle pressure, and where to get help if you want to cut back or quit.

What teens are using now

The Monitoring the Future survey asks thousands of US students each year about substance use. In 2025, the share who used each substance at least once in the past year was:¹

A separate federal survey found that in 2025, about 7% of middle and high school students used any tobacco product, about 2 million students. E-cigarette use fell from 2022 to 2025. Nicotine pouch use rose among high schoolers over those years but stayed low and steady from 2024 to 2025.²

Researchers are keeping an eye on small but significant rises in heroin and cocaine use in some grades in 2025, though both stay rare (around 1% or less).¹

Signs that use may be a problem

Trying something once does not mean a person is addicted. But watch for patterns like these:

• Needing to vape first thing in the morning or feeling cranky, anxious or restless without it
• Using to cope with stress, sadness or anxiety
• Using more often or more than planned, or failing to cut back
• Grades dropping, skipping school or quitting activities
• New friends and secrecy, missing money or items
• Changes in sleep, appetite or mood

Smoking, drinking or drug use can also be a sign of an underlying mental health problem that needs attention.⁹ See signs of a substance use problem.

Why teens use

People use substances for many reasons: curiosity, wanting to fit in, stress relief, boredom, or trying to sleep or calm anxiety. Flavors and sleek devices can make vaping seem harmless. Ads and social media posts can make drinking or weed look normal and fun.

Peer pressure is real, and having a plan for what to say helps.⁶ Teens are also more likely to use if they think no one will notice, which is why caring adults who pay attention matter.⁶

How substances affect mental health

Nicotine

Nicotine is highly addictive. It can harm the parts of a teen's brain that control attention, learning, mood and impulse control.⁴ Many people vape to relax, but nicotine withdrawal between uses can make you feel more anxious and irritable. Vaping is not an effective way to deal with stress, anxiety or low mood.⁵

Cannabis

The brain keeps developing until around age 25. Regular or heavy cannabis use during the teen years may harm the developing brain, and some effects may be permanent.³ Teens who use cannabis can have trouble with memory, learning, attention and problem-solving, and are more likely to drop out of high school.³ Cannabis use is linked to depression and social anxiety, and to temporary psychosis (losing touch with reality). In some cases it is linked to long-lasting conditions such as schizophrenia. These risks are higher when use starts young and happens often.³ About 3 in 10 people who use cannabis develop cannabis use disorder.³ See cannabis, sedatives and stimulants.

Alcohol

Alcohol can make you feel relaxed at first, but it disrupts sleep and can leave you feeling more anxious or down the next day. It also leads to risky choices, like getting in a car with a driver who has been drinking. See alcohol and test what you know with our alcohol, mood and sleep quiz.

Fake pills and fentanyl

Pills bought online or passed between friends may look like real prescription medicines but contain fentanyl. From 2019 to 2021, overdose deaths among US young people aged 10 to 19 roughly doubled. About 84% involved illegally made fentanyl, and about 1 in 4 showed signs of counterfeit pills.⁷ In about two-thirds of these deaths, someone else was nearby who could have helped.⁷ Experts recommend that families learn how to recognize and respond to an overdose and keep naloxone (a medicine that can reverse an opioid overdose) on hand.⁷ See opioids and overdose.

What helps

The badges show how strong the research is (see how we rate evidence).

Steps you can take

1. Decide ahead of time. Know your answer before you are offered something.
2. Pick an easy line. "No thanks, I've got practice." "My coach would bench me." "I'm driving." "Not my thing." Practice it so it comes out naturally.⁶
3. Have an exit plan. Agree on a code word with a parent that means "Come get me, no questions tonight."
4. If you vape and want to quit, pick a quit day, learn your triggers and plan how you will handle cravings.⁵ Expect a few hard days. Cravings pass.
5. Find other ways to calm down. Try box breathing, a walk or music. Our calm plan can help.
6. Never take pills that were not prescribed to you by a doctor and given by a pharmacy.⁷
7. If someone passes out, cannot be woken or is breathing very slowly, call 911 right away.

For parents and friends

Parents can lower the odds that their teen uses substances. SAMHSA suggests five goals for talks with teens:⁶

1. Make it clear you disapprove of underage drinking and drug use.
2. Show you care about their health and success.
3. Be a reliable source of facts.
4. Show you are paying attention, by asking about friends and plans with care, not judgment.
5. Help them build skills to say no, and practice together.

It is never too late to start these talks.⁶ If you find out your teen is using, stay calm, ask questions and listen. Talk with your pediatrician. See helping a family member with substance use and our guide for parents.

Friends: If a friend is using a lot, say what you have noticed without judging. Do not cover for them in a dangerous situation. If a friend may be overdosing, call 911 and stay with them.

Common questions

Are vapes safer than cigarettes?

Vapes still deliver nicotine, which is highly addictive and can harm the developing teen brain.⁴ For teens, the safest choice is not to use either.

Is weed safe since it is legal in some places?

Being legal for adults does not make it safe for teens. Cannabis can affect memory, attention and learning, and is linked to depression, anxiety and psychosis, especially with early and frequent use.³

What are nicotine pouches?

They are small pouches placed in the mouth that deliver nicotine without smoke. Use among teens is low but grew among high schoolers from 2022 to 2025.² They carry the same addiction risk as other nicotine products.

How can I quit vaping?

Make a quit plan, know your triggers and plan for cravings. Free programs offer quit plans, chat and text support.⁵ A doctor can also help.

More teen topics are on the teens hub.

When to get help

Talk to a doctor, school counselor or another trusted adult if:

• You feel you cannot stop or cut back
• You use to deal with stress, sadness or anxiety
• Use is hurting your grades, sleep, friendships or family life
• You have withdrawal symptoms like strong cravings, irritability or trouble sleeping when you stop

Education only. This page is general information written from the sources listed. It is not medical, legal or financial advice and does not replace a doctor, therapist or lawyer who knows your situation. How we write and check pages.