Addictions and Substance Use Prevention

Washington County regularly tracks and monitors substance use and risky behaviors among youth through the Oregon Student Wellness Survey (OSWS)

The OSWS is given to a sample of middle and high school students across the state every two years, including nearly 13,000 Washington County youth. The survey captures the behaviors, attitudes and perceptions of 6th, 8th and 11th graders on over 100 variables, including substance use and gambling. Data for sixth-graders is not shown, since many of the substance use questions are directed only at 8th and 11th graders.

The data presented in the tables below serve as the basis for generating policy, designing prevention programs and projects, and helping the county understand the risks emerging for young people in Washington County.

Tobacco and E-Cigarettes

Tobacco use is the leading preventable cause of disease, disability and death in the United States. Smoking leads to cancer, heart disease, stroke, lung diseases, diabetes, chronic obstructive pulmonary disease (COPD), emphysema and chronic bronchitis. Disparities in tobacco use remain across groups defined by educational level, socioeconomic status, race and ethnicity. Other populations impacted include the LGBTQ+ community and people with disabilities.

Access to affordable cessation resources and smokefree environments  encourage and help those who want to quit. Restricting access, promoting anti-tobacco programs and strong policies all support individuals from ever starting.

Over the past four years, the percentage of students who report using cigarettes in the past 30 days has been declining.

E-Cigarettes and Vaping

While Washington County has seen a decrease in cigarette use among youth, there has been a steady increase in the use of e-cigarettes or vaping. “Vaping is the act of inhaling and exhaling the aerosol, often referred to as vapor, which is produced by an e-cigarette or similar device.” (Center on Addiction, 2018). The aerosol cartridges used in e-cigarettes can contain a variety of substances, including water vapor, scented oils, nicotine, marijuana and illicit drugs.

Youth are particularly vulnerable to initiation and long-term use of these products due to nicotine exposure. Nicotine has an adverse effect on adolescent brain development, including learning, memory and attention. Nicotine is also linked to behavior problems, mental illness and addiction to other substances later in life.

In 2016, the OSWS added questions about e-cigarettes and vaping for 11th graders only. The proportion of Washington County 11th graders who said they used e-cigarettes (vaping) rose over 4 percentage points from 2016 (11.7%) to 2018 (15.8%), a 26% increase in past 30-day vaping.


Research shows marijuana use can negatively affect memory, learning, attention, coordination and reaction time, particularly among adolescents. Smoked marijuana, in any form, can harm lung tissues and cause scarring and damage to small blood vessels. Marijuana smoke also contains many of the same toxins, irritants, and carcinogens as tobacco smoke.

The chemical THC affects the prefrontal cortex, which is not fully developed in adolescence, and is a part of the brain involved in decision making. THC undermines natural inhibition, and increases the tendency toward other risky behaviors.

Marijuana is also addictive. The CDC estimates 1 in 10 marijuana users will become addicted; 1in 6 among those who use marijuana before age 18.


Alcohol remains the number one illicit substance used by youth in Washington County, though use rates have declined slightly over the past four years. From the OSWS, we know that youth access alcohol from a variety of sources, including at parties, from parents or from older friends.

While the majority of youth do not drink regularly, research shows there is no safe level of alcohol use for youth. Alcohol negatively impacts brain development among youth, including memory, learning, executive functioning and self-regulation. The earlier a person starts drinking alcohol, the greater the risk of impacting brain development.

Illicit and Prescription Drugs

Prescription Drugs

Prescription drug use is low among Washington County youth; however, any use of non-prescribed medications, such as opioids, can be dangerous. 

Of the youth who are accessing prescription drugs, the majority are getting them from family and friends’ medicine cabinets. Opioids and other prescription drugs can be highly addictive and can negatively impact youth’s developing brains.

The percentage of students who reported using prescription drugs without a prescription declined among 11th graders from 2016 to 2018.

Illicit Drugs

For the purposes of the survey, illicit drugs include marijuana, cocaine, methamphetamines and heroin. 

Eleventh graders are much more likely to use illicit drugs than 8th graders, although the actual percentage of the student population who report using drugs has remained relatively steady for the last four years.


Gambling is a form of recreation for most people. For some, however, gambling is a disorder with behaviors very similar to alcohol, nicotine or opioid addiction.

Research shows that gambling among youth is on the rise and can take many forms, such as betting on sporting events, games of chance, and easily accessible gambling on the internet. The risks associated with substance use among youth are well known. Much less is known, however, about the potential risks associated with gambling among youth.

Past 30-day gambling rates among Washington County youth are higher than past 30-day tobacco, marijuana, illicit drugs and, in most cases, alcohol use rates. In addition, survey research shows that youth who gamble regularly are more likely to engage in other risky behaviors, such as substance use, and are also more likely to have thoughts of suicide. Comprehensive efforts to inform and educate must include information on gambling and the associated risks.