With cigarette ads on display, the Philips 66 gas station 59th and Troost is a few hundred feet from Troost Elementary School in Kansas City (Chase Castor/The Beacon).
Missouri teens were less interested in cigarettes, alcohol and marijuana in 2024 than in previous years.
Vapes were the most reported among teens when asked what they had used in the last 30 days, with 9.1% of respondents saying they used one.
The results of the state Department of Mental Health’s Missouri Student Survey were welcome news to substance use prevention experts across the state.
“Things are trending in a good direction,” said Chris Davis, the vice president of prevention and youth support at the Community Partnership of the Ozarks, a prevention resource network in southwest Missouri.
“The concern and challenge with that is when people start seeing things get better, they want to stop doing the prevention,” Davis said. “Prevention isn’t a one-and-done. It’s something that we continue.”
While some metrics improved, others worsened. Prescription drug use and use of over-the-counter medicines rose in 2024. And teens reported using things like marijuana or cigarettes at younger ages than in previous years. Because the dataset was so large and weighted to match statewide demographics, the Department of Mental Health said in their report, these changes shouldn’t be analyzed as statistically significant over time.
Cigarettes and nicotine use in Missouri
Over time, cigarette use is decreasing among teens in Missouri, but the state still ranks higher than the national average. In Missouri, 11% of teens surveyed said they had used a vape or cigarette in the last 30 days, compared to 8.1% of teens nationally.
National data show that teens seem to be moving away from e-cigarette use. In 2024, 1.63 million teens said in a nationwide tobacco use survey that they used e-cigarettes once or more during the past 30 days, down from 2.13 million in 2023.
Nationally, 8.1% of all students reported current use of tobacco products. Among high school students, the rate was just above 10%. In Missouri, most teens reported getting cigarettes, vapes or e-cigarettes from a friend.
Tobacco vaping devices on the market today use stronger concentrations of nicotine. Popular vapes can have the nicotine content of 600 cigarettes. Vapes also use acids called salts, which reduce things like throat burning and coughing.
“There’s a lot of misinformation that contributes to the belief that [vaping] is safe and a good alternative,” Davis said.
Davis and the Community Partnership of the Ozarks led a program to place vape drop boxes in high schools across Springfield in an effort to reduce their usage.
Centers for Disease Control and Prevention data show that vaping was highest among high school students from 2018 to 2020, when nearly 20% of students reported using them. The rate has fallen over the past few years.
Researchers looked at studies from the U.S., Australia, South Korea and European countries and found that there were significant links between mental health outcomes, including depression and suicidal ideation, among current youth users of electronic cigarettes.
Across the studies, impulsive behaviors were also associated with electronic cigarette use.
The American Lung Association’s 2025 State of Tobacco Control gave Missouri poor rankings for most of its metrics. Missouri received an “F” for tobacco prevention and cessation funding, tobacco taxes and access to flavored tobacco products. Missouri received a “C” for access to cessation services.
The group recommended Missouri increase funding for tobacco prevention and cessation programs to prevent youth from starting to use tobacco or nicotine products. Research shows that if youth use e-cigarettes or vapes, they’re more likely to use cigarettes in the future.
Teens report less alcohol, marijuana usage
The student survey found that alcohol had the highest lifetime usage of any substance among teens in Missouri. Overall, usage fell from previous surveys. Nearly 20% of teens reported drinking alcohol over time, less than than the national average of 22.3%.
Of teens who had said they’d consumed alcohol in the last month, about 24% said they had less than one drink.
For Davis, alcohol use among teens is still the biggest problem to tackle.
“Alcohol is still the number one drug problem for our youth. It’s not the one that’s the hot topic,” Davis said. “Underage drinking is still the number one drug problem that we have in youth who are in treatment.”
Two years after Missouri voters approved recreational use of marijuana, teens in the state reported their use dropped slightly. But a higher percentage of teens said that occasional use posed no risk at all, compared to other substances.
About half of teens who responded to the survey said alcohol was easy to obtain, while one-third said marijuana was easy for them to get.
Legalization of recreational marijuana has made accessing it easier and softened the public’s perception of the risk, Davis said.
“Because of legalization, there’s a lot of information talking about how it is a medicine and it’s safe and things like that,” Davis said. “All of that contributes to you thinking, ‘What’s the big deal?’”
Missouri trends lower than the national average when it comes to marijuana use among teens, with 7.3% of Missouri teens saying they had used marijuana in the last 30 days, compared to 11.5% of teens nationwide.
Prescription drug, over-the-counter medication use rises
Prescription drug use rose slightly from 2022, but is still down dramatically from 2016, when 10.6% of surveyed teens said they had used prescription drugs in the last month. In 2024, 1.6% of teens surveyed said they had used prescription drugs.
Pain medication was the most misused, followed by anxiety medication and sleeping medication. Teens reported getting access to the medications from a family member 51% of the time.
“That’s simply because the medications are easily, more easily available, like that in the medicine cabinet,” Davis said.
The Community Partnership of the Ozarks has a medication lockbox program which allows families to safely store their medications at home.
It is one of many methods they are pursuing when it comes to preventing substance misuse in the community.
“We just have to do lots of strategies at different times in different ways,” Davis said. “Time and time again, when you let your foot off the gas, things get worse.”
This article first appeared on Beacon: Missouri and is republished here under a Creative Commons license.