Herbal products and their association with substance use in adolescents

To describe the prevalence of herbal product use in adolescents and the association between herbal product use and tobacco, alcohol, and other drug use.

The 1999 Monroe County, New York Youth Risk Behavior Survey provided data on a random sample of 2,006 high school students. Herbal product use was defined by lifetime use of "herbal or other natural products--to feel better, or perform better in sports or school." Bivariate analyses using chi2 tests and logistic regressions were used to describe the independent associations between herbal product use and substance use.

Overall, 28.6% reported using herbal products. Herbal product use increased with age (24.5% of 9th graders to 29.9% of 12th graders; p < .04) and varied by ethnicity (33% of Hispanics, 30.9% of Caucasians, 28.8% of Asians, Native Americans, or Pacific Islanders, and 12.1% of African Americans; p < .001), but not by gender. After controlling for gender, grade, and ethnicity, logistic regression models showed herbal product use to be associated with lifetime use of: cigarettes (OR = 2.2; 95% CI = 1.8-2.8), alcohol (OR = 3.5; 2.5-4.9), marijuana (OR = 2.2; 1.8-2.7), and other drugs (odds ratios from 4.4 to 14.5). All p values were < .001.

Over one-quarter of high school students report herbal product use, and this use is associated with drug use. Health care providers should inquire about adolescents' herbal product use, and disclosure should prompt an in-depth substance use history.