WSLCB - Board Caucus
(May 31, 2022) - Summary

Healthy Youth Survey 2021 Results
[ Event Details ]

The 2021 Healthy Youth Survey of Washington school students showed mostly positive signs around cannabis, but a three year gap disrupted comparison of trends with past results.

Here are some observations from the Tuesday May 31st Washington State Liquor and Cannabis Board (WSLCB) Board Caucus.

My top 3 takeaways:

  • A board briefing on the 2021 Healthy Youth Survey (HYS) was prefaced with numerous “caveats” in background provided by Washington State Health Care Authority (WA HCA) Prevention Research and Evaluation Manager Tyler Watson.
    • Former Public Health Education Liaison Sara Cooley Broschart went over 2018 Healthy Youth Survey (HYS) results with the board in January 2020 and again during an Executive Management Team meeting that December. Director Rick Garza first noted the 2021 survey results during comments on April 13th.
    • Public Health Education Liaison Mary Segawa introduced the subject by noting the HYS had been conducted “for a long time” and they would discuss the latest results for 2021. She turned the presentation over to Watson, one of the “key evaluation people who really studies the data carefully” (audio - 1m, WSLCB video, TVW video).
    • Watson reviewed the process behind the “statewide effort,” a collaborative survey designed by many agencies he specified as including the WSLCB, WA HCA, the Washington State Department of Health (DOH), the Washington State Office of the Superintendent of Public Instruction (OSPI), educational service districts, and “community prevention providers.“ The majority of surveys were administered through the “public schools systems” and funded through the dedicated marijuana account and “substance abuse block grant” money, he added (audio - 4m, WSLCB video, TVW video, presentation).
      • He made it clear that the “project is reviewed by” the Washington State Institutional Review Board (WSIRB). One function was “surveillance” of youth and Watson explained that survey datasets were available for researchers to “do their own analysis.”
      • Participating schools notified parents ahead of the survey, “survey coordinators” were present in schools during administration, and students were shown a video about the purpose of the voluntary and anonymous survey, remarked Watson. He laid out how surveyed students could skip any question and how individual results “were never shared.” Watson then noted that survey results were “suppressed” if a school’s participant pool couldn’t ensure anonymity. “Quality control checks on the backend” gauged truthfulness, he said, including dropping results with obvious repeating patterns as those respondents “probably didn’t answer honestly.”
        • He noted in answering a question, that sometimes other grades would be included in the survey “if it's a small school and they want to make sure they have enough responses.”
      • In 2021, officials surveyed 206,000 students throughout every county in Washington, indicated Watson, covering “over 200 school districts, almost 900 schools” whose administrators agreed to participate. Though the vast majority were public schools, he stated that several charter and private schools, along with one tribal school and a “school for the blind” also chose to take the survey as well. Watson pointed out that each school’s leadership received an individualized report on their school’s result. He directed people wanting “more detail” to check out AskHYS.net as it had “factsheets…frequency reports,” question analysis tools, and powerpoints on the HYS.
    • The survey had been scheduled for the 2020 school year, but he described how the coronavirus pandemic made administering the previously “paper and pencil survey” impractical (audio - 6m, WSLCB video, TVW video).
      • HYS was “mainly an online survey” now, with Watson qualifying that schools had the option in 2021 to request traditional paper surveys. However, the gap between 2018 and 2021 broke “our trends analysis” for the intervening years, he said, and officials couldn’t “directly compare” survey results the way they had in previous years since the survey monitored the same class in even numbered years from 6th through 12th grades. Amidst many other disruptions to student life, the survey gap resulted in a different cohort of students responding, he indicated. Watson’s presentation focused on a before and after analysis of changes between 2018 and 2021 survey answers, and he refrained from claiming differences showed patterns of youth use.
      • Watson commented that students “across the board” were reporting “low levels of substance use.” Past 30-day use of substances was reported to be a “much larger decrease” from the responses in the 2018 survey, he told the board, and “polydrug” use was lower. A potential reversal of “a previous trend” in youth vaping and e-cigarette use was suggested by the data, which he believed may have been partially due to vaping-associated lung illnesses nationwide beginning in 2019. Negative perceptions of cannabis and other drugs “slightly increased as well,” Watson mentioned. Though not able to affirm trends, he called attention to the fact that alcohol, cannabis, and tobacco use had been declining in the 2018 survey, and “decreased much more.”
      • The 10th grade respondents were a “good indicator grade” and had been favored when presenting some results because, according to Watson, they had a “really good response rate,” were “no longer in junior high” but still not past the halfway point of high school. For these reasons, he said their replies were considered more valuable than “combining” responses from all grades surveyed.
      • Learn more from a March 1st powerpoint on statewide data and from factsheets on “Marijuana Use for Washington State”:
  • Public Health Education Liaison Mary Segawa addressed more specifics about decreases in youth rates of cannabis use and an increase in negative perceptions of the plant while Watson spoke about cannabis in polydrug use by school children (audio - 5m, WSLCB video, TVW video).
    • Segawa clarified that survey questions used the word ‘marijuana,’ though the state was in the process of transitioning references in law and rule to ‘cannabis.’
    • Segawa confirmed the results showed a “pretty substantial decrease” in cannabis use by youth in the 30 days preceding their survey by three percent of 8th graders, seven percent of 10th graders, and “16% of 12th graders.” She said this was higher than survey framers liked (“obviously zero would be the target”) and student responses overall were classified as indicative of “substantial use.”
      • Take a look at the 2012 HYS factsheet for cannabis, the last survey prior to cannabis legalization in the state. It showed that cannabis use rates for 8th, 10th, and 12th graders had been at nine percent, 19%, and 27% respectively.
    • As for the responses to cannabis survey questions, Segawa was troubled by “the number of days that they’d been using in the past 30 days” as well as the impact using 10 or more days had on scholastic achievement and “on brain development.” She perceived other “areas of concern from a health standpoint” from smoking cannabis “because of the particulate matter” and also “dabbing because of the concentration of cannabis,” claiming a “link to psychosis and other mental health issues.” Segawa evinced “concern that they’re using,”
      moreso “that they’re using it in ways that are less healthy than other ways.”
      • In 2018, the Washington State Legislature directed the Washington State Institute for Public Policy (WSIPP) to “examine current data collection methods measuring use of cannabis by youth and report to the legislature on potential ways to improve data collection and comparisons.” The resulting report suggested “improvements to the HYS” based on a review of “current research on harmful consequences of marijuana use, with the aim of identifying specific aspects of use that are most strongly related to harm.”
    • The most common avenue for accessing cannabis continued to be through friends, Segawa stated. While rates of youth buying or shoplifting from cannabis retailers was low, three percent of 8th grade respondents claimed they had bought from a store, higher than the alleged rates of sales to 10th and 12th graders, which concerned her. Segawa added that accessing cannabis at “home, with permission is lower than what we saw with alcohol in this area.”
    • The perception of risk from cannabis continued to show a decrease “the older they get,” Segawa reported, and was widely considered “not harmful” by respondents even when used “five to ten times per month.”
    • As for driving “within three hours” of consuming cannabis or riding with drivers who had done so, Segawa commented that this time frame was something the survey authors were “looking at for possibl[y] changing that number” based on newer research. “Almost one out of ten 12th graders have said…that they’ve driven” following cannabis use, she stated, and 15% answered that they’d ridden with someone who had, as well as “almost one out of ten…on 10th grade.” Segawa mentioned that the group behind the HYS recognized they hadn’t included questions covering “who was driving” and were considering that for the next survey. 
    • Watson looked at youth vaping, showing survey results that 41% were using cannabinoids - and 31% didn’t actually know the contents of what they’d vaped. “Students reporting using more than one substance” in the preceding 30 days was “substantial[ly]” lower than the 2018 survey, he added, with less than 6% of all students indicating using more than one substance. The most common polydrug combination was alcohol and cannabis, which he said “seem to go pretty hand-in-hand” among youth using drugs. Watson’s final point was on “risk and protective factors” in the communities and families of youth. He pointed out that availability of and peer/friend use of substances was lower than the previous survey. Watson closed by saying the HYS planning committee met monthly and the group always welcomed feedback, particularly about questions and input for the next survey “in fall 2023” (audio - 5m, WSLCB video, TVW video).
  • Board members had several questions and remarks about the survey itself and wondered what conclusions or education the agency might try to develop as a result.
    • Board Member Ollie Garrett was not present at this caucus.
    • Board Member Jim Vollendroff asked how many students participated in the 2021 survey compared to previous years and how much those rates had changed in light of the pandemic (audio - 2m, WSLCB video, TVW video).
      • Watson acknowledged that “participation did decrease, but not by a lot.” With “maybe ten percent less participation,” HYS coordinators remained “pretty happy with the sample we got.” Overall, he believed the 2021 survey to be “representative of students” across Washington public schools.
    • Vollendroff next wondered about the number of schools participating, as well as any reasons school administrators opted not to have their students participate (audio - 3m, WSLCB video, TVW video).
      • Watson replied that HYS surveys had included “closer to a thousand schools in the past,” and the 2021 HYS covered 877 schools. School administrators chose not to participate for reasons like continuing pandemic difficulties, overlap with other testing, a feeling that “students are over surveyed,” and higher “scrutiny of…data collection overall.”
    • Vollendroff felt his other questions would be better asked in private meetings with Segawa and Watson so he could bring “together my past experience with” HYS and his “new role” on the board. Having just heard a lot about “alcohol, tobacco, and vaping,” he stated he had “questions about some other areas.” Vollendroff did want to dig more into drug use “at home, with permission” feeling the board had “an obligation to find out more about that and perhaps think about ways” WSLCB could “mitigate that” (audio - 1m, WSLCB video, TVW video).
    • Board Chair David Postman was less surprised by lower rates of substance use “if people in these age groups are stuck at home,” but he was curious about possible reasons for higher rates of negative perceptions of substance use (audio - 3m, WSLCB video, TVW video). 
      • Segawa’s reaction was to wonder if the coronavirus pandemic had led to “a health concern, overall” especially between smoking, “lung issues, and COVID all mixed together.” Youth becoming more health conscious was one possibility, though she also asked “what are they seeing at home now?” Segawa speculated there could be “a correlation” between students seeing more consumption by the adults in their home and a greater perception of negative effects from substance use.
      • Watson called attention to the fact that “the perception of risk didn’t go up a lot” and hadn’t grown “the same amount that we saw self-reported use go down.”
    • Finally, Postman brought up the responses youth gave on access to substances “at home, with permission” in addition to the “large number of kids who said they didn’t even know what they were vaping.” He asked if these were topics WSLCB should begin dedicated public awareness efforts on, or “should we wait for another one before” trying to “draw conclusions on those” (audio - 6m, WSLCB video, TVW video).
      • Segawa concurred that youth not knowing what they’re vaping was troubling. She wondered if products, in particular those containing nicotine, were inadequately labeled or whether youth simply weren’t paying attention. Perhaps some youth believed vaping “looks cool/sounds cool and they’ll just start it,” she hypothesized, and were mainly paying attention to the flavor of a vapor product rather than what substances were in it.
      • As parents continued to be the biggest influence on youth, Segawa felt regulators had “to keep hammering on” substance use prevention education with parents. Even without coming to firm conclusions on the trends of substance use, she reminded the group that “we still know use is harmful for youth, it’s a brain development thing.” She suggested using survey data to refine and target their messages to minors, their parents, and the public.
      • Watson suggested doing “better with our social norming” and using the survey to show students that “the norm is not to be using substances.” He hoped to increase “positive social norms” among youth and their parents that would show how substance use was not “the cool thing to do, this isn’t the normal thing to do.” Watson argued this would contribute to a goal of keeping youth use rates lower. Postman agreed that the results of the survey demonstrate that “90%” not using substances like alcohol or cannabis was “pretty good news.”
    • Segawa promised to follow up with board members to “get into more detail” with Postman and Vollendroff (audio - <1m, WSLCB video, TVW video).

Information Set