WSLCB - Board Caucus
(July 9, 2024) - Healthy Youth Survey

2024-07-09 - WSLCB - Board Caucus - Healthy Youth Survey - Takeaways
[ Event Details ]

The latest Healthy Youth Survey responses showed a downward trend in underage cannabis use, but board members were troubled by the enduring popularity of vapor products.

Here are some observations from the Tuesday July 9th Washington State Liquor and Cannabis Board (WSLCB) Board Caucus.

My top 3 takeaways:

  • Research Specialist Tyler Watson presented on the 2023 Healthy Youth Survey (HYS) results, starting with background on the role WSLCB played in the survey.
    • Watson told board members he’d be giving a “results snapshot” and had a “simple agenda today just to describe the Healthy Youth Survey 2023 background and context and then review” some of the substance use responses (audio - 1m, video - TVW, video - WSLCB).
    • Watson provided background on the long running survey of 6th, 8th, 10th, and 12th grade students across Washington state. The “very, very large collaborative project” was conducted through WA HCA, and WSLCB was one of several agencies to contribute to the survey’s development and analysis of the results, noting “folks involved here at LCB [were Public Health Education Liaison] Kristen Haley, [Research Manager] Sarah Okey and myself.” State officials had contracted with Looking Glass Analytics as well as “state schools, community prevention and wellness initiative coalitions, community based organizations, ESDs [educational service districts], health jurisdictions, tribes, and then we have a great communications team [with] a point person from each agency to help us communicate some of the results of this project, as well,” said Watson (audio - 8m, video - TVW, video - WSLCB).
      • The oldest reference Watson had to HYS was a picture from 1988, and he talked about how substance use was one of many “health behaviors” surveyed. He spoke to the survey development process, how HYS went from being “cobbled” together from different state surveys to a document mandated under state law with dedicated funding allocated by lawmakers. Watson also stated the survey covered mostly public schools, but some tribal, private, and charter schools were also included.
      • Since the coronavirus pandemic, Watson indicated that HYS was conducted in odd-numbered years, rather than even-numbered, which “changed our grade cohort…instead of asking the same group of students every two years” they were asking a different group of students. Coupled with several methodology changes, the team included a “disclaimer statement throughout our materials that something like this trend data from before and during/after the pandemic should be interpreted with caution, because we know there was a lot of changes that occurred from our 2018 survey.”
      • Watson explained that since the survey of more than 200,000 students was concluded, “we've been doing a lot of results sharing in the springtime” and had finished “pretty much all of our products that are going to be produced or have now been posted to the website.” The “public results are available” for counties and ESDs, but Watson indicated “we don't publicly post school district and school level results, those are instead sent directly to school.” He relayed that their team had already begun survey revisions ahead of finalizing the next survey which would be conducted in autumn 2025.
      • The survey results included topical ones with “some high level themes,” and people could conduct their own analysis using “a cube IQ analytic tool that allows you to cross tabulate, for example, how many students who identify as this way also report this behavior,” said Watson.
  • Watson went through the results snapshot of 10th graders in HYS which addressed mental health; cannabis and other substance use and access; plus vaping disparities among demographic groups (audio - 11m, video - TVW, video - WSLCB, Presentation).
    • The initial narrative State officials offered was that results showed “signs of hope and resiliency among Washington students” and that the HYS team felt “we actually saw some good news.” While there were concerns, Watson commented “we saw a lot of improvement in a lot of different indicators” and an overall improving picture of mental health among respondents, the “best we've seen in 20 years and signs of hope for young people.” But the headline he had for youth substance use “remains 50% or more below what we saw pre-pandemic, which…means the 2018 survey cycle.” Watson continued, stating what “we consider current use of substances for alcohol, marijuana, vaping, and cigarettes all basically stayed the same, we didn't see significant change from 2021 to 2023.”
    • For some of the substances, including cannabis, “it looks like we're a little bit lower than national results,” he observed, as well as the “perception of harm” which had been trending up. “And I use the term ‘marijuana’ intentionally,” clarified Watson, “because when we do student focus groups, we haven't yet heard from students that ‘we actually use the term cannabis’ now, that might change for 2025.”
    • Watson offered data points that approximately “9% of 10th graders said they currently use alcohol, 8% said they currently use marijuana, 8% said they currently vape, 3% said they use smokeless tobacco, and 2% said they use cigarettes.” Delving into specifics on marijuana use (factsheet), he said:
      • “Using marijuana at least once in the past month, increases up to 16% for 12th grade, about 8% for 10th graders, not as much of a decline over time as we saw for alcohol, but we did see again a big drop once we switched grade cohorts [and] currently about 8% of 10th graders saying they they currently use marijuana.”
      • “The most popular form of using marijuana is vape, vaping now, followed by smoking, eating, dabbing, and drinking, and then some other way.”
      • “As a prompt from Board Member Vollendroff, I also…charted this so you can just see how popular vaping became,” narrowly overtaking smoking as the most common consumption method.
      • “Easy access has also decreased over time…we would want there to not be very easy access…about 31% of 10th graders [said] it's easy, sort of easy, or very easy to get marijuana…mostly from friends,” followed by access because “someone sold it to me, gave money to someone, from someone older not related, from home without permission, with permission, older sibling at a party, and bought it from a store.”
    • Watson explained that students who reported vaping were using “mostly nicotine products,” but cannabis items were also prevalent, and “14% said they don't know.” He added that disparities were also prominent, with vaping being twice as common among ‘Sexually or gender diverse’ and ‘Migratory working family’ groups, plus three times as common among students ‘Having one or more disability.’ He also noted an exception in the downward trend in “other illegal drugs, painkillers and prescription drugs, they did increase significantly. But we're still talking about under 3% of students reporting use of these substances.”
    • According to Watson, WSLCB staff had pushed for “new questions of what are students reporting, are they using these other marijuana products” with 2% of 10th graders responding that they had used a cannabinoid product such as delta-8-THC.
    • “So we largely see things moving in the right direction. With a few exceptions…we still see large disparities among student demographic groups. When we think about youth, when we think about access, there's very, very different outcomes across some of these demographic groups.”
  • Board members responded to the new information and posed questions about WSLCB input on the HYS, and patterns in youth vapor use related to cannabis.
    • Board Member Ollie Garrett shared her surprise at “how many at 10th grade level are getting alcohol and, and vaping with, at home…with permission” (audio - <1m, video - TVW, video - WSLCB).
    • Vollendroff—who’d taken an interest in the WSLCB contribution to HYS in his first survey briefing in 2022—praised Watson, remarking “we're so lucky to have you on board with our research team” given Watson’s background with the survey at WA HCA. Vollendroff was curious who’s “the decider in this group? At the end of the day? Is it consensus based decision making, or who really is in the driver's seat at the Healthy Youth Survey with so many partners?” (audio - 3m, video - TVW, video - WSLCB)
      • Watson answered that they "strive for consensus" and in circumstances where HYS contributors needed “one person from each agency to come to the table and make a decision” former Public Health Education Liaison Mary Segawa had taken that role.
      • Vollendroff agreed that Segawa had been “heavily involved. But with you on board, in particular, I really want us to be at the table…a driver in this in terms of what information do we need to make good public policy decisions on…products that we regulate.” He reflected that a “decrease in use over time and increase in perception of harm, a decrease in access, those all sound like we're doing really good stuff in this state.” Vollendroff told Watson he planned to follow up with WSLCB staff involved in HYS with additional comments and questions.
      • Haley clarified that she was the official leader for WSLCB representation on the HYS team, and “if there's ever anything that you need…us to advocate for, or lean on, that should come through me.”
    • Postman pointed to the high number of youth reporting using vapor products and asked “what is that compared to on the adult side of usage,” or “how many cannabis consumers out of our 502 stores are doing vape over anything else?” (audio - 3m, video - TVW, video - WSLCB)
      • Watson said he’d looked at that: “vaping has also increased over time as a preference” for young adults, the other age group he’d focused on, “but not as much as adolescents.” Postman agreed he’d seen a “sharp” increase in previous surveys involving vapor items, “one of the questions I have is there, is there something in that result that should prompt us to look at vape, cannabis vape in particular, if that seems to be so popular among under age and younger users?” Watson agreed its popularity made the products worthy of greater scrutiny, especially as use of vapor products “continued to increase over time.” He guessed they could be used more covertly and with ease, “also differentiating by age group, I think is also an important thing to do [because] preference also changes as, as you go up in the age groups, for example, I think edibles become more popular as well.”

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