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story.lead_photo.caption In this July 23, 2014 photo are a variety of e-cigarette at Aqueous Vapor in Columbia, Mo. Gov. Jay Nixon is eliciting support from health professionals as he tries to persuade Missouri lawmakers to sustain his veto of legislation dealing with electronic cigarettes. Photo by The Associated Press

A state survey released last fall shows a mix of good and bad results when it comes to Cole County students' use of tobacco, alcohol and drugs, but local anti-drug advocates see indicators in the data that more young people are at least realizing the dangers of those substances.

The Missouri Department of Mental Health every two years releases the results of the Missouri Student Survey — questions asked of middle and high school students on topics and behaviors such as their reported use of drugs and alcohol; being a bully or being bullied; the state of their mental health; their friends' and parents' perceptions of how wrong it is to use drugs and alcohol; how easy students think it is to get drugs and alcohol; and how harmful they think it is to use drugs and alcohol.

Participation in the survey is optional, and it's conducted jointly by the Missouri Department of Elementary and Secondary Education with the state's mental health department.

Out of the Cole County students surveyed in 2018, 11.6 percent reported they had used cigarettes or chewing tobacco in the last 30 days, compared to 9.2 percent in 2016 and 12.4 percent in 2014. Of the students surveyed in the county, 15.5 percent reported they had used electronic cigarettes in the past 30 days, compared to 11.3 percent in 2016 and 14 percent in 2014.

The survey also compares each Missouri county's results with statewide figures based on a random sample of students that's weighted to proportionally reflect the state's student population of sixth- through 12th-graders, as well as what percent of them are male, Hispanic/Latino, African-American, white or multi-racial.

The 330 or so Cole County students whose responses are included in the 2018 survey results represent a sample size that's skewed a little more toward middle school, males and whites than for the state.

Across Missouri, 8.7 percent of students surveyed for the 2018 report indicated they had used cigarettes or chewing tobacco in the last 30 days; 15.3 percent reported having used e-cigarettes in that time.

Locally and across the state, according to the data, e-cigarettes have become more popular methods of tobacco use for young people than traditional cigarettes or chew.

"Unfortunately, e-cigarette products are very trendy and popular right now. Because there are so many styles and flavors, people do not realize the nicotine content and how harmful it is to use the products," Kristi Campbell said Friday via email. Campbell is the director of the Cole County Health Department.

The Jefferson City Council passed an ordinance in April 2017 that set the minimum age for the sale of tobacco in the city at 21 instead of 18.

"As far as tobacco products and e-cigarettes, more education about the harmful effects is needed to prevent youth from trying the products. The education will have to be delivered in a manner that reaches the youth; television is less popular now in the age of social media and online videos. As with most things, prevention is the key because the products are all very addictive, so once youth start using, it's very difficult to quit," Campbell added.

Joy Sweeney — executive director of the Jefferson City Council for Drug Free Youth — emailed Friday that the Council for Drug Free Youth's focus over the past four years "has been to reduce underage drinking and marijuana use, and two years ago, we added opioids (and prescription) drugs to our action plan.

"As you will note, all three of those substances' last 30-day use has declined. Although CDFY is not taking all of the credit, we certainly understand that when education of youth and community members increases regarding the harm of substances, youth use tends to decline," she added.

Eighteen percent of Cole County students surveyed by the Department of Mental Health indicated for the 2018 report that they had used alcohol in the last 30 days, compared to 21.1 percent in 2016 and 15.3 percent in 2014. The amount statewide was 14.5 percent in 2018.

Of Cole County youth surveyed, 8.7 percent reported in 2018 they had used marijuana in the past 30 days, compared to 8.9 percent in 2016 and 7.6 percent in 2014; and 6.5 percent across the state in 2018.

More significant changes are visible in the data about local young people's attitudes about drugs and alcohol.

Since 2014, smaller percentages of students surveyed by the state have reported that they think it's very easy or sort of easy to get cigarettes, alcohol, marijuana and prescription medication not prescribed to them.

Even more significant, the percentage of local students surveyed who reported they think there's no risk or only a slight risk from using e-cigarettes dropped from 49.3 percent in 2016 to 39.6 percent last year. Data about students' attitudes in 2014 was not available. Statewide last year, 41.8 percent of students reported they thought there's no or only a slight risk from using e-cigarettes.

"That is an indicator that the educational campaigns are reaching the youth, and we typically see behaviors follow that trend. Hopefully that means that the 2020 survey will show a decline in past-30 day use," Sweeney said of the local trend.

The percent of students surveyed in Cole County who reported in 2018 that they thought there's no risk or only a slight risk of drinking one or two alcoholic beverages almost every day declined to 29 percent from 44 percent in 2014. Across Missouri, 31.4 percent of students last year reported they thought the same way.

Almost 39 percent of local students surveyed last year reported they thought there's no risk or only a slight risk from drinking alcohol of an unspecified dosage. That's a perception that's about even with the level of it across the state, and an increase locally over 35.1 percent in 2016; 2014 data was not available.

"Those numbers can fluctuate slightly, especially since the drug has been around for so long and we don't emphasize the danger — just that you should wait until you are 21," Sweeney said.

She was most excited about changes in students' reported attitudes toward marijuana. Just under 32 percent of Cole County students surveyed last year reported they thought there's no risk or only a slight risk from smoking marijuana once or twice a week, compared to 37.2 percent in 2016 and 35.6 percent in 2014. Cole County last year was below the state's 37 percent of students.

"The fact that youth are getting the message that marijuana is harmful is very reassuring. Even though the increase in perception of harm only changed by a few points, it is especially reassuring because the messaging around marijuana is that it is a 'medicine.' Regardless, it is not safe for youth and can cause harm; the youth are getting that message," Sweeney said.

Full results of the Missouri Student Survey — by county and even-numbered year — are available at

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