Alison Knopf
A cohort study of California public high schools found that sustained availability of a dedicated health course was associated with modestly lower prevalence in several common forms of adolescent substance use. The results from almost 2 million student survey responses from 915 California public high schools showed that sustained availability of a dedicated health course was associated with lower prevalence of past 30‐day alcohol use, binge drinking, marijuana use and vaping. Estimates remained statistically significant after adjustment for false discovery rate. The findings suggest that these programs are helpful in reducing the prevalence of adolescent substance use. The California Healthy Kids Survey was linked to the annual University of California Office of the President course lists. Participants included high school students in grades 9 and 11 who completed the California Healthy Kids Survey in high school between the 2017 to 2018 school year and the 2023 to 2024 school year. Data were analyzed from January to February 2026. The main outcomes were related to any past 30‐day substance use: alcohol use, binge drinking, cigarette smoking, drug use, marijuana use, prescription drug misuse and vaping. Results showed that sustained availability of a dedicated health course was associated with lower school year prevalence of vaping, marijuana use, alcohol use and binge drinking. The study, “Sustained Availability of Dedicated High School Health Courses and Adolescent Substance Use,” will be published in the September issue of JAMA Network Open .