A report issued Wednesday by the Center on Addiction and Substance Abuse (CASA) at Columbia University finds  the top public health problem in the United States is teen drug abuse, including  the use of  alcohol, tobacco, prescription drugs, marijuana and other controlled substances. 
According to the study's authors, "The study looks at how American culture increases the risk that teens will use addictive substances and how the messages sent by adults, and glamorized by the tobacco and alcohol industries and the media, normalize substance use and undermine the health and futures of our teens." 
—Susan Foster, CASA vice presidentCASA  found that 90% of adults who have addictive disorders started using substances before the age of 18. In comparison, only 4% of  Americans who abuse as adults started using these drugs when 21 or older. 
Further, the consumption of these substances by American teens is rising. Currently almost half of American high school students smoke, drink alcohol or use other drugs, according to the study, and 1 in 5  meet the medical criteria for addiction. Seventy-five percent of all high school students have used addictive substances including tobacco, alcohol, marijuana or cocaine at some point. Over 65% have used more than one.   
The researchers found  social factors  related to the risk of American teens use of addictive substances included parental, community and school  acceptance of these substances and the positive media portrayals of drug use as harmless, fun and attractive.  Advertising of drugs, alcohol and cigarettes also contributes to the positive image of drug use.
The researchers used online surveys filled out by 1,000 high school students, 1,000 parents of high school students, 500 educators, as well as information from  five focus groups and reviews of 2,000 scientific articles and reports, according to US News. 
"Addiction is a disease that in most cases begins in adolescence, so preventing or delaying teens from using alcohol, tobacco or other drugs for as long as possible is crucial to their health and safety," said Susan Foster, CASA's vice president in a news release. "We rightfully worry about other teen health problems like obesity, depression or bullying, but we turn a blind eye to a more common and deadly epidemic that we can in fact prevent."
The study's authors  pointed out that the teenage  brain is not fully developed and the use of drugs during the teenage years hampers further development of the  brain, impairs judgment and increases the risk of addiction as an adult. Heavy substance abuse harms the developing brain far more than the already developed adult  brain. They  concluded their data shows that adolescence is the critical age  period for the onset of substance abuse and its repercussions. 

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Report finds teen substance abuse is top public health problem in US