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Although any nonmedical use of drugs (including tobacco and alcohol) by adolescents is illegal and can therefore be viewed as a form of abuse, this perspective ignores some key epidemiological findings. Specifically, the high prevalence of alcohol and tobacco use underscores the fact that use of alcohol and tobacco can be viewed as normative, or at least not exceptionally deviant. By age 18 years, approximately 80% of youth in the United States have consumed alcohol, two-thirds have smoked cigarettes, and half have used an illicit drug at least once. Four percent of adolescents drink alcohol daily and 13% smoke half a pack of cigarettes a day (Johnston et al. 2006).

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