Pathways to Substance Abuse Among Girls and Young Women Ages 8-22

    Published: February 2003

    Early experimentation with substances can increase the likelihood of addiction in girls and young women. This report examines the reasons girls may use substances, as well as the effects of substance use on key transition periods in a girl’s life. Most importantly, it reveals vital opportunities for prevention and intervention during these key transitions.

    Key Takeaways

    This report found that girls and young women use cigarettes, alcohol and other substances for different reasons than boys, and that they are more vulnerable than boys to substance use, addiction and their consequences. Further, substance use can turn into addiction more quickly for girls and young women than for boys and young men, even when they use the same amount or less of a substance. Additional findings include the following:

    • Despite recent declines in youth substance use, 45 percent of high school girls reported drinking alcohol, more than 25 percent reported current cigarette smoking and binge drinking, and 20 percent reported using marijuana.
    • Girls who experienced early puberty were at higher risk of using substances sooner, more often and in greater quantities than their later-maturing peers.
    • Girls were more likely than boys to report being depressed, having eating disorders or being sexually or physically abused — all of which increase the risk for substance use and addiction.


    • Health professionals should screen young female patients for substance use, depression, sexual and physical abuse, poor school performance, eating disorders and stress, and should provide appropriate referrals.
    • Governments should invest resources in research, prevention and treatment that focus on the special needs of girls and young women.
    • The media should refrain from presenting glamorous images of women smoking or drinking, and refrain from making positive associations between smoking or drinking and thinness or sex appeal.
    • The media should refuse to accept alcohol advertisements for television and magazines with high proportions of young female readers, and refrain from programming that conveys messages in favor of substance use and excessive dieting.

    Research Methods

    This report relied on data from focus groups of pre-adolescent girls and their parents; a unique, longitudinal national survey of 1,220 girls and young women going through key life phases; analyses of data from three national data sets; an examination of the impact of substance use prevention programs among girls and young women; and a review of more than 1,000 publications.

    Last Updated

    November 2023