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​​March 2, 2023

Media Contact:

Chase Cook, Acting Director, Office of Communications, 410-767-8649


Maryland Department of Health releases 2021-2022 Youth Risk Behavior Survey and Youth Tobacco Survey data

Key findings show substance use decline, mental health challenges and stressors increase during the pandemic


Baltimore, MD – The Maryland Department of Health (MDH) today released the results of the 2021-2022 Maryland Youth Risk Behavior Survey and Youth Tobacco Survey (YRBS/YTS).

For the first time, the survey addressed mental health status, COVID-19, screen time, disability, and additional information on adverse childhood experiences. Survey findings show that the COVID-19 pandemic greatly affected the mental health of Maryland youth. The survey also finds a reduction in the use of tobacco products, alcohol, and marijuana for high school students. However, there was an increase in alcohol initiation and prescription drug misuse at the middle school level.

“While we see some encouraging results, there is clear data indicating a need for continued comprehensive approaches to support mental health and limit tobacco, alcohol, and drug use," said MDH Secretary Dr. Laura Herrera Scott. “Now that students have returned to schools after navigating arduous challenges heightened by the pandemic, we can address findings through youth-centered health programming, education and outreach."

School-based services that promote mental health support and positive childhood experiences are critical for students. MDH continues to expand youth-specific crisis services across the state including through the Mobile Response and Stabilization Services intervention for children and caregivers in the early phase of a crisis, and the 988 Suicide & Crisis Lifeline for anyone experiencing a mental health or substance use crisis, having thoughts of suicide, or being worried about someone who may need crisis support.

Other findings from the 2021-2022 Maryland YRBS/YTS show:

More than one-third of middle (37%) and high school (39%) students reported feeling sad or hopeless for at least two weeks or more within the past year, with 29% of high school students and 23% of middle school students reporting that their mental health was not good most of the time or always. Female students were significantly more likely to report feeling sad or hopeless or that their mental health was not good compared to male students. Nationally, nearly 60% of female students experienced persistent feelings of sadness or hopelessness according to the Centers for Disease Control and Prevention (CDC) YRBS 2021 youth data summary and trends report.

High school students' use of cigarettes (4%), cigars (3%), smokeless tobacco (3%), e-cigarettes (15%), alcohol (19%), and marijuana (15%) declined significantly from the previous survey year. 

Middle school students reported increased prescription drug misuse from 7% in 2018 to 12% in 2021. Middle school students also reported an increase in alcohol initiation before the age of 11, up from 9% in 2018 to 10% in 2021.

Students identifying as LGBTQ+ were more likely to report more of the risk behaviors measured on the survey compared to their heterosexual (straight) and cisgender counterparts.

The Maryland YRBS/YTS is a CDC-sponsored survey that was conducted in the fall of 2021 among nearly 60,000 students in 366 public middle and high schools across the state. The survey tracks behaviors contributing to the leading causes of death and disability. Measures include alcohol, drug and tobacco use, sexual behaviors, unintentional injuries and violence, physical activity and dietary behaviors.

The MDH Student and Young Adult Resource Guide for Coping During COVID-19 provides an expansive and evolving list of behavioral health resources for Maryland youth tackling mental health and substance use issues. Parents and providers can explore Mental Health and Crisis Resources for Coping with Violence. The Maryland Tobacco Quitline provides FREE phone, web, and text message-based support to help people as young as age 13 to quit tobacco use, and youth ages 13-17 years can text “VAPEFREE" to 873-373 for support to quit vaping.

The full Maryland 2021-22 YRBS/YTS results, including state-level and jurisdiction-level data, are available here.


The Maryland Department of Health is dedicated to protecting and improving the health and safety of all Marylanders through disease prevention, access to care, quality management and community engagement.