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2016-2020 NIDA Strategic Plan

Objective 4.1: Determine the impact of drug use and addiction on individuals, families, peers, and society

The effects of drug use, including nicotine, affect not just the individual but also his or her family, friends, and peers. Families and friends can be negatively impacted by drug use not just from the stress of seeing a loved one suffer through addiction but also through financial impacts. SUDs commonly affect the structure of a family because of divorce or the need to fill different roles to compensate for neglect of responsibilities by the drug user.61 There is also an increased risk for interpersonal violence and child abuse and neglect (both physical and emotional), and these factors can lead to diminished attachments to parents and others, impaired self-regulation and problem-solving, decreased development of prosocial attitudes and behaviors, and impairment of healthy development. Indeed, parental drug use can have profound effects on children, from direct effects of using drugs while pregnant (e.g., neonatal abstinence syndrome) to impacts on perceptions of normative behaviors. Children of parents who abuse drugs have a greater risk for SUDs, depression, exposure to violence, and other health outcomes.112

Drug use, including tobacco, also has significant effects on society, including public health outcomes related to chronic disease (cancer, chronic obstructive pulmonary disease [COPD]) and the spread of infectious diseases (HIV and HCV)8,10; public safety hazards such as crime, violence, and drugged driving62; and a large economic burden associated with increased health care costs, lost productivity, and criminal justice costs.3 Understanding these consequences and the factors that influence their expression is critical for developing effective prevention, treatment, and mitigation strategies; for guiding development of laws and policies related to drug use; and for targeting limited resources to the efforts that will have the most potent effects.


  • Determine the impact of drug use and SUDs on public health outcomes
  • Clarify the impact of drug use and addiction on families and peers
  • Measure the societal costs associated with drug use and addiction

Studying Why People Use Tobacco to Inform Public Policy

Over the last several decades, dramatic changes in attitudes and behaviors have resulted in significant declines in cigarette use. Still, smoking continues to be the leading cause of preventable disease, disability, and death with nearly half a million people dying each year in the United States.4 In 2011, NIDA and NIH began collaborating with the U.S. Food and Drug Administration (FDA) Center for Tobacco Products to develop the Population Assessment of Tobacco and Health (PATH) Study.

The PATH Study is a household-based, nationally representative, longitudinal cohort study of nearly 46,000 adults and youth in the United States. Interviewers are meeting with each person once a year for at least 3 years. The study will provide comprehensive data on tobacco use behaviors, including patterns of use, attitudes, beliefs, exposures, and related health outcomes among the U.S. population. Data collection began in September 2013 and will continue into 2016. These data will help inform FDA’s regulatory decisions and actions to further reduce tobacco-related death and disease in the future.