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Racial and ethnic patterns in adolescent substance use The 2026 JAACAP clinical practice guideline synthesizes recent survey data showing that among 12th grade students, White students used certain specific substances more frequently than other groups , but Black 12th grade students had higher rates of alcohol use (including binge drinking) and tobacco use (including vaping) than other racial/ethnic groups, with overall substance use by Black students higher in 2022 than in prior survey years [1]