Purpose.-To examine adolescents' self-reported exposure to cannabis marketing in states with legalized cannabis and its association with past-year cannabis use.Methods.-We conducted a cross-sectional, online panel survey of 469 adolescents age 15-19 years residing in four states with legal retail cannabis for adult use. Adolescents self-reported exposure to cannabis marketing on social or traditional media (i.e. outdoor or print) and past-year cannabis use. Logistic regression generated estimated odds of youths' past-year cannabis use by marketing exposure after adjusting for demographic factors and cannabis-related social norms.Results.-Exposure to cannabis marketing on Facebook, Twitter, and Instagram was associated with increased odds of past-year cannabis use of 96% (95% CI: 15%−234%), 88% (95% CI: 11% −219%), and 129% (95% CI: 32%−287%), respectively. Odds of past-year cannabis use increased by 48% (95% CI:16%−87%) with each additional social media platform where adolescents reported exposure.Conclusion.-Despite restrictions that prohibit cannabis advertising on social media, adolescents are exposed to cannabis marketing via social media, and this exposure is associated with recent cannabis use. States should consider further regulation of cannabis marketing on social media.

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Key Points Question How often are recreational marijuana companies adhering to the state of Washington Administrative Code regulations when posting product promotion messages on social media? Findings This cross-sectional content analysis of 1027 posts on Facebook and Twitter platforms evaluated the social media content of business pages from 6 recreational marijuana companies. Violations of regulations regarding prohibited content were present for between 2% and 13% posts across regulation categories; required warnings were present on only 11% of posts. Meaning Social media are influential and accessible platforms for youths in which recreational marijuana companies promote prohibited content and avoid required health warning messages.

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