Cannabis Legalization and Adolescent Use of Electronic Vapor Products, Cannabis, and Cigarettes

Abstract

Objectives: Cannabis legalization may have unintended consequences, such as effects on prevalence of adolescent use of other substances. We hypothesize that in states that have legalized recreational cannabis (RCL states), electronic vapor product use (''vaping''), cannabis, and cigarette use among adolescents is more prevalent than in states that have only legalized medical cannabis (MCL states) and states that have neither legalized recreational nor medical cannabis (NL states). Methods: Data are from the Center for Disease Control's 2017 Youth Risk Behavior Surveillance Survey (n ¼ 107,665), a nationally representative survey of US high school students. We categorized student responses by cannabis legalization status of the state in which they lived at time of survey, then tested associations between cannabis legalization status and adolescent vaping, cannabis, and cigarette use, using logistic regressions. Results: Students in RCL states were significantly more likely to report current vaping behaviors compared to NL students [odds ratios (OR's) 2.07-2.21]. Students in cannabis-legal states were significantly more likely to report ever or currently using cannabis compared to NL students (OR's 1.27-1.40). MCL students were significantly less likely to report current cigarette smoking (OR ¼ 0.86) compared to NL students. Conclusions: Adolescents in cannabis-legal states were more likely to report vaping and cannabis use compared to adolescents in NL states. Public health officials, policymakers, and clinicians should consider the associations between cannabis legalization and adolescent vaping, cigarette, and cannabis use patterns.

Cell type specific cannabinoid CB1 receptor distribution across the human and non-human primate cortex

“…Cannabis, a drug derived from the Cannabis plant, is the most widely used illicit psychoactive substance worldwide, with a steady increase in usage over the past decade in the setting of increased legalization of recreational marijuana use 1 , 2 . Cannabis use has been associated with various psychiatric comorbidities 3 , including substance use disorders and schizophrenia 4 .…”

Frequency of adolescent cannabis smoking and vaping in the United States: Trends, disparities and concurrent substance use, 2017–19

“…[31][32][33][34][35][36] Indeed, adolescent cannabis vaping prevalence is higher in some states with legalized cannabis for adults. 37 Marketing efforts for a wide variety of cannabis products have proliferated in the legalized cannabis environment; these campaigns are viewed frequently by adolescents, 38,39 and probably influence their behavior.…”

“…Overall, cannabis products are generally more available to youth as more states allow legalized use for adults, although the impact of these laws on youth cannabis use remains inconsistent and generally null 31–36 . Indeed, adolescent cannabis vaping prevalence is higher in some states with legalized cannabis for adults 37 . Marketing efforts for a wide variety of cannabis products have proliferated in the legalized cannabis environment; these campaigns are viewed frequently by adolescents, 38,39 and probably influence their behavior.…”

Effects of cannabis legalization on the use of cannabis and other substances

“…A study using the Consumer Expenditure Interview Survey found that households in RCL states increased their spending on food and alcohol, indicating a connection between cannabis, food and alcohol use [38]. Three studies using the US Behavioral Risk Factor Surveillance System and YRBS data found a significant association between RCL with increased alcohol use, primarily among younger adults and men [39], electronic vapor product use (''vaping''), cannabis, and cigarette use [40] and a small increase in the likelihood of any e-cigarette use among adolescents [41]. Similarly, data from the first four waves (2013-2018) of the PATH study shows a significant association between baseline past-30-day e-cigarette use and past-30-day cannabis use at 12-month follow-up (AOR¼5.92, CI: 3.52, 9.95) among adolescents who have never used cannabis at baseline, with AOR being higher among adolescents living in RCL states (AOR¼18.39; CI: 4.25, 79.68) than that of adolescents in NL states (AOR¼5.09; CI: 2.86, 9.07), indicating the effect modification of state RCL law on this association [42].…”