Cannabis Policy Changes and Adolescent Cannabis Use: Evidence from Europe.

Elisa Benedetti,Giuliano Resce,Sabrina Molinaro,Paolo Brunori

doi:10.3390/ijerph18105174

Abstract

Cannabis accounts for the largest share of the illicit drug market, with a high prevalence of use even among adolescents. To tackle this longstanding problem, many kinds of reforms to national cannabis control policies have been implemented in Europe, but their effectiveness is still unclear. This paper analyses the association between selected categories of cannabis policy reforms and changes in perceived cannabis availability and patterns of use among adolescents. Data from 20 European countries across 15 years were drawn from a novel database of the European school Survey Project on Alcohol and other Drugs (ESPAD). Our analysis is based on a Difference-in-Differences design, which application is allowed by the fact that only thirteen out of the twenty countries included implemented policy changes. The results suggest that selected categories of reforms influence the availability and prevalence of cannabis use. In particular, some forms of restrictive intervention reduce the general prevalence of use and more liberal reforms seem linked to an increase in the share of students initiating use of cannabis. We find no evidence of an effect of policy changes on the share of frequent users, which are presumably those more likely to develop use-related health consequences.

Highlights

Cannabis policy is a topic of constant discussion and changes worldwide
We conducted a sensitivity analysis focusing on the main finding of this paper, which is that the influence of the different types of cannabis policy changes on the prevalence of adolescent cannabis use is strongly related to the frequency of use
To perform this analysis we focus on the main finding of this paper, which is that the influence of the different types of cannabis policy changes on the prevalence of adolescent cannabis use is strongly related to the frequency of use

Summary

Introduction

Cannabis policy is a topic of constant discussion and changes worldwide. This is because, notwithstanding the coordinated efforts to disrupt cannabis market, both supply and consumption indicators have constantly increased over the past decades [1]. It is estimated that in Europe around 15% of young adults (aged 15–34) used cannabis in 2019, and the prevalence reaches 19% when only 15- to 24-year-olds are considered [2]. Since 2013, Uruguay, 10 jurisdictions in the United States and Canada have passed laws that license the production and retail sale of cannabis to adults for non-medical purposes, often referred to as recreational use. A renewed debate about reforms to the national cannabis policies has developed in Europe [3,4]. Cannabis policies range from the more liberal example of the Netherlands, with a system of limited distribution, to countries like Hungary, where personal possession of cannabis is punishable with imprisonment

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