Abstract

Aim: This study examined the relationship of youth marijuana use and perceived ease of access with the number of medical marijuana cards at the county-level, and marijuana norms as indicated by per cent of voters approving legalization of medical marijuana in 2004.Methods: Survey data from 17,482 youths (aged 13–19) in Montana and county-level archival data, including votes for the legalization of medical marijuana and the number of medical marijuana cards were analysed using hierarchical linear modelling.Findings: Living in a county with more medical marijuana cards was not related to lifetime or 30-day marijuana use. However, voter approval of medical marijuana was positively related to lifetime and 30-day use. Perceived ease of access to marijuana was positively related to medical marijuana cards, but this relation became non-significant when voter approval was controlled. Among marijuana users, marijuana cards and voter approval were positively related to perceived ease of access.Conclusions: The relation between medical marijuana cards and youth use may be related to an overall normative environment that is more tolerant of marijuana use. Interventions to prevent youth marijuana use should focus on adult norms regarding use by and provision of marijuana to youths.

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