Abstract
Aims: To describe trends in cannabis use from 2010 to 2019 among Norwegian adolescents and relate these to individual- and municipal-level variables.Design: Data from nationwide repeated cross-sectional surveys collected in 2010–2013 (T1), 2014–2016 (T2), and 2017–2019 (T3) were used to describe secular trends in proportions of adolescent cannabis use.Setting: Cross-sectional surveys in 410 of the total 428 municipalities of Norway.Participants: A total of 628,678 survey responses from adolescents aged ~13–19 years of age, in which 566,912 survey responses were eligible for analyses, representing data from 340 municipalities.Measurements: Respondent's past year cannabis use, time, gender, school grade, municipality, geographical location, and municipality population.Findings: Boys reported overall higher cannabis use, with ~2:1 gender ratio for any past year cannabis use and a 3:1 gender ratio for frequent cannabis use. Adolescents in Eastern Norway reported higher cannabis use compared with other areas in the country, and adolescents from municipalities with a higher population size reported higher rates of cannabis use than smaller municipalities. A gradual increase in cannabis use from T1 to T3 was found in Eastern Norway and in the largest municipalities. More generally, proportions of past year cannabis use showed a marked increase from T2 to T3 across genders, grade/age groups, geographical location, and municipality population, with few exceptions.Conclusions: Our findings indicate that proportions of past year cannabis use have increased among Norwegian adolescents in recent years. Preventive interventions to hinder initiation of cannabis use, as well as measures to address frequent cannabis use among Norwegian adolescents, are needed.
Highlights
Cannabis is the most widely used illicit drug globally [1] with relatively high prevalence rates among adolescents and young adults in several Western countries [2,3,4,5]
Trends in Total Cannabis Use by Gender and Age Group The results presented in Table 3 show that no change in rates of past year cannabis use was observed from T1 to T2, while rates of cannabis use increased significantly for both boys and girls from T2 to T3
Fluctuations in rates were observed from T1 to T2 for a specific geographical region (i.e., Western Norway), our findings suggest that cannabis use has become more widespread and normalized among Norwegian adolescents in recent years
Summary
Cannabis is the most widely used illicit drug globally [1] with relatively high prevalence rates among adolescents and young adults in several Western countries [2,3,4,5]. As patterns of use may change, epidemiological studies on time trends are important to monitor the extent and correlates of cannabis use across different settings. In some regions (e.g., western Europe, USA, and Australia), cannabis use appears to have stabilized or declined, after a period of increased use throughout the 1990s and early 2000s [1]. A study based on the Health Behavior in School-aged Children (HBSC) study, which included 160,606 adolescents aged 15 years from 30 European and North American countries, reported that the frequency of lifetime cannabis use generally decreased from 2002 to 2010 in Europe and North America [13]. The decrease occurred after a prolonged period of normalization, whereby the normative acceptance of using these drugs in the adolescent group had been reduced [13, 14]
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