Higher Rates Of Marijuana Use Research Articles

Marijuana use and its correlates among school-going Jamaican adolescents: a finding from a national survey.

The recent data indicate almost a fifth of Jamaican adolescents used marijuana in the past 30 days. To ensure the optimal allocation of resources, a country-specific understanding of factors associated with marijuana use among adolescents is essential. Therefore, this study aimed to address this gap among adolescents aged 13-17 years in Jamaica. We analyzed data from the recent Jamaica Global School-Based Student Health Survey conducted in 2017. The sample consists of school-going Jamaican adolescents of 7th-12th grades. The prevalence of recent marijuana use was assessed and compared across different demographics, substance use, and risk behaviors using bivariate and multivariable logistic regression analyses. Older adolescents and men had a higher likelihood of recent marijuana use. Psychosocial risks, such as loneliness, frequent worry, suicidal ideation, physical attacks, and school absenteeism, were associated with higher marijuana usage. Parental smoking increased the odds, whereas strong parental support and awareness decreased it. Other substance uses, especially amphetamine and tobacco products, had strong associations with marijuana use. Early initiation of substances was associated with a higher risk of marijuana use. Sexually active adolescents, especially those initiated before the age of 14 years, had higher rates of marijuana use. The intricate link between harmful and supportive psychosomatic and risk behaviors with recent marijuana use highlights the importance of holistic interventions and policies focusing on emotional health, parental guidance, substance education, and sexual activity implications.

Marijuana Policy Bundles in the American States Over Time and Their Impact on the Use of Marijuana and Other Drugs.

American states have used different approaches in adoption of cannabis policies and continue to modify those policies after approval. States also differ in how long it takes to implement such policies, and this influences the availability of legal marijuana. Such policy differences and implementation timelines could influence usage of marijuana and other illicit drugs by adolescents, young adults, and older adults. We develop an original coding scheme for marijuana legalization policies by classifying policy bundles characterized by three views of marijuana: as a pharmaceutical; as a permissive drug, or as a state fiscal revenue source. We test the impact of state legal marijuana policy characteristics on age group rates of marijuana use with panel regression models including control variables and fixed effects for 2000-2019. This design moves beyond a dichotomous construct of marijuana legalization and accounts for the dynamic adaptation of policies beyond their initial adoption. States with a higher pharmaceutical score experienced lower marijuana usage rates for adolescents and young adults while states with a permissive approach or fiscal approach experienced higher rates of marijuana use for all age groups. We find no consistent spillover effect of the pharmaceutical or permissive marijuana policy bundles on other illicit drug use for any age group, but fiscal bundles show some association with greater illicit drug use for adults. These more nuanced measures better reflect state policies as implemented and provide more clarity of the policy impact on target populations' marijuana usage.

Same, opposite and both-sex attracted adolescents’ mental health, safe-sex practices and substance use

Introduction: This study examined mental health, substance use, and sexual health across sexual attraction groups. Methods: 428 adolescents recruited from school-based health centers completed self-report measures. 72% were only opposite-sex attracted, 19% both-sex attracted, 3% same-sex attracted, 4% not sure. Results: Reported partners did not always align with reported attraction. Compared to opposite-sex attracted youth, 1) both-sex attracted youth had significantly higher rates of marijuana use (OR = 1.75, p = .04), depressive symptoms (OR = 2.62, p = .001) and inconsistent condom use (OR = 1.71, p = .05); 2) the “not sure” group had higher anxiety symptoms (OR = 4, p = .01). Conclusion: This study highlights the importance of considering sexual attraction in providing quality care to young people.

Turning over a new leaf: Vape shop closings, openings and transitions in six U.S. Metropolitan statistical areas.

This study characterizes vape shop closings, openings, and changes in product mix in six U.S. metropolitan statistical areas with different tobacco and marijuana policies. With concern for higher rates of marijuana use among those who vape nicotine, the presence of marijuana-related terms in store names was also assessed. A census of stores that were classified online as vape shops/stores or vaporizer stores were telephoned in April-May 2018 (n = 739) and July-September 2019 (n = 919) to verify whether vape products and other tobacco products (OTP) were sold. We computed the percent of stores that closed, opened, and started/stopped selling OTP. Multilevel models tested whether these events varied by store type and by neighborhood demographics. Within 16 months, 11.5% of 739 stores had closed and 29.8% of 919 stores at follow-up had opened. Closings were more likely among vape-only than vape + OTP stores (AOR = 2.51, 95% CI = 1.47,4.29); vape-only stores were less likely to open (AOR = 0.46, 95% CI = 0.34,0.62). Regardless of store type, the odds of a store opening increased as the proportion of non-Hispanic/Latino White residents in the census tract increased (AOR = 1.47, 95% CI = 1.18,1.85). Overall, 2.0% of stores (vape-only and vape + OTP) had marijuana-related names at baseline and 3.5% at follow-up. The observed change (1.6% to 5.8%) was greatest in Oklahoma City, where the state legalized medical marijuana between baseline and follow-up. More stores were opening than closing in six U.S. metropolitan statistical areas before statewide sales restrictions on flavored tobacco and COVID-19. Uniform licensing is recommended to define vape shops and track their location and sales practices.

Latent Class Analysis and Predictors of Marijuana Use among Reservation-based American Indian High School Students

ABSTRACT American Indian (AI) youth residing on reservations report higher rates of marijuana use compared to national youth. Latent class analysis (LCA) was used to identify unique types of marijuana use among 2,884 AI high school students surveyed from 26 schools across six indigenous geographic regions. Predictors of class membership were then assessed using social, cultural, and individual measures relevant to adolescent substance use. Classes and predictors were examined separately for males and females. Four-class models fit the data best for both male and female AI students. Classes differed by sex, as did predictors. Overall, social predictors related to family and peers and the individual predictor, using marijuana to cope, were the best predictors of class membership. Based on these results, prevention and intervention efforts should provide alternative coping methods for these adolescents who often live in difficult situations, and should focus on encouraging parents to effectively monitor their adolescent children and communicate clear sanctions against marijuana use.

Three As of American Indian adolescent marijuana use: Availability, acceptability, and approval

BackgroundAmerican Indian (AI) adolescents report high rates of marijuana use and related consequences and availability of marijuana has a robust relationship with marijuana use. The purpose of the present study was to examine the role of perceptions of approval (i.e., injunctive norms), and acceptability (i.e., descriptive norms and perceived harm) in the relationship between marijuana availability and marijuana use. MethodsData collected from 2009 to 2013 included 3498 AI 7th-12th graders residing on or near a reservation (47.8 % female). Multilevel mediation analyses were conducted using the MLmed macro in IBM SPSS v26.0 to account for the nesting of data within schools. ResultsThe associations between marijuana availability and perceived risks (b=-.38, p < .001), descriptive norms (b = .80, p < .001), and injunctive norms related to marijuana use (b=−.24, p < .001), were significant. The associations between perceived risks (b=−.27, p < .001), descriptive norms (b = .14, p < .001), and injunctive norms (b=−.18, p < .001) and marijuana use were also significant. The indirect effects of marijuana availability on marijuana use through the pathways of perceived risks (b = .10, p < .001, 95 %CI[.08, .12]), descriptive norms (b = .11, p < .001, 95 %CI[.09, .14]), and injunctive norms related to marijuana use (b = .04, p < .001, 95 %CI[.03, .06]) were significant. The direct effect linking marijuana availability to marijuana use remained significant (b = .28, p < .001) but decreased by 37.8 %. when controlling for perceived risks, descriptive norms, and injunctive norms related to marijuana use. ConclusionsInterventions aiming to reduce AI adolescent marijuana use should focus on availability and may also be well served by targeting descriptive and injunctive norms, as well as perceived risks of marijuana use.

Medical Use and Misuse of Prescription Opioids in US 12th-Grade Youth: School-Level Correlates.

Opioid misuse and overdose remains a leading US public health concern, and many youth are first exposed to opioids via medical use. In this study, we examine school-level prevalence and correlates of medical use and misuse of prescription opioids among US 12th-grade students. A sample of 228 507 US 12th-graders in 1079 public and private schools from 2002 to 2017 from the Monitoring the Future study was used to identify school-level prevalence and correlates associated with medical use and misuse of prescription opioids. The past-year prevalence of prescription opioid misuse was 7.6% and ranged from 0% to 73% across US high schools. Lifetime medical use of prescription opioids was 16.9% and ranged from 0% to 85% across US high schools. The odds of prescription opioid misuse were higher at schools with higher proportions of male students, more white students, higher rates of marijuana use, and more medical use of prescription opioids. Students attending schools with the highest rates of medical use of prescription opioids had 57% increased odds of past-year prescription opioid misuse compared with schools with no medical use (adjusted odds ratio = 1.57, 95% confidence interval = 1.35-1.83); this association was found to weaken in recent years. Differences exist in the prevalence of prescription opioid misuse among US high schools. The association between greater school-level medical use of prescription opioids and higher prevalence of prescription opioid misuse, although declining, indicates a key risk factor to target for prevention efforts.

Association Between Electronic Cigarette Use and Marijuana Use Among Adolescents and Young Adults

Use of electronic cigarettes (often called e-cigarettes) has increased considerably among young people in the past 5 years. Use of e-cigarettes has been associated with higher rates of marijuana use, which is associated with several adverse health outcomes in youth. To characterize and quantify the association between e-cigarette and marijuana use among youth using a meta-analysis. PubMed, Embase, and Web of Science & ProQuest Dissertations and Theses were searched from inception to October 2018. A gray-literature search was also conducted on conference abstracts, government reports, and other sources. Included studies compared rates of marijuana use among youth aged 10 to 24 years who had used e-cigarettes vs those who had not used e-cigarettes. Two reviewers independently assessed studies for inclusion; disagreements were discussed with a third reviewer and resolved by consensus. Data were extracted by 2 independent reviewers following Meta-analyses of Observational Studies in Epidemiology (MOOSE) reporting guidelines and pooled using a random-effects analysis. The Newcastle-Ottawa Scale was used to assess data quality and validity of individual studies. Adjusted odds ratios (AORs) of self-reported past or current marijuana use by youth with vs without past or current e-cigarette use. Twenty-one of 835 initially identified studies (2.5%) met selection criteria. The meta-analysis included 3 longitudinal and 18 cross-sectional studies that included 128 227 participants. Odds of marijuana use were higher in youth who had an e-cigarette use history vs those who did not (AOR, 3.47 [95% CI, 2.63-4.59]; I2, 94%). Odds of marijuana use were significantly increased in youth who used e-cigarettes in both longitudinal studies (3 studies; AOR, 2.43 [95% CI, 1.51-3.90]; I2, 74%) and cross-sectional studies (18 studies; AOR, 3.70 [95% CI, 2.76-4.96]; I2, 94%). Odds of using marijuana in youth with e-cigarette use were higher in adolescents aged 12 to 17 years (AOR, 4.29 [95% CI, 3.14-5.87]; I2, 94%) than young adults aged 18 to 24 years (AOR, 2.30 [95% CI, 1.40-3.79]; I2, 91%). This meta-analysis found a significant increase in the odds of past or current and subsequent marijuana use in adolescents and young adults who used e-cigarettes. These findings highlight the importance of addressing the rapid increases in e-cigarette use among youths as a means to help limit marijuana use in this population.

The Safety and Efficacy of Marijuana in Persons Living with HIV.

The prevalence of the use of marijuana throughout the world is substantial. In light of ongoing increases in accessibility to marijuana, safety and efficacy must be established to guide recommendations for safe use. Of particular interest is at-risk populations such as persons living with HIV (PLWH) in whom there are higher rates of marijuana use and inherent risks of comorbid conditions. Databases and reference lists were searched for relevant studies investigating marijuana or cannabinoid use, HIV, and/or pulmonary diseases. The effect of marijuana on the human body is complex and not yet fully understood. The principal components, tetrahydrocannabinol, and cannabidiol interact with cannabinoid receptors. As some cannabinoid receptors are located in the immune system, many have investigated the effect of marijuana on the immune system. Although marijuana would appear to have anti-inflammatory properties, there are conflicting findings on its immune effect in PLWH. In the lung, marijuana smoke is thought to cause harm. Marijuana smokers have shown increased rates of respiratory symptoms, and a variety of changes on lung function has been reported. Limited data are available specific to the safety of marijuana on the lung, cognition, malignancy risk, and cardiovascular disease in PLWH who are already at increased risk of chronic diseases. Marijuana use is common in PLWH, but significant research gaps exist with regard to its safety and efficacy. Until further evidence on its safety is available, recommendations should be to avoid the use in PLWH.

Medical Use and Misuse of Prescription Opioids in the US Adult Population: 2016-2017.

Objectives. To characterize prescription opioid medical users and misusers among US adults.Methods. We used the 2016-2017 National Surveys on Drug Use and Health to compare medical prescription opioid users with misusers without prescriptions, misusers of own prescriptions, and misusers with both types of misuse. Multinomial logistic regressions identified substance use characteristics and mental and physical health characteristics that distinguished the groups.Results. Among prescription opioid users, 12% were misusers; 58% of misusers misused their own prescriptions. Misusers had higher rates of substance use than did medical users. Compared with with-prescription-only misusers, without-and-with-prescription misusers and without-prescription-only misusers had higher rates of marijuana use and benzodiazepine misuse; without-and-with-prescription misusers had higher rates of heroin use. Compared with without-prescription-only misusers, without-and-with-prescription and with-prescription-only misusers had higher rates of prescription opioid use disorder. Most misusers, especially with-prescription-only misusers, used prescription opioids to relieve pain. Misusers were more likely to be depressed than medical users.Conclusions. Prescription opioid misusers who misused both their own prescriptions and prescription opioid drugs not prescribed to them may be most at risk for overdose. Prescription opioid misuse is a polysubstance use problem.

Perceived prevalence of peer marijuana use: changes among college students before and after Oregon recreational marijuana legalization

ABSTRACTBackground: Oregon students’ rates of marijuana use have increased following recreational marijuana legalization (RML), but the relation between RML and students’ perceived peer use of marijuana – or descriptive norms – is unknown. Objectives: This study examined whether perceived peer use of marijuana changed more following RML for college students in Oregon than in states without RML. Methods: Repeated cross-sectional data were collected from the National College Health Assessment-II surveys from 2008 to 2016 to assess changes in descriptive norms (“Within the last 30 days, what percent of students at your school used marijuana?”) among 18–26 year-old undergraduates from two Oregon institutions and 123 institutions in non-RML states (N = 280,006; 66.23% female; 33.19% male) following Oregon RML (7/1/2015). Mixed-effects regressions were used to account for clustering at the institutional level; models controlled for covariates and secular changes in descriptive norms. Results: RML was associated with higher perceived rates of marijuana use by peers [Percent Increase = 3.09, p < .001]. The effect was significant for respondents who had never used marijuana [Percent Increase = 3.72, p < .001], but not for respondents who recently or ever previously used marijuana. Respondents who had recently used marijuana had higher descriptive norms than those who had never used [Percent Increase = 12.83, p < .001]. Conclusions: Given the association between descriptive norms and personal use, RML-related increases in descriptive norms among non-using students could contribute to future marijuana use initiation and may be one mechanism linking RML with higher rates of marijuana use among college students.

The Impact of the Urban Neighborhood Environment on Marijuana Trajectories During Emerging Adulthood.

Although there is little difference in rates of marijuana use between White and Black youth, Blacks have significantly higher rates of marijuana use and disorder in young adulthood. Theory suggests that factors tied to social disadvantage may explain this disparity, and neighborhood setting may be a key exposure. This study sought to identify trajectories of marijuana use in an urban sample during emerging adulthood, neighborhood contexts that predict these trajectories and social role transitions or "turning points" that may redirect them. Data are from a longitudinal cohort study of 378 primarily Black emerging adults who were first sampled in childhood based on their residence in low-income neighborhoods in Baltimore City and followed up annually. Group-based trajectory modeling identified three groups: No Use (68.8%), Declining Use (19.6%), and Chronic Use (11.7%). Living in close proximity to an alcohol outlet, and living in a neighborhood with more female-headed households and higher rates of violent crime increased the odds of membership in the Chronic Use group relative to No Use. Living in a neighborhood with more positive social activity increased the odds of membership in the Declining Use group relative to No Use. Not receiving a high school diploma or GED, pregnancy, and parenting also increased the odds of membership in the Declining Use group relative to No Use. These findings provide support that minority youth living in socially toxic and disordered neighborhoods are at increased risk of continuing on a trajectory of marijuana use during emerging adulthood while positive social activity in neighborhoods has the potential to redirect these negative trajectories. Besides taking on the responsibilities of parenting, emerging adults in the marijuana user groups had similar educational and family outcomes, suggesting that early marijuana use may have long-term implications.

Effect of Urethroplasty on Anxiety and Depression

To our knowledge anxiety and depression in patients with urethral stricture disease and the impact of urethroplasty on mental health has never been explored. We hypothesized that patients with urethral stricture disease would have higher than normal anxiety and depression levels, and urethroplasty would improve mental health. We retrospectively reviewed the records of patients in a multi-institutional reconstructive urology database who underwent anterior urethroplasty. Preoperative and postoperative evaluation of anxiety and depression, and overall health was recorded using the validated EQ-5D™-3L Questionnaire. Sexual function was evaluated with the IIEF (International Index of Erectile Function) and the Men's Sexual Health Questionnaire. Stricture recurrence was defined as the need for a subsequent procedure. Median followup in the 298 patients who met study inclusion criteria was 4.2 months. Preoperative anxiety and depression was reported by 86 patients (29%). Those with anxiety and depression reported higher rates of marijuana use, a worse preoperative IIEF score (17.5 vs 19.6, p = 0.01) and a lower image of overall health (66 vs 79, p ≤0.001). Improvement or resolution of anxiety and depression was experienced by 56% of patients treated with urethroplasty while de novo postoperative anxiety and depression were reported by 10%. These men reported a decreased flow rate (16 vs 25 ml per second, p = 0.01). Clinical failure in 8 patients (2.7%) had no effect on the development, improvement or resolution of anxiety and depression. Of patients with preoperative anxiety and depression 56% reported improvement or resolution after urethroplasty. Although new onset anxiety and depression was rare, these patients had a significantly lower postoperative maximum flow rate, possibly representing a group with a perceived suboptimal surgical outcome. A urethral stricture disease specific questionnaire is needed to further elucidate the interplay of urethral stricture disease with anxiety and depression.

Patterns of Marijuana Use in a 6-Month Pain Management Sample in the United States.

This study is a 6-month retrospective analysis of urine drug testing (UDT) data from a pain management population among specimens with clinician-ordered marijuana testing (N = 194 809). Descriptive statistics about the specimen positivity of clinician-ordered marijuana UDT are provided as well as other drug positivity. Specimens from men and adults aged 18 to 34 years had the highest prevalence rates of marijuana positivity. The prevalence of past-month marijuana use among a comparative national population was lower than the prevalence of positive marijuana tests in the UDT specimens by all characteristics. Among the specimens tested for illicit drugs and marijuana, 4.0% were positive for amphetamine, 2.8% were positive for cocaine, and 0.9% were positive for heroin. The most common prescription drugs listed were opioids (64.7%), benzodiazepines (20.5%), and antidepressants (19.9%). In sum, the findings reflect previous research showing high rates of marijuana use, illicit drug use, and prescription drug use in a pain management population.

A preliminary evaluation of a web-based intervention for college marijuana use.

Young adults in college have high rates of marijuana use, abuse, and dependence. Web-based interventions are increasingly popular, but their dissemination exceeds empirical support. One popular but understudied program is The Marijuana eCHECKUP TO GO (e-TOKE) for Universities & Colleges (San Diego State University Research Foundation, 2009). The aim of the present study was to evaluate its short-term effectiveness in changing marijuana involvement and perceived norms in undergraduates. Participants were 317 undergraduates (52% female, 78% White) who reported marijuana use within the month preceding baseline; each was randomly assigned to 1 of 4 conditions formed by crossing e-TOKE versus assessment only, with brief versus extensive baseline assessment (to assess assessment reactivity). Thus, 161 (51%) received eTOKE (77 with extended baseline, 84 with brief baseline), and 156 (49%) received assessment-only control (85 with extended baseline, 71 with brief baseline). 1 month later, all participants reported on marijuana use, problems, abuse and dependence symptoms, and norms. Assessment reactivity analyses yielded no significant differences by assessment condition. Individuals completing the e-TOKE program reported less extreme descriptive norms (ps < 0.01) but no decrease in marijuana use frequency, problems, abuse or dependence symptoms, or changes in injunctive norms (ps > 0.10). Thus, e-TOKE reduces perceptions of others' use, but this study did not provide evidence for its utility in changing personal use and problem indicators in the short-term. More research with longer follow-ups is indicated, given the possibility that descriptive norms could mediate behavior change.

Continued Detention Involvement and Adolescent Marijuana Use Trajectories

Justice-involved youth have high rates of marijuana use. Less is known about what may drive these rates, particularly when justice-involved youth return to the community. One factor that has been implicated is continued detention involvement. Yet, it is unknown how this factor may influence marijuana use trajectories. Using longitudinal growth curve modeling, the researchers evaluated the association between continued detention involvement and marijuana use trajectories in two large, ethnically diverse samples of community-based, justice-involved youth. Across both samples, marijuana use decreased over time for youth with continued detention involvement but did not change for youth without continued detention involvement. These findings underscore the importance of attending to the influence of detention involvement in community-based, justice-involved adolescents' marijuana use trajectories. This study also highlights the importance of coordinating prevention/intervention programming for justice-involved youth once they are in the community.

The Effect of Tobacco and Marijuana Use on Dental Health Status in Nevada Adolescents: A Trend Analysis

Tobacco use is the leading cause of preventable death worldwide. If current trends persist, tobacco will kill more than 8 million people worldwide by 2030 and 1 billion by the end of the century. The purpose of this study was to determine trends in tobacco/marijuana use in Nevada adolescents and their effect on dental health status. Relative comparative data were compared with nationally reported data. Retrospective data in this cohort study was from an ongoing statewide, school-based, dental health screening initiative that was conducted across 8 years (2002-2010) in public/private middle/high schools in Nevada. A total of 66,941 dental health screenings of adolescents between ages 13-18 were conducted. Self-reported data were collected on tobacco/marijuana use. Descriptive statistics and trends were reported. Means (SE) were computed for caries prevalence and severity. Effect size was reported on dental caries and use of tobacco/marijuana. Overall, percentage prevalence of tobacco use was approximately the same as the national average; however, there were significantly higher rates of marijuana use (12.0% vs. 3.3%). Prevalence and severity of dental caries was significantly higher in those who used tobacco/marijuana than those who did not across all variables and across all 8 years controlling for gender, race/ethnicity, where they lived, and exposure to secondhand smoke. Tobacco use negatively affected dental health status with marijuana having the largest negative effect. The findings from this study identified the need for tobacco/marijuana prevention services targeting adolescents residing in the geographic areas most at risk.

Medical marijuana laws in 50 states: Investigating the relationship between state legalization of medical marijuana and marijuana use, abuse and dependence

Background Marijuana is the most frequently used illicit substance in the United States. Little is known of the role that macro-level factors, including community norms and laws related to substance use, play in determining marijuana use, abuse and dependence. We tested the relationship between state-level legalization of medical marijuana and marijuana use, abuse, and dependence. Methods We used the second wave of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a national survey of adults aged 18+ ( n = 34,653). Selected analyses were replicated using the National Survey on Drug Use and Health (NSDUH), a yearly survey of ∼68,000 individuals aged 12+. We measured past-year cannabis use and DSM-IV abuse/dependence. Results In NESARC, residents of states with medical marijuana laws had higher odds of marijuana use (OR: 1.92; 95% CI: 1.49–2.47) and marijuana abuse/dependence (OR: 1.81; 95% CI: 1.22–2.67) than residents of states without such laws. Marijuana abuse/dependence was not more prevalent among marijuana users in these states (OR: 1.03; 95% CI: 0.67–1.60), suggesting that the higher risk for marijuana abuse/dependence in these states was accounted for by higher rates of use. In NSDUH, states that legalized medical marijuana also had higher rates of marijuana use. Conclusions States that legalized medical marijuana had higher rates of marijuana use. Future research needs to examine whether the association is causal, or is due to an underlying common cause, such as community norms supportive of the legalization of medical marijuana and of marijuana use.

Marijuana and tobacco use among young adults in Canada: are they smoking what we think they are smoking?

The authors characterized marijuana smoking among young adult Canadians, examined the co-morbidity of tobacco and marijuana use, and identified correlates associated with different marijuana use consumption patterns. Data were collected from 20,275 individuals as part of the 2004 Canadian Tobacco Use Monitoring Survey. Logistic regression models were conducted to examine characteristics associated with marijuana use behaviors among young adults (aged 15-24). Rates of marijuana use were highest among current smokers and lowest among never smokers. Marijuana use was more prevalent among males, young adults living in rural areas, and increased with age. Young adults who were still in school were more likely to have tried marijuana, although among those who had tried, young adults outside of school were more like to be heavy users. Males and those who first tried marijuana at an earlier age also reported more frequent marijuana use. These findings illustrate remarkably high rates of marijuana use and high co-morbidity of tobacco use among young adult Canadians. These findings suggest that future research should consider whether the increasing popularity of marijuana use among young adults represents a threat to the continuing decline in tobacco use among this population.

Prevalence of Substance Use and Delinquent Behavior in Adolescents From Victoria, Australia and Washington State, United States

This article compares prevalence estimates of substance use and delinquent behavior in Washington State, United States and Victoria, Australia, two states chosen for their different policy environments around problem behavior. Few comparisons of international differences on rates of multiple problem behavior exist, and most are based on methods that are not matched, raising the question of whether findings are based on methodological differences rather than actual rate differences. The International Youth Development Study used standardized methods to recruit and administer an adaptation of the Communities That Care Youth Survey to representative state samples of fifth-, seventh-, and ninth-grade students in each state. Rates of delinquent behavior were generally comparable. However, striking differences in substance use were noted, with Victoria students reporting higher rates of alcohol use, alcohol misuse, smoking, and inhalant use, whereas Washington State students reported higher rates of marijuana use. Implications for conducting international comparisons are discussed.