Youth Marijuana Use Research Articles

Recreational Marijuana Laws and Teen Marijuana Use, 1993-2021

This cross-sectional study uses data from the Youth Risk Behavior surveys to assess the association of state-level recreational marijuana laws and youth marijuana use.

The effect of youth marijuana use on high-risk drug use: Examining gateway and substitution hypothesis

Youth high-risk drug use causes harm to individuals and raises social concerns in the United States (US). To prevent youth high-risk drug use effectively, it is crucial to identify and address the significant risk factors. Some view the use of low-risk drugs (e.g., marijuana) as one such risk factor, though studies posit conflicting arguments about the effect of youth marijuana use. Some argue that youth marijuana use is a gateway to high-risk drug use; therefore, youth marijuana use boosts the likelihood of high-risk drug use. However, others postulate that there is a substitution effect of youth marijuana use, in which youth marijuana use replaces and, therefore, reduces their high-risk drug use. Our study aims to clarify these two conflicting arguments by examining the following hypotheses: (i) there is a significant discrepancy in youth high-risk drug use between marijuana-using youths and non-marijuana-using youths, and (ii) youths who consume marijuana are significantly more likely to use high-risk drugs after controlling for individual and environmental characteristics. To test our hypotheses, we analyzed nationally representative youth survey data collected between 2010 and 2019, determining the annual average comparison and performing comparative multiple regression analyses. The results from these analyses show that there is a significant gateway effect of youth marijuana use, with youth marijuana use significantly increasing high-risk drug use after controlling for individual and environmental risk factors. Considering the recent marijuana legalization trends in the US, this finding suggests that policymakers should pay close attention to the gateway effect of youth marijuana use.

The Public Health Effects of Legalizing Marijuana

Thirty-six states have legalized medical marijuana and 18 states have legalized the use of marijuana for recreational purposes. In this paper, we review the literature on the public health consequences of legalizing marijuana, focusing on studies that have appeared in economics journals as well as leading public policy, public health, and medical journals. Among the outcomes considered are: youth marijuana use, alcohol consumption, the abuse of prescription opioids, traffic fatalities, and crime. For some of these outcomes, there is a near consensus in the literature regarding the effects of medical marijuana laws (MMLs). As an example, leveraging geographic and temporal variation in MMLs, researchers have produced little credible evidence to suggest that legalization promotes marijuana use among teenagers. Likewise, there is convincing evidence that young adults consume less alcohol when medical marijuana is legalized. For other public health outcomes such as mortality involving prescription opioids, the effect of legalizing medical marijuana has proven more difficult to gauge and, as a consequence, we are less comfortable drawing firm conclusions. Finally, it is not yet clear how legalizing marijuana for recreational purposes will affect these and other important public health outcomes. We will be able to draw stronger conclusions when more posttreatment data are collected in states that have recently legalized recreational marijuana. (JEL I12, I18, K32, K42, R41)

Latent Classes of Perceived Addictiveness Predict Marijuana, Alcohol, and Tobacco Use in Youth and Young Adults

Background: Mass media substance use prevention efforts target addiction perceptions in young people. This study examined youth and young adults’ (YAs) perceived addictiveness across several substances and the associations between addiction perceptions and substance use. Methods: Data were collected in 2019 in an online cohort study of Vermonters aged 12–25. Latent class analyses grouped participants by perceived addictiveness of nicotine, caffeine, alcohol, marijuana, cigarettes, electronic vapor products (EVPs), and opioids. Bivariate multinomial logistic and modified Poisson regression estimated associations between sociodemographics, substance use correlates, and subsequent use across latent classes. Results: Four latent classes captured addiction perceptions: high perceived addictiveness of EVPs, cigarettes, marijuana, and alcohol (Class 1: n = 317; 31.3%), low perceived addictiveness of marijuana, alcohol, and caffeine (Class 2: n = 151; 14.3%), low perceived addictiveness of marijuana (Class 3: n = 581; 46.5%), and low perceived addictiveness of nicotine, cigarettes, and EVPs (Class 4: n = 83; 7.9%). For each year increase in age, there was a 36% increased likelihood of being in Class 2 (vs. Class 1) and a 148% increased likelihood of belonging to Class 3 (vs. Class 1). Low perceived addictiveness classes were associated with ever and past 30-day marijuana and alcohol use and predicted past 30-day alcohol use at three-month follow-up. Membership in Classes 2 and 3 also predicted past 30-day marijuana use at Wave 3. Discussion: The strong association between age and latent classes defined by low perceived addictiveness suggests age group differences in addiction perceptions. Findings suggest that YAs may benefit from prevention messaging on addictiveness.

The kids aren’t alright: The effects of medical marijuana market size on adolescents

We exploit shocks to US federal enforcement policy to assess how legal medical marijuana market size affects youth marijuana use and consequences for youth traffic-related fatalities. Using hand-collected data on state medical marijuana patient rates to develop a novel measure of market size, we find that legal market growth increases youth marijuana use. Likely mechanisms are lower prices and easier access. Youth die more frequently from alcohol-involved car accidents, suggesting complementarities for youths. The consequences of marijuana legalization for youth are not immediate, but depend on how supply-side regulations affect production and prices.

The influence of parent and peer disapproval on youth marijuana use mediated by youth risk perception: Focusing on the state comparison

BackgroundThe prevention of youth marijuana use has become a national priority in the United States. This study examined the influence of parent and peer disapproval on youth marijuana use, mediated by youth risk perception. Because the legal status of marijuana use can influence individual perceptions of the drug, this study investigated differences in the mediating mechanism between youth living in states with medical marijuana legalization (MML) and those living in non-MML states. MethodsThe 2019 National Survey of Drug Use and Health was used with a youth population aged 12–17 years (N = 2293). Structural equation modeling and bias-corrected bootstrapping were used to examine hypothesized path models and to evaluate the mediating effect of youth risk perception. ResultFindings demonstrated that parent and peer disapproval significantly increased youth risk perception of marijuana and reduced youth marijuana use. Second, youth risk perception significantly mediated the association between parent and peer disapproval and youth marijuana use. Third, parent disapproval had a more significant direct effect on youth marijuana use, while peer disapproval had a more significant indirect effect on youth marijuana use via youth risk perception. Finally, the results showed a similar pattern in the mechanism between youths living in MML states compared with those in non-MML states in terms of significance and direction. ConclusionThe findings suggested a need for improvements in marijuana related policies for both MML and non-MML states. Moreover, parent and peer focused strategies for education and prevention concerning marijuana use among youth are emphasized.

Regional Disparities in Youth Marijuana Use Before and After Recreational Marijuana Legalization: A Longitudinal Examination from 2010 to 2020

Studies have argued that the recent recreational marijuana legalization should increase the accessibility and acceptability of marijuana for youth and elevate youth marijuana use. While many empirical studies have supported this argument and presented the increase in youth marijuana use after the legalization, there has been no study that examines regional disparities in the effect of legalization on youth marijuana use. The examination of regional disparities is required because the different sub-culture and attitudes across regions should generate differentiated situations for youth marijuana use. The current study analyzes eleven-year datasets, “Monitoring the Future: A Continuing Study of American Youth - 12th-Grade Survey ” from 2010 to 2020, and investigates the distinctive temporal changes in youth marijuana use across regions before and after marijuana legalization. The results show that the legalization effect is critical in some regions without pre-existing availability of marijuana but not in the other regions with pre-existing availability. This study concludes that policymakers should consider local situations to deter youth marijuana use more effectively.

Examination of the Relationship Between Daily Perceptions of Collective Efficacy and Marijuana Use Among Black Youth: Does the Location of the Perception Matters?

Neighborhood-level collective efficacy protects Black youth from substance use; however, neighborhood research does not account for the entirety of adolescents' exposure or their perceptions of space which may be critical to understanding the role of context in substance use. To address this limitation, the SPIN Project recruited 65 Black adolescents (M(SD) = 15.32(1.06)) to complete four brief surveys each day for a month describing their perceptions of spaces and marijuana use. Multilevel negative binomial models were estimated to test the relationship between an individual's perceptions of collective efficacy and the marijuana used during a day, and if the location of the observations moderated these relationships. Findings indicated that the perceptions of collective efficacy protected adolescents from marijuana use when occurring within their home neighborhood, but not outside of it; thereby suggesting important variations in adolescents' perceptions based on the location that matter for Black youth marijuana use.

Parental Educational Attainment and Frequency of Marijuana Use in Youth: Hispanics’ Diminished Returns

Background: While socioeconomic status (SES) indicators such as parental educational attainment show robust associations with health behaviors such as substance use, the protective effects of these indicators may differ across racial groups. This phenomenon of weaker associations between SES indicators and health outcomes for marginalized and minoritized groups relative to non-Hispanic White people has been labeled “Marginalization-related Diminished Returns” (MDRs). Here, we test both whether parental educational attainment is associated with marijuana use frequency in youth as well as whether we observe racial and ethnic variation in this association consistent with MDRs. Methods: This study used data from the cross-sectional 2019 Monitoring the Future survey (MTF 2019). Participants included 29,230 youth who were either Hispanic (24.1%), non-Hispanic Black (16.1%), or non-Hispanic White (59.9%). We used weighted logistic regression models to test for (1) associations between maternal educational attainment and youth cannabis use frequency as well as (2) moderation of this association by race/ethnicity, while adjusting for the complex sample design of the MTF 2019 data. Age, sex, father presence, and maternal employment were entered into models as covariates. Results: Overall, children born to mothers with higher educational attainment reported less frequent marijuana use than peers born to mothers with lower educational attainment. However, this association was significantly weaker in Hispanic versus non-Hispanic White youth. Conclusion: The strength of the association between parental educational attainment and youth marijuana use frequency appears to differ across ethnic groups. Specifically, we observed that whereas non-Hispanic White youth from high-SES families tend to report less marijuana use than peers from lower-SES families, Hispanic youth report roughly equal levels of use across the full SES spectrum. This finding is in line with the MDRs framework and may reflect factors such as structural racism, social stratification, and the marginalization of ethnic minority families in the US.

Pandemic sees steady alcohol and marijuana use in youth

Despite seeing a historic decline in youths' perceived availability of alcohol and marijuana during last year's peak of COVID‐19 restrictions, use of these substances did not show a corresponding drop, newly released data indicates. The study's lead author told CPU that the findings were so surprising to him that he had to set them aside for a time to try to process what he was seeing.

42.8 EFFECT OF MARIJUANA LEGALIZATION IN CHILDREN AND YOUTH IN THE UNITED STATES: A SYSTEMATIC REVIEW

Marijuana legalization has been on the rise in the United States. However, there is significant concern regarding the effect of legalization on youth marijuana use. The current study aims to review the literature related to the effects of recreational and medical marijuana legalization (RML and MML, respectively) on marijuana use in youth.

Youth Exposure to Marijuana Advertising in Oregon's Legal Retail Marijuana Market.

IntroductionResearch from tobacco and alcohol markets suggests advertising exposure is associated with perceptions of lower risk and increased use among young people. Limiting marketing may be a regulatory approach to prevent potential negative effects of retail marijuana legalization on youth use. This study assessed marijuana advertising exposure reported by youths in Oregon after the start of retail marijuana sales in October 2015.MethodsData from a 2017 school-based survey of Oregon 8th (N = 14,852) and 11th (N = 11,895) graders were used to characterize marijuana advertising exposure. Subgroup differences in reported exposure were assessed by using Pearson χ2 tests and multiple logistic regression.Results About three-quarters of 8th (72.2%) and 11th graders (78.1%) in Oregon reported seeing marijuana advertising in the past month. Youths most frequently reported seeing advertising on storefronts and online, and odds of exposure were significantly higher for girls; lesbian, gay, or bisexual youths; current marijuana users; 8th graders living with an adult who uses marijuana; and youths in school districts with a closer average proximity to retail marijuana stores.ConclusionReporting exposure to marijuana advertising is common among youths in Oregon’s legal retail market. Oregon and other states working to prevent youth marijuana use may want to examine how well their rules are working to prevent youth exposure. Although some sources of youth advertising exposure may be difficult to regulate and enforce (eg, online), others may be within the purview of state authority (eg, billboards, storefronts) depending on state-specific interpretation of free speech protections.

Marijuana Legalization and Youth Marijuana, Alcohol, and Cigarette Use and Norms

Rates of adolescent substance use have decreased in recent years. Knowing whether nonmedical marijuana legalization for adults is linked to increases or slows desirable decreases in marijuana and other drug use or pro-marijuana attitudes among teens is of critical interest to inform policy and promote public health. This study tests whether nonmedical marijuana legalization predicts a higher likelihood of teen marijuana, alcohol, or cigarette use or lower perceived harm from marijuana use in a longitudinal sample of youth aged 10-20 years. Data were drawn from the Seattle Social Development Project-The Intergenerational Project, an accelerated longitudinal study of youth followed both before (2002-2011) and after nonmedical marijuana legalization (2015-2018). Analyses included 281 youth surveyed up to 10 times and living in a state with nonmedical marijuana legalization between 2015 and 2018 (51% female; 33% white, 17% African American, 10% Asian/Pacific Islander, and 40% mixed race or other). Multilevel modeling in 2019 showed that nonmedical marijuana legalization predicted a higher likelihood of self-reported past-year marijuana (AOR=6.85, p=0.001) and alcohol use (AOR 3.38, p=0.034) among youth when controlling birth cohort, sex, race, and parent education. Nonmedical marijuana legalization was not significantly related to past-year cigarette use (AOR=2.43, p=0.279) or low perceived harm from marijuana use (AOR=1.50, p=0.236) across youth aged 10-20 years. It is important to consider recent broad declines in youth substance use when evaluating the impact of nonmedical marijuana legalization. States that legalize nonmedical marijuana for adults should increase resources for the prevention of underage marijuana and alcohol use.

CIGARETTE TAXES AND TEEN MARIJUANA USE.

The spillover effect of cigarette taxes on youth marijuana use has been the subject of intense public debate. Opponents of cigarette taxes warn that tax hikes will cause youths to substitute toward marijuana. On the other hand, public health experts often claim that because tobacco is a "gateway" drug, higher cigarette taxes will deter youth marijuana use. Using data from the National and State Youth Risk Behavior Surveys (YRBS) for the period 1991-2017, we explore the relationship between state excise taxes on cigarettes and teen marijuana use. In general, our results fail to support either of the above hypotheses. Rather, we find little evidence to suggest that teen marijuana use is sensitive to changes in the state cigarette tax. This null result holds for the sample period where cigarette taxes are observed to have the largest effect on teen cigarette use and across a number of demographic groups in the data. Finally, we find preliminary evidence that the recent adoption of state e-cigarette taxes is associated with a reduction in youth marijuana use.

A survey-wide association study to identify youth-specific correlates of major depressive episodes.

Major depressive disorder is a common disease with high mortality and morbidity worldwide. Though peak onset is during late adolescence, the prevalence of major depressive disorder remains high throughout adulthood. Leveraging an association study design, this study screened a large number of variables in the 2017 National Survey on Drug Use and Health to characterize differences between adult and youth depression across a wide array of phenotypic measurements. All dichotomous variables were manually identified from the survey for association screening. Association between each dichotomous variable and past-year major depressive episode (MDE) occurrence was calculated as an odds ratio for adults (≥18 years) and youth (12-17 years), and tested for significance with Fischer's exact test. Logarithm of the calculated odds ratios were plotted and fitted to a linear model to assess correlation between adult and youth risk factors. Many of the screened variables showed similar association between past-year depressive episode occurrence in youth and adults; Lin's concordance correlation coefficient between adult and youth associations was 0.91 (95% CI 0.89-0.92). Differentially associated variables were identified, tracking: female sex, alcohol use, cigarette use, marijuana use, Medicaid/CHIP coverage, cognitive changes due to a mental, physical or emotional condition, and respondents' identification of a single depressive event as the worst experienced. While some youth-specific correlates of major depressive episodes were identified through screening, including some novel associations, most examined variables showed similar association with youth and adult depression. Further study of results is warranted, especially concerning the finding of increased association between marijuana use and depressive episodes in youth.

Adolescent treatment admissions for marijuana following recreational legalization in Colorado and Washington

IntroductionThere is concern that recreational marijuana legalization (RML) may lead to increased cannabis use disorder (CUD) among youth due to increased marijuana use. This study investigates whether adolescent substance use disorder treatment admissions for marijuana use increased in Colorado and Washington following RML. MethodsAnnual data on 2008–2017 treatment admissions for marijuana use from the SAMHSA TEDS-A dataset for adolescents age 12–17 were used to model state treatment admissions trends. Difference-in-differences models were used to investigate whether treatment admissions increased following RML in Colorado/Washington compared to non-RML states, after adjusting for socioeconomic characteristics and treatment availability. ResultsOver all states in the analysis, the rate of adolescent treatment admissions for marijuana use declined significantly over the study period (β=−3.375, 95 % CI=−4.842, −1.907), with the mean rate falling nearly in half. The decline in admissions rate was greater in Colorado and Washington compared to non-RML states following RML, though this difference was not significant (β=-7.671, 95 % CI=-38.798, 23.456). ConclusionAdolescent treatment admissions for marijuana use did not increase in Colorado and Washington following RML. This may be because youth marijuana use did not increase, CUD did not increase (even if use did increase), or treatment seeking behaviors changed due to shifts in attitudes and perceptions of risk towards marijuana use.

The Critical Lack of Data on Alcohol and Marijuana Use by Adolescents on the Autism Spectrum.

Why is this topic important?: Alcohol is the most commonly used substance among adolescents, and marijuana is the most commonly used illicit drug. Previous studies suggest that at least some autistic individuals may be at increased risk of substance use disorder compared with allistic counterparts, potentially to control social anxiety or facilitate social interaction. However, to the best of our knowledge, estimates of substance use by autistic youth in the United States are limited.What is the purpose of this article?: This study was performed to highlight the lack of data sets that collect information about alcohol and/or marijuana use by autistic youth in the United States. We systematically reviewed U.S. data sources on child and/or adolescent health, disability, and/or substance use to identify sources that could generate estimates of the prevalence of substance use among autistic adolescents in the United States, even if those estimates may not be stable due to small sample sizes or other methodological weaknesses.What is the perspective of the authors?: The authors are a team of allistic researchers. M.B.-M. and S.B.-F. are pediatricians. E.F.R. and A.A. are public health researchers. S.B.-F. has an extensive background in providing clinical health care services to children with autism and is an autism researcher. R.A.N.P. and A.C.S.-R. are master's level public health research assistants. E.F.R., A.A., and M.B.-M. are adolescent health research experts. E.F.R. has an adolescent daughter on the autism spectrum. Our collective positionality is that we identify as people who are not autistic and who select to focus on research that we hope will benefit autistic people and society in general.What did the authors find?: Based on our four-step investigation, we identified 19 U.S. data sources that had the potential to generate estimates of the prevalence of alcohol and/or marijuana use in autistic youth. Only one included information about both autism and substance use.What do the authors recommend?: The National Institutes of Health (NIH), and the National Institute of Alcohol Abuse and Alcoholism (NIAAA) and National Institute of Drug Abuse (NIDA), specifically, should prioritize funding data collection from autistic youth and adults on alcohol and marijuana use, misuse, hazardous use, dependence, and use disorders. In addition, it is critical that nationally representative surveys and data sources include robust questions on autism and substance abuse. This includes assessing autism status in multiple ways (e.g., self-report, diagnosis by a clinician, neuropsychology reports). Substance use questions should include age of first drink or use, frequency of use, quantity of use per day or within a certain number of hours, expectancies, consequences of use, and indicators of alcohol use disorder.How will these recommendations help autistic individuals?: These findings highlight a critical gap in the literature on substance use among autistic youth. Substance use is recognized as a pressing adolescent health problem, and autistic youth deserve evidence-based substance use prevention strategies. Without an estimate of substance use by autistic youth, it is difficult to justify to funding entities the expenditure of resources on the development of evidence-based substance use prevention strategies to benefit them.

Cigarette Taxes and Teen Marijuana Use

The spillover effect of cigarette taxes on youth marijuana use has been the subject of intense public debate. Opponents of cigarette taxes warn that tax hikes will cause youths to substitute toward marijuana. On the other hand, public health experts often claim that because tobacco is a “gateway” drug, higher cigarette taxes will deter youth marijuana use. Using data from the National and State Youth Risk Behavior Surveys (YRBS) for the period 1991-2017, we explore the relationship between state excise taxes on cigarettes and teen marijuana use. In general, our results fail to support either of the above hypotheses. Rather, we find little evidence to suggest that teen marijuana use is sensitive to changes in the state cigarette tax. This null result holds for the sample period where cigarette taxes are observed to have the largest effect on teen cigarette use and across a number of demographic groups in the data. Finally, we find preliminary evidence that the recent adoption of state e-cigarette taxes is associated with a reduction in youth marijuana use. Institutional subscribers to the NBER working paper series, and residents of developing countries may download this paper without additional charge at www.nber.org.

Child Maltreatment, Relationship With Father, Peer Substance Use, and Adolescent Marijuana Use

This longitudinal prospective study examined the relationship between child maltreatment as per reports to child protective services (CPS) and adolescent self-reported marijuana use, and the association between relationships with mothers and fathers and use of marijuana. The association between relationships with parents early in childhood (ages 6 to 8 years) and during adolescence with adolescent marijuana use were also probed. Another aim examined whether relationships with parents moderated the link between child maltreatment and youth marijuana use. The sample included 702 high-risk adolescents from the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN), a consortium of five studies related to maltreatment. Children were recruited at age 4 or 6 years together with their primary caregiver. Some were recruited due to their risk for child maltreatment, others were already involved with CPS, and children in one site had been placed in foster care. Logistic regression analysis was performed using youth self-report of marijuana use as the criterion variable and child maltreatment and the relationships with parents as predictor variables, controlling for youths’ perceptions of peer substance use and parental monitoring, parental substance use, race/ethnicity, sex, and study site. Approximately half the youths had used marijuana. Most of them described quite positive relationships with their mothers and fathers. Participant marijuana use was associated with a poorer quality of relationship with mother during adolescence, and with peer and parental substance use. A better relationship with father, but not mother, during adolescence attenuated the connection between child maltreatment and youth marijuana use.

Consequences of Marijuana Use in HIV-infected Youth

Consequences of Marijuana Use in HIV-infected Youth