Marijuana legalization not associated with encouraged use among youth


Though concern exists about the associations of marijuana legalization and youth use, no links were found in a recent study.

Marijuana legalization not associated with encouraged use among youth | Image Credit: © wollertz - © wollertz -

Marijuana legalization not associated with encouraged use among youth | Image Credit: © wollertz - © wollertz -

With increased support for marijuana legalization across the country, and 24 states that have already legalized marijuana as of March 2024, concerns continue to be raised that youth could be negatively affected or encouraged to use marijuana.1

The reason for concern stems from the negative health outcomes and poorer academic performances associated with youth marijuana use.1

In a recent interview with Contemporary Pediatrics, Angela Nash, PhD, APRN, CPNP-PC, PMHS, associate professor, Cizik School of Nursing Faculty, UT Health Houston noted several substance use trends among youth.2

"The most commonly used substances are, in order, alcohol, marijuana, nicotine, and [counterfeit] prescription drugs," said Nash. See below for the full interview on substance use trends among youth.2

To assess associations between recreational marijuana laws (RMLs) and youth marijuana use, authors of a research letter published in JAMA Psychiatry used a cross-sectional study approach and used data from the Youth Risk Behavior Surveys (YRBS). The authors also used interaction-weighted estimators that allow for heterogeneous and dynamic treatment effects to provide updated estimates of associations.1

Weighted YRBS data for state and nationally from 1993 to 2021 were analyzed separately, as pooling data between sources is "not recommended because underlying person-level weights are different," the authors wrote.1

Any use in the last 30 days defined current marijuana use, while frequent marijuana use was defined as use at least 10 times in the previous 30 days.1

National YRBS data included pre- and post-RML adoption in 12 states, while 9 states included data pre- and post-dispensary sales. The national data also included 36 non-RML states. For state YRBS data, pre- and post-RML adoption were included for 16 states, with 8 states contributing data before and after dispensary sales began. Data from 31 non-RML stats were included.1

The investigative team used multivariate logistic regression analysis, and separately called on the interaction-weighted estimator, allowing for heterogeneous and dynamic treatment effects.1

There were 207,781 national YRBS respondents (mean age 16.04 [1.23] years; 50.90% male). There were 1,549,075 state YRBS respondents (mean age 16.01 [1.23] years; 50.20% male).1

RML adoption, based on national YRBS, was not associated with current marijuana use (odds ratio, 0.97; 95% CI, 0.85-1.10) or frequent marijuana use (odds ratio, 0.98; 95% CI, 0.83-1.16). The investigators found, based on the national YRBS, no association between RMLs and marijuana use during the prelegalization period. No evidence of an increase was observed after legalization.1

Overall, the study revealed no evidence that RMLs were linked with youth encouragement to use marijuana. "Going forward, researchers will want to update our es- timates as additional posttreatment data become available and more states legalize marijuana for recreational purposes," concluded the investigators.1

Related: Substance use trends among youth and importance of screenings


1. Anderson DM, Fe HT, Liang Y, Sabia JJ. Recreational Marijuana Laws and Teen Marijuana Use, 1993-2021. JAMA Psychiatry. Published online April 24, 2024. doi:10.1001/jamapsychiatry.2024.0698

2. Fitch, J. Substance use trends among youth and importance of screenings. Contemporary Pediatrics. April 16, 2024. Accessed April 26, 2024.

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