Risk of Persistence and Progression of Use of Five Cannabis Products after Experimentation among Adolescents

With many adolescents experimenting with cannabis and the variety of cannabis products available with each product varying in their THC level, mechanism of use, and intoxicating effects experienced, this study aimed to determine whether certain products are associated with persistent or frequent use among adolescents who experiment with cannabis. This study included students from 10 public high schools in Los Angeles, California, with baseline data assessed during their 11th grade year and follow up data assessed during their senior year. The baseline included students who reported either no cannabis use within the past 30 days or light cannabis use, defined as using cannabis once or twice within the past 30 days. Students were then assessed for follow up data at 6 and 12 months. The measures assessed included previous 6-month use and the number of days of use within the previous 30 days for the following five cannabis products: combustible cannabis, blunts, electronic device for use of vaping cannabis or hash oil, food or drinks containing THC, and cannabis concentrates. Various covariates were included in the analysis.

When adjusted for covariates including poly-cannabis product use, students who reported using any cannabis product on one or two days within the previous 30 days at the initial assessment were associated with significantly greater odds of using that product at follow up. The strength of association was stronger for combustible cannabis and cannabis concentrate products. In analyzing the frequency of previous 30-day cannabis use after adjusting for covariates, using cannabis concentrates or combustible cannabis at baseline were observed to have a statistically significant stronger association with the average number of days of use at follow up than the other products. In analysis of cross-product associations, using combustible cannabis at baseline was associated with significantly greater odds of using any cannabis product at follow up. Combustible cannabis was also associated with increased frequency of using other products with the exception of cannabis concentrates.

Based on these findings, persistence and progression of cannabis use likely varies pending the cannabis product used, with greater risk associated with using combustible cannabis and cannabis concentrates among adolescents who experiment with cannabis. Regardless of the product used, prevalence of cannabis at follow up was higher for those who experimented with cannabis at baseline, underscoring the importance of preventing initiation of cannabis use among adolescents, especially considering the adverse effects of cannabis use on adolescents’ development.

Barrington-Trimis, J. L., Cho, J., Ewusi-Boisvert, E., Hasin, D., Unger, J. B., Miech, R. A., & Leventhal, A. M. (2020). Risk of persistence and progression of use of 5 cannabis products after experimentation among adolescents. Jama Network Open, 3(1). doi: 10.1001/jamanetworkopen.2019.19792.

Citation
Barrington-Trimis, J. L., Cho, J., Ewusi-Boisvert, E., Hasin, D., Unger, J. B., Miech, R. A., & Leventhal, A. M. (2020). Risk of persistence and progression of use of 5 cannabis products after experimentation among adolescents. Jama Network Open, 3(1). doi: 10.1001/jamanetworkopen.2019.19792.
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