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Trends and Patterns in Cannabis Use across Different Age Groups

Butler Center for Research - May 2023
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Download the Trends and Patterns in Cannabis Use across Different Age Groups Research Update

Introduction

As of May 2022, 19 U.S. states and the District of Columbia have legalized nonmedical cannabis use, while an additional 17 states have legalized adult medical use.1, 2 The diffusion of cannabis legalization across the U.S. has been coupled with an ever-evolving cannabis market in regards to modes of use, as well as potential increases in cannabis-related disparities and co-use of cannabis and other substances.3–8 Complex patterns of cannabis use have emerged in recent years, with different trends occurring among adults, young adults, and adolescents. These trends and patterns have made cannabis use a critical area of focus for public health and substance use treatment and research.

Trends in the Prevalence of Cannabis Use

According to multiple nationally representative surveys, cannabis use has increased among U.S. adults. Monitoring the Future (MTF) data show that, among adults between 35 and 50, past-year cannabis use significantly increased between 2020 and 2021, subsequently reaching the highest prevalence of past-year use the MTF adult study has ever documented.9 All available nationally representative data indicate that not only has cannabis use been increasing among adults, it has been increasing for over a decade. Specifically, MTF data from 2011 to 2021 indicate that cannabis use nearly doubled in the past 10 years.9

Data from the National Survey on Drug Use and Health (NSDUH) and the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) similarly show that past-year as well as daily (or near-daily) cannabis use among U.S. adults aged 18 and older has increased since approximately 2000.2, 5, 10, 11 Although there are mixed results according to different surveys,12 there are also signs that cannabis use disorder (CUD) is increasing among U.S. adults,2, 13, 14, 15 with the most definitive information being rooted in medical record data.2, 15

Since approximately 2005, cannabis use has increased among U.S. young adults between the ages of 19 and 30.9 In 2021, cannabis use in the past year and past 30 days among young adults reached the highest levels ever recorded since 1988.9

Past Year and Past 30-Day Cannabis Use, Adults Ages 35 to 50 

  2011 2021
Past-Year Cannabis Use           12.6% 24.9%
Past 30-Day Cannabis Use            7.4% 15.8%

Source: Monitoring the Future (2022)

Data from the National Survey on Drug Use and Health (NSDUH) and the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) similarly show that past-year as well as daily (or near-daily) cannabis use among U.S. adults aged 18 and older has increased since approximately 2000.2, 5, 10, 11 Although there are mixed results according to different surveys,12 there are also signs that cannabis use disorder (CUD) is increasing among U.S. adults,2, 13, 14, 15 with the most definitive information being rooted in medical record data.2, 15

Since approximately 2005, cannabis use has increased among U.S. young adults between the ages of 19 and 30.9 In 2021, cannabis use in the past year and past 30 days among young adults reached the highest levels ever recorded since 1988.9

Past Year and Past 30-Day Cannabis Use, Adults Ages 19 to 30

  2005 2021
Past-Year Cannabis Use            26.7% 42.6%
Past 30-Day Cannabis Use            15.1% 28.5%

Source: Monitoring the Future (2022)

In terms of frequency of use, trends indicate that daily and nondaily cannabis use has increased among young adults, with a markedly sharp increase in near-daily use between 2019 and 2021.9

Even though cannabis use among adolescents remains the most prevalent form of drug use and has increased in the past decade,16, 17 cannabis use in general has declined among adolescents in recent years.16

  • Between 2020 and 2021, past-year cannabis use significantly declined by 6.7 percentage points.
  • Between 2020 and 2021, past 30-day cannabis use also significantly declined by 3.6 percentage points, as did daily cannabis use.

Cannabis use is increasing among adults, and it is sharply increasing among young adults. Importantly, there have been marked increases in daily or near-daily use among these two age groups. However, cannabis use has declined among adolescents.

Modes of Cannabis Use

In terms of different modes of cannabis use, leaf/combustible cannabis use remains the most common mode in the U.S., but other modes are increasing in prevalence.3 In fact, the most dramatic increases in cannabis use prevalence among U.S. adults have been found for emerging modes such as edible and vaping modes.3, 6, 18, 19 Other modes of consumption include dabbing and drinking.20 These emerging patterns are not limited to U.S. adults. Among young adults and adolescents, leaf/combustible cannabis use remains prevalent; however, vaping, synthetic, and edible cannabis use have become increasingly common.3, 9

High potency products have emerged in the market that are frequently used with vaping devices and that have more deleterious effects on the brain, and particularly developing brains among young adults.

One of the most pronounced trends in cannabis use is the marked increase in cannabis vaping among young adults in the past five years.9 The rise in cannabis vaping is important for multiple reasons, but a primary concern associated with this increased prevalence is that high potency products have emerged in the market that are frequently used with vaping devices and that have more deleterious effects on the brain, and particularly developing brains among young adults.21 Leaf/combustible cannabis use remains relatively common among young adults, but cannabis vaping markedly increased in 2018 and 2019, and the prevalence of cannabis vaping among U.S. young adults is now stably high, with 18.7% reporting past-year cannabis vaping and 12.4% reporting past 30-day cannabis vaping.9

Among adolescents, cannabis vaping, which is the most common mode aside from leaf/combustible use among adolescents, started to increase from approximately 2017 to 2020.16 Past-year cannabis vaping among adolescents increased from 7% in 2017 to 16% in 2020.16 However, it is important to highlight that past-year cannabis vaping among adolescents declined between 2020 and 2021 by 4.7 percentage points,16 perhaps in relation to the COVID-19 pandemic.23

Disparities in Cannabis Use

For U.S. adults, the increasing prevalence of cannabis use is not occurring uniformly across the entire population. Marked disparities in cannabis use, and increases in cannabis use, have emerged among certain subgroups in recent years,2, 24–26 and particularly males and adults who live in urban areas.9, 22 These disparities exist for any and daily cannabis use.2, 9 Moreover, cannabis use prevalence is markedly higher among U.S. adults who are experiencing mental health issues such as depression.11, 25 Recent increases in cannabis use are disproportionately occurring among those who experience mental health problems.11, 25, 27 Consequently, disparities in cannabis use according to mental health appear to be worsening over time. This disparity in cannabis use associated with mental health is especially marked in states with legalized nonmedical cannabis.25 Depression, anxiety, and psychological distress are strongly associated with any and regular cannabis use, as well as cannabis use disorder.11, 28–30 It is difficult to disentangle the directionality of the mental health-cannabis use relationship, but it is clear that mental health problems, such as untreated depression, are linked to emerging cannabis-related disparities.

Cannabis use is also increasing more rapidly among male, urban, and non-college student young adults,2, 24 as well as young adults with depression, anxiety, and other psychological distress.11, 17 More young adults are also using cannabis as a form of coping.25

Cannabis-related disparities also exist among adolescents. Typically, adolescent males have higher prevalence of cannabis use than females, but in 2021 females reported slightly higher cannabis use.16 Cannabis use is also higher among adolescents who report lower socioeconomic status (SES) compared to their higher SES peers.16, 31 Cannabis use is also higher among adolescents with mental health issues, such as depression.17 There are minimal to no differences in past-year cannabis use across race/ethnicity among adolescents;16 however, White adolescents tend to have higher prevalence of cannabis vaping than their non-White peers.16

Dual Use of Cannabis and Other Substances

Increases in cannabis use prevalence is disproportionately occurring among U.S. adults who use other substances such as nicotine and alcohol. More specifically, the rate of increase in cannabis use prevalence is steeper among U.S. adults who smoke cigarettes and those who drink alcohol.14, 26 Dual use of cannabis and other substances, such as nicotine and/or alcohol, is common among adults and young adults,32, 33 and particularly young adults aged 19–21.33 Many young adults also now engage in simultaneous use of alcohol and cannabis,33 and this co-use can potentially increase the risk of harmful consequences associated with the use of either substance.34

Promoting cumulative protective factors can help adolescents and young adults cope with stress, thereby reducing the risk for cannabis vaping.

Among adolescents, cannabis use is higher among those who report other substance use such as nicotine and alcohol use.31, 35, 36 For instance, nationally representative data show that dual use of cannabis and nicotine vaping is more common than e-cigarette use alone.37–39 Yet, there are emerging trends among adolescents that demonstrate unique patterns of cannabis use and the co-use of nicotine or alcohol. Among adolescents who report lifetime cannabis use, the percentage who had never smoked a combustible cigarette grew from 11% in 2000 to 58% in 2020,40 indicating cannabis use among adolescents who smoke cigarettes (which historically was common) has substantially declined.40 Moreover, simultaneous use of alcohol and cannabis has declined among U.S. adolescents, with historical declines in alcohol use being the driving force behind this trend.41 The prevalence of adolescents who reported past-year cannabis use without past-year alcohol use more than doubled in the last decade,41 indicating cannabis use has increased over time despite declines in alcohol use among adolescents.

Avenues for Prevention and Treatment

Prevention of cannabis vaping among young adults and adolescents should consider the role of risk and protective factors. Protective factors are internal and external processes that increase the likelihood of resilience by contributing to a dynamic process that allows for successful adaptation to challenges or disturbances.42, 43 Youth with more protective factors in their life are less likely to report cannabis vaping, even after adjusting for other substance use.44 Because cumulative protective factors are associated with vaping outcomes, prevention programs should follow evidence-based practices that promote healthy development by building multiple assets, which creates an environment where youth thrive.44 Promoting cumulative protective factors can help adolescents and young adults cope with stress, thereby reducing the risk for cannabis vaping.

A clear pattern in recent years is that cannabis vaping, especially among young adults and adolescents, is increasing rapidly and remains high in prevalence. With an ever-changing market of cannabis use modes that has included a rapid expansion of vaping-related products, cannabis vaping should be a central focus for prevention and treatment efforts. Vaping in general (i.e., nicotine or cannabis vaping) is markedly high among young adults and adolescents.45, 46 Moreover, the co-use of nicotine and cannabis vaping is especially high, and this will likely remain a prevalent form of substance co-use among young adults and adolescents. As a result, treatment of cannabis use disorder should consider the role of other substance use, such as alcohol among adults and young adults, as well as nicotine use, and specifically nicotine vaping, among adolescents and young adults in treatment for CUD. Treatment of alcohol use disorder should also consider the context of increasing cannabis use, and how the co-use of cannabis and alcohol can influence the recovery process.

Finally, both prevention and treatment of cannabis use should continue to integrate the role of mental health, as trends indicate mental health plays a role in cannabis use and current trends in cannabis use.

Conclusion

There are several key takeaways about cannabis use trends and patterns. First, cannabis use prevalence is increasing among U.S. adults and young adults, while there are moderate declines among adolescents in recent years. Second, there are emerging modes of use that are dramatically increasing, such as cannabis vaping. This has especially been the case among young adults. This increase in cannabis vaping is important not only due to the high concentration levels of THC in vaping products, but also because of e-cigarette or vaping-product use associated lung injury, which has been linked to cannabis vaping due to chemicals included in some products.46, 47 Third, there are disparities in cannabis use and increases in cannabis use, and this is particularly the case for disparities linked to mental health. Finally, the trends and patterns in cannabis use outlined here indicate that more harmful patterns of cannabis use (i.e., frequent use, polysubstance use, using to cope) are increasing, especially among young adults. The co-use of cannabis and other substances is prevalent across multiple age groups; additionally, among adults and young adults, cannabis is most prevalent and increasing most rapidly among those who use nicotine and/or alcohol.

The Hazelden Betty Ford Foundation Experience

The Hazelden Betty Ford Foundation helps individuals, families and communities affected by addiction. Hazelden Betty Ford addresses cannabis misuse and addiction in both their inpatient and outpatient settings. Cannabis misuse and addiction are treated with evidence-based therapies such as Twelve Step facilitation, cognitive-behavioral therapy and motivational enhancement therapy, among others, depending on individual needs.

For More Information

About Medical Cannabis

Medical cannabis is a term for derivatives of the Cannabis sativa plant that are used to ease symptoms caused by certain medical conditions. While every state has laws dictating the use of medical marijuana, more than two thirds of U.S. states and the District of Columbia have actually legalized it for medical treatments. The FDA has not approved the cannabis plant for any medical use but has approved medical cannabis for the treatment of two rare and severe forms of epilepsy, Dravet syndrome and Lennox-Gastaut syndrome. The FDA has also approved Marinol and Syndros, which contain dronabinol (synthetic THC), and Cesamet, which contains nabilone (a synthetic substance similar to THC) which are used to treat nausea and vomiting caused by cancer chemotherapy and to treat loss of appetite and weight loss in people with HIV/AIDS.48, 49

However, whether consuming cannabis in any form has therapeutic benefits that outweigh its health risks is still an open question that science has not resolved.48 There is still considerable controversy in the scientific community around a variety of concerns: the plant species to be used; the medical conditions that can be treated, and consequently, the efficacy and safety of use; the routes of administration; the methods of preparation; the type and dosage of cannabinoids to be used; and the active molecules of interest. The results of currently completed and internationally published studies are inconclusive and often contradictory.50 It is important to understand what is known about both the adverse health effects and the potential therapeutic benefits linked to cannabis.

For more information, visit NIDA's research on cannabis. NIDA.NIH.gov/Research-Topics/Marijuana/NIDA -Research-Cannabis-Cannabinoids

References

  1. National Conference of State Legislatures. (2022, May 31). Cannabis overview. ncsl.org/research/civil-and-criminal-justice/marijuana-overview.aspx
  2. Hasin, D., & Walsh, C. (2021). Trends over time in adult cannabis use: A review of recent findings. Current Opinion in Psychology, 38, 80–85. 
    doi.org/10.1016/j.copsyc.2021.03.005
  3. Hammond, D., Goodman, S., Wadsworth, E., Freeman, T. P., Kilmer, B., Schauer, G., Pacula, R. L., & Hall, W. (2022). Trends in the use of cannabis products in Canada and the USA, 2018–2020: Findings from the International Cannabis Policy Study. International Journal of Drug Policy, 105, 103716. doi.org/10.1016/j.drugpo.2022.103716
  4. Patrick, M. E., Bray, B. C., & Berglund, P. A. (2016). Reasons for marijuana use among young adults and long-term associations with marijuana use and problems. Journal of Studies on Alcohol and Drugs, 77(6), 881–888. doi.org/10.15288/jsad.2016.77.881
  5. Pacek, L. R., Weinberger, A. H., Zhu, J., & Goodwin, R. D. (2020). Rapid increase in the prevalence of cannabis use among people with depression in the United States, 2005–17: The role of differentially changing risk perceptions. Addiction, 115(5), 935–943. doi.org/10.1111/add.14883
  6. Smart, R., Caulkins, J. P., Kilmer, B., Davenport, S., & Midgette, G. (2017). Variation in cannabis potency and prices in a newly legal market: Evidence from 30 million cannabis sales in Washington state. Addiction, 112(12), 2167–2177. doi.org/10.1111/add.13886
  7. Seaman, E. L., Stanton, C. A., Edwards, K. C., & Halenar, M. J. (2020). Use of tobacco products/devices for marijuana consumption and association with substance use problems among US young adults (2015–2016). Addictive Behaviors, 102, 106133. doi.org/10.1016/j.addbeh.2019.106133
  8. Seaman, E. L., Green, K. M., Wang, M. Q., Quinn, S. C., & Fryer, C. S. (2019). Examining prevalence and correlates of cigarette and marijuana co-use among young adults using ten years of NHANES data. Addictive Behaviors, 96, 140–147. doi.org/10.1016/j.addbeh.2019.04.014
  9. Patrick, M. E., Schulenberg, J. E., Miech, R. A., Johnston, L. D., O’Malley, P. M., & Bachman, J. G. (2022). Monitoring the Future Panel Study annual report: National data on substance use among adults ages 19 to 60, 1976–2021. Monitoring the Future Monograph Series. University of Michigan Institute for Social Research: Ann Arbor, MI. monitoringthefuture.org/wp-content/uploads/2022/09/mtfpanelreport2022.pdf
  10. Hasin, D. S. (2018). US epidemiology of cannabis use and associated problems. Neuropsychopharmacology, 43(1), 195–212.  doi.org/10.1038/npp.2017.198
  11. Weinberger, A. H., Pacek, L. R., Sheffer, C. E., Budney, A. J., Lee, J., & Goodwin, R. D. (2019). Serious psychological distress and daily cannabis use, 2008 to 2016: Potential implications for mental health? Drug and Alcohol Dependence, 197, 134–140. doi.org/10.1016/j.drugalcdep.2019.01.010
  12. Compton, W. M., Han, B., Jones, C. M., & Blanco, C. (2019). Cannabis use disorders among adults in the United States during a time of increasing use of cannabis. Drug and Alcohol Dependence, 204, 107468. doi.org/10.1016/j.drugalcdep.2019.05.008
  13. Connor, J. P., Stjepanović, D., Le Foll, B., Hoch, E., Budney, A. J., & Hall, W. D. (2021). Cannabis use and cannabis use disorder. Nature Reviews Disease Primers, 7(1), 16. doi.org/10.1038/s41572-021-00247-4
  14. Weinberger, A. H., Pacek, L. R., Wall, M. M., Zvolensky, M. J., Copeland, J., Galea, S., Nahvi, S., Moeller, S. J., Hasin, D. S., & Goodwin, R. D. (2018). Trends  in cannabis use disorder by cigarette smoking status in the United States, 2002–2016. Drug and Alcohol Dependence, 191, 45–51. doi.org/10.1016/j.drugalcdep.2018.06.016
  15. Singh, J. A. (2022). Time-trends in hospitalizations with cannabis use disorder: A 17-year U.S. national study. Substance Abuse, 43(1), 408–414. doi.org/10.1080/08897077.2021.1944956
  16. Miech, R. A., Johnston, L. D., O’Malley, P. M., Bachman, J. G., Schulenberg, J. E., & Patrick, M. E. (2022). Monitoring the Future national survey results on drug use, 1975–2021: Volume I, Secondary school students. Monitoring the Future Monograph Series. University of Michigan Institute for Social Research: Ann Arbor, MI. monitoringthefuture.org/wp-content/uploads/2022/08/mtf-vol1_2021.pdf
  17. Weinberger, A. H., Zhu, J., Lee, J., Anastasiou, E., Copeland, J., & Goodwin, R. D. (2020). Cannabis use among youth in the United States, 2004–2016: Faster rate of increase among youth with depression. Drug and Alcohol Dependence, 209, 107894. doi.org/10.1016/j.drugalcdep.2020.107894
  18. Patrick, M. E., Miech, R. A., Kloska, D. D., Wagner, A. C., & Johnston, L. D. (2020). Trends in marijuana vaping and edible consumption from 2015 to 2018 among adolescents in the US. JAMA Pediatrics, 174(9), 900–902. doi.org/10.1001/jamapediatrics.2020.0175
  19. Romm, K. F., West, C. D., & Berg, C. J. (2021). Mode of marijuana use among young adults: Perceptions, use profiles, and future use. Substance Use & Misuse, 56(12), 1765–1775. doi.org/10.1080/10826084.2021.1949724
  20. Loflin, M., & Earleywine, M. (2014). A new method of cannabis ingestion: The dangers of dabs? Addictive Behaviors, 39(10), 1430–1433. doi.org/10.1016/j.addbeh.2014.05.013
  21. Cuttler, C., LaFrance, E. M., & Stueber, A. (2021). Acute effects of high-potency cannabis flower and cannabis concentrates on everyday life memory and decision making. Scientific Reports, 11, 13784. doi.org/10.1038/s41598-021-93198-5
  22. Parks, M., & Cole, C. (March 2020). Vaping of THC among adults in Minnesota. Minnesota Department of Health. health.state.mn.us/communities/tobacco/ecigarettes/injury/docs/thc_vape.pdf
  23. Miech, R., Patrick, M. E., Keyes, K., O’Malley, P. M., & Johnston, L. (2021). Adolescent drug use before and during U.S. national COVID-19 social distancing policies. Drug and Alcohol Dependence, 226, 108822. doi.org/10.1016/j.drugalcdep.2021.108822
  24. Patrick, M. E., Kloska, D. D., Mehus, C. J., Terry-McElrath, Y., O’Malley, P. M., & Schulenberg, J. E. (2021). Key subgroup differences in age-related change from 18 to 55 in alcohol and marijuana use: U.S. national data. Journal of Studies on Alcohol and Drugs, 82(1), 93–102. doi.org/10.15288/jsad.2021.82.93
  25. Weinberger, A. H., Zhu, J., Levin, J., Barrington-Trimis, J. L., Copeland, J., Wyka, K., Kim, J. H., & Goodwin, R. D. (2020). Cannabis use among US adults with anxiety from 2008 to 2017: The role of state-level cannabis legalization. Drug and Alcohol Dependence, 214, 108163. doi.org/10.1016/j.drugalcdep.2020.108163
  26. Salas-Wright, C. P., Hai, A. H., Oh, S., Alsolami, A., & Vaughn, M. G. (2021). Trends in cannabis views and use among American adults: Intersections with alcohol consumption, 2002–2018. Addictive Behaviors, 116, 106818. doi.org/10.1016/j.addbeh.2021.106818
  27. Fleming, C. B., Duckworth, J. C., Rhew, I. C., Abdallah, D. A., Guttmannova, K., Patrick, M. E., & Lee, C. M. (2021). Young adult simultaneous alcohol and marijuana use: Between- and within-person associations with negative alcoholrelated consequences, mental health, and general health across two years. Addictive Behaviors, 123, 107079. doi.org/10.1016/j.addbeh.2021.107079
  28. Hill, M. L., Nichter, B. M., Norman, S. B., Loflin, M., & Pietrzak, R. H. (2021). Burden of cannabis use and disorder in the U.S. veteran population: Psychiatric comorbidity, suicidality, and service utilization. Journal of Affective Disorders, 278, 528–535. doi.org/10.1016/j.jad.2020.09.099
  29. Leventhal, A. M., Bae, D., Kechter, A., & Barrington-Trimis, J. L. (2020). Psychiatric comorbidity in adolescent use and poly-use of combustible, vaporized, and edible cannabis products. Journal of Psychiatric Research, 124, 91–98. doi.org/10.1016/j.jpsychires.2020.02.021
  30. Patton, G. C., Coffey, C., Carlin, J. B., Degenhardt, L., Lynskey, M., & Hall, W. (2002). Cannabis use and mental health in young people: Cohort study. BMJ, 325(7374), 1195–1198. doi.org/10.1136/bmj.325.7374.1195
  31. Keyes, K. M., Kreski, N. T., Ankrum, H., Cerdá, M., Chen, Q., Hasin, D. S., Martins, S. S., Olfson, M., & Miech, R. (2022). Frequency of adolescent cannabis smoking and vaping in the United States: Trends, disparities and concurrent substance use, 2017–19. Addiction, 117(8), 2316–2324. doi.org/10.1111/add.15912
  32. Parks, M. J., Maggs, J. L., & Patrick, M. E. (2022). Daily fluctuations in drinking intensity: Links with vaping and combustible use of nicotine and marijuana. Drug and Alcohol Dependence, 233, 109347. doi.org/10.1016/j.drugalcdep.2022.109347
  33. Patrick, M. E., Terry-McElrath, Y. M., Lee, C. M., & Schulenberg, J. E. (2019). Simultaneous alcohol and marijuana use among underage young adults in the United States. Addictive Behaviors, 88, 77–81. doi.org/10.1016/j.addbeh.2018.08.015
  34. Lee, C. M., Patrick, M. E., Fleming, C. B., Cadigan, J. M., Abdallah, D. A., Fairlie, A. M., & Larimer, M. E. (2020). A daily study comparing alcohol-related positive and negative consequences for days with only alcohol use versus days with simultaneous alcohol and marijuana use in a community sample of young adults. Alcoholism: Clinical & Experimental Research, 44(3), 689–696. doi.org/10.1111/acer.14279
  35. Paschall, M. J., García-Ramírez, G., & Grube, J. W. (2022). Recreational marijuana legalization and co-use with alcohol among adolescents. American Journal of Preventive Medicine, 62(1), 57–64. doi.org/10.1016/j.amepre.2021.06.003
  36. Wellman, R. J., Dugas, E. N., O’Loughlin, E. K., Sylvestre, M-P., Pelekanakis, A., & O’Loughlin, J. (2022). Natural course of co-use of alcohol and cannabis in adolescents and young adults in Montréal, Canada. Psychology of Addictive Behaviors, 36(7), 775–785. doi.org/10.1037/adb0000766
  37. Farsalinos, K., Barbouni, A., & Niaura, R. (2021). Changes from 2017 to 2018 in e-cigarette use and in ever marijuana use with e-cigarettes among US adolescents: Analysis of the National Youth Tobacco Survey. Addiction, 116(1), 139–149. doi.org/10.1111/add.15162
  38. Gilbert, P. A., Kava, C. M., & Afifi, R. (2021). High-school students rarely use e-cigarettes alone: A sociodemographic analysis of polysubstance use among adolescents in the United States. Nicotine & Tobacco Research, 23(3), 505–510. doi.org/10.1093/ntr/ntaa037
  39. Roberts, M. E., Tackett, A. P., Singer, J. M., Wagner, D. D., Lu, B., Wagener, T. L., Brinkman, M., Klein, E. G., Vickerman, K. A., Wold, L. E., Gumina, R. J., & Mohler, P. J. (2022). Dual use of e-cigarettes and cannabis among young people in America: A new public health hurdle? Journal of Studies on Alcohol and Drugs, 83(5), 768–770. doi.org/10.15288/jsad.2022.83.768
  40. Miech, R. A. (2022). Adolescent cannabis users who have never smoked a combustible cigarette: Trends and level of addictive drug use from 1976 to 2020. Discover Social Science and Health, 2, 3. doi.org/10.1007/s44155-022-00005-1
  41. Keyes, K. M., Kaur, N., Kreski, N. T., Chen, Q., Martins, S. S., Hasin, D., Olfson, M., & Mauro, P. M. (2022). Temporal trends in alcohol, cannabis, and simultaneous use among 12th-grade U.S. adolescents from 2000 to 2020: Differences by sex, parental education, and race and ethnicity. Alcoholism: Clinical & Experimental Research, 46(9), 1677–1686. doi.org/10.1111/acer.14914
  42. Scales, P. C., Benson, P. L., Leffert, N., & Blyth, D. A. (2000). Contribution of developmental assets to the prediction of thriving among adolescents. Applied Developmental Science, 4(1), 27–46. doi.org/10.1207/S1532480XADS0401_3
  43. Masten, A. S. (2015). Ordinary magic: Resilience in development. The Guilford Press.
  44. Parks, M. J., & Patrick, M. E. (2022). Protective factors for nicotine and marijuana vaping among U.S. adolescents. American Journal of Preventive Medicine, 62(3), 414–421. doi.org/10.1016/j.amepre.2021.08.022
  45. Miech, R., Leventhal, A., Johnston, L., O’Malley, P. M., Patrick, M. E., & Barrington-Trimis, J. (2021). Trends in use and perceptions of nicotine vaping among US youth from 2017 to 2020. JAMA Pediatrics, 175(2), 185–190. doi.org/10.1001/jamapediatrics.2020.5667
  46. King, B. A., Jones, C. M., Baldwin, G. T., & Briss, P. A. (2020). The EVALI and youth vaping epidemics—Implications for public health. New England Journal of Medicine, 382(8), 689–691. doi.org/10.1056/nejmp1916171
  47. Ellington, S., Salvatore, P. P., Ko, J., Danielson, M., Kim, L., Cyrus, A., Wallace, M., Board, A., Krishnasamy, V., King, B. A., Rose, D., Jones, C. M., & Pollack, L. A. (2020). Update: Product, substance-use, and demographic characteristics of hospitalized patients in a nationwide outbreak of e-cigarette, or vaping, product use-associated lung injury—United States, August 2019–January 2020. Morbidity and Mortality Weekly Report, 69(2), 44. dx.doi.org/10.15585/mmwr.mm6902e2
  48. National Institute on Drug Abuse. (2020, July). Cannabis (marijuana) research report. nida.nih.gov/download/1380/cannabis-marijuana-research-report.pdf?v=7fc7d24c3dc120a03cf26348876bc1e4
  49. National Center for Complementary and Integrative Health. (2019, November). Cannabis (marijuana) and cannabinoids: What you need to know. nccih.nih.gov/health/cannabis-marijuana-and-cannabinoids-what-you-need-to-know
  50. Barrata, F., Pignata, I., Ravetto Enri, L. & Brusa, P. (2022). Cannabis for medical use: Analysis of recent clinical trials in view of current legislation. Frontiers in Pharmacology, 13, 888903. doi.org/10.3389/fphar.2022.888903
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