TY - JOUR
KW - Adolescent
KW - Adolescent Behavior/psychology
KW - Cannabis/adverse effects
KW - Drug Users/psychology/statistics & numerical data
KW - Female
KW - Humans
KW - Male
KW - Marijuana Smoking/psychology
KW - Odds Ratio
KW - Risk Factors
KW - Self Report/statistics & numerical data
KW - Students/psychology
KW - Substance-Related Disorders/psychology
KW - Surveys and Questionnaires
KW - United States
AU - J. L. Barrington-Trimis
AU - J. Cho
AU - E. Ewusi-Boisvert
AU - D. Hasin
AU - J. B. Unger
AU - R. A. Miech
AU - A. M. Leventhal
A1 - 
AB - IMPORTANCE: While a diverse array of cannabis products that may appeal to youth is currently available, it is unknown whether the risk of persistent cannabis use and progression to higher frequency of use after experimentation differs among cannabis products. OBJECTIVE: To estimate the comparative relative risk of experimental use of 5 cannabis products on use status and frequency of use among adolescents during 12 months of follow-up. DESIGN, SETTING, AND PARTICIPANTS: In this cohort study, data were collected from 3065 adolescents at 10 high schools in southern California, with baseline data collected in spring 2016, when students were in 11th grade, and 6-month and 12-month follow-up surveys collected in fall 2016 and spring 2017, when students were in 12th grade. Analyses, conducted from April to June 2019, were restricted to 2685 participants who were light or nonusers of any cannabis product (ie, ≤2 days in the past 30 days) at baseline. EXPOSURES: Number of days of use of each cannabis product (ie, combustible, blunts, vaporized, edible, or concentrated) in the past 30 days at baseline (ie, 1-2 vs 0 days). MAIN OUTCOMES AND MEASURES: Past 6-month use (ie, yes vs no) and number of days of use in the past 30 days at 6-month and 12-month follow-ups for each product. RESULTS: Of 2685 individuals in the analytic sample, 1477 (55.0%) were young women, the mean (SD) age was 17.1 (0.4) years, and a plurality (1231 [46.6%]) were Hispanic individuals. Among them, 158 (5.9%) reported combustible cannabis use on 1 to 2 days of the past 30 days at baseline, 90 (3.4%) reported blunt use, 78 (2.9%) reported edible cannabis use, 17 (0.6%) reported vaping cannabis, and 15 (0.6%) reported using cannabis concentrates. In regression models adjusting for demographic characteristics and poly-cannabis product use, statistically stronger associations of baseline use with subsequent past 6-month use at the 6-month and 12-month follow-ups were observed for combustible cannabis use (odds ratio, 6.01; 95% CI, 3.66-9.85) and cannabis concentrate use (odds ratio, 5.87; 95% CI, 1.18-23.80) compared with use of blunts (OR, 2.77; 95% CI, 1.45-5.29) or edible cannabis (OR, 3.32; 95% CI, 1.86-5.95) (P for comparison < .05); vaporized cannabis use (OR, 5.34; 95% CI, 1.51-11.20) was not significantly different from the other products. In similarly adjusted models, we found the association of cannabis use at baseline with mean days of use at the 6-month and 12-month follow-ups was significantly stronger for cannabis concentrate than for other cannabis products; participants who had used cannabis concentrate on 1 to 2 of the past 30 days at baseline (vs 0 days) used cannabis concentrate a mean of 9.42 (95% CI, 2.02-35.50) more days in the past 30 days at the 6-month and 12-month follow-ups (P for comparison < .05). CONCLUSIONS AND RELEVANCE: Cannabis control efforts should consider targeting specific cannabis products, including combustible cannabis and cannabis concentrate, for maximum public health consequences.
AD - Department of Preventive Medicine, University of Southern California, Los Angeles.; Department of Preventive Medicine, University of Southern California, Los Angeles.; Department of Preventive Medicine, University of Southern California, Los Angeles.; Department of Psychology, University of Southern California, Los Angeles.; Department of Epidemiology, Columbia University, New York, New York.; Department of Preventive Medicine, University of Southern California, Los Angeles.; Institute for Social Research, University of Michigan, Ann Arbor.; Department of Preventive Medicine, University of Southern California, Los Angeles.; Department of Psychology, University of Southern California, Los Angeles.
BT - JAMA network open
C5 - Education & Workforce; Healthcare Disparities; Opioids & Substance Use
CP - 1
DO - 10.1001/jamanetworkopen.2019.19792
IS - 1
JF - JAMA network open
LA - eng
M1 - Journal Article
N2 - IMPORTANCE: While a diverse array of cannabis products that may appeal to youth is currently available, it is unknown whether the risk of persistent cannabis use and progression to higher frequency of use after experimentation differs among cannabis products. OBJECTIVE: To estimate the comparative relative risk of experimental use of 5 cannabis products on use status and frequency of use among adolescents during 12 months of follow-up. DESIGN, SETTING, AND PARTICIPANTS: In this cohort study, data were collected from 3065 adolescents at 10 high schools in southern California, with baseline data collected in spring 2016, when students were in 11th grade, and 6-month and 12-month follow-up surveys collected in fall 2016 and spring 2017, when students were in 12th grade. Analyses, conducted from April to June 2019, were restricted to 2685 participants who were light or nonusers of any cannabis product (ie, ≤2 days in the past 30 days) at baseline. EXPOSURES: Number of days of use of each cannabis product (ie, combustible, blunts, vaporized, edible, or concentrated) in the past 30 days at baseline (ie, 1-2 vs 0 days). MAIN OUTCOMES AND MEASURES: Past 6-month use (ie, yes vs no) and number of days of use in the past 30 days at 6-month and 12-month follow-ups for each product. RESULTS: Of 2685 individuals in the analytic sample, 1477 (55.0%) were young women, the mean (SD) age was 17.1 (0.4) years, and a plurality (1231 [46.6%]) were Hispanic individuals. Among them, 158 (5.9%) reported combustible cannabis use on 1 to 2 days of the past 30 days at baseline, 90 (3.4%) reported blunt use, 78 (2.9%) reported edible cannabis use, 17 (0.6%) reported vaping cannabis, and 15 (0.6%) reported using cannabis concentrates. In regression models adjusting for demographic characteristics and poly-cannabis product use, statistically stronger associations of baseline use with subsequent past 6-month use at the 6-month and 12-month follow-ups were observed for combustible cannabis use (odds ratio, 6.01; 95% CI, 3.66-9.85) and cannabis concentrate use (odds ratio, 5.87; 95% CI, 1.18-23.80) compared with use of blunts (OR, 2.77; 95% CI, 1.45-5.29) or edible cannabis (OR, 3.32; 95% CI, 1.86-5.95) (P for comparison < .05); vaporized cannabis use (OR, 5.34; 95% CI, 1.51-11.20) was not significantly different from the other products. In similarly adjusted models, we found the association of cannabis use at baseline with mean days of use at the 6-month and 12-month follow-ups was significantly stronger for cannabis concentrate than for other cannabis products; participants who had used cannabis concentrate on 1 to 2 of the past 30 days at baseline (vs 0 days) used cannabis concentrate a mean of 9.42 (95% CI, 2.02-35.50) more days in the past 30 days at the 6-month and 12-month follow-ups (P for comparison < .05). CONCLUSIONS AND RELEVANCE: Cannabis control efforts should consider targeting specific cannabis products, including combustible cannabis and cannabis concentrate, for maximum public health consequences.
PY - 2020
SN - 2574-3805; 2574-3805
T1 - Risk of Persistence and Progression of Use of 5 Cannabis Products After Experimentation Among Adolescents
T2 - JAMA network open
TI - Risk of Persistence and Progression of Use of 5 Cannabis Products After Experimentation Among Adolescents
U1 - Education & Workforce; Healthcare Disparities; Opioids & Substance Use
U2 - 31977062
U3 - 10.1001/jamanetworkopen.2019.19792
VL - 3
VO - 2574-3805; 2574-3805
Y1 - 2020
Y2 - Jan 3
ER -