By Seema Choksy Pessar, Rosanna Smart, Tim Naimi, Marlene Lira, Jason Blanchette, Anne Boustead, and Rosalie Liccardo Pacula

Aims: To measure the association between state cannabis policies and use among adults and youth in the United States from 2002 to 2019, given rapid policy liberalization and complex state cannabis policy environments.

Design: Repeated cross-sectional time series analysis. Three sets of models assessed the linear association between the Cannabis Policy Scale (CPS), an aggregate measure of 17 state cannabis policy areas that weights each policy by its efficacy and implementation rating, and prevalence of cannabis use. The first included year and state fixed effects; the second added state-level controls; the third replaced state fixed effects with state random effects. Standard errors were clustered at the state level in all models.

Setting and participants - United States.

Measurements: Past-month prevalence of cannabis use is from the National Survey on Drug Use and Health Small Area Estimates, a nationally and state-representative cross-sectional survey of household population ages 12 and older for years 2002–2003 to 2018–2019. Exposure data include the CPS.

Findings: A 10 percentage-point increase in the CPS (i.e. greater cannabis policy restrictiveness) was associated with lower past-month use prevalence by 0.81 (95% confidence interval [CI] = -1.05 to −0.56) to 0.97 (95% CI = -1.19 to −0.75) percentage-points for the population ages 12 years and older. When models were stratified by age, a 10 percentage-point increase in the CPS was associated with a 0.87 (95% CI = -1.13 to −0.61) to 1.04 percentage-point (95% CI = -1.03 to −0.84) reduction in past-month use prevalence for adults ages 18 years and older, and a 0.17 (95% CI = -0.24 to −0.09) to 0.21 percentage-point (95% CI = -0.35 to −0.07) reduction for youth ages 12–17 years.

Conclusions: More restrictive US cannabis policies appear to be associated with reduced cannabis use for both adults and youth.

Addiction; Early View, 2024, 7p.

By Namkee G. Choi, C. Nathan Marti, Bryan Y. Choi

Background: Cannabidiol (CBD) use has been increasing for its putative therapeutic potential for various health conditions. Research using a nationally representative sample is needed to examine characteristics of CBD users. Methods: Data came from the adult sample (N=47,100) of the 2022 U.S. National Survey on Drug Use and Health. We fitted generalized linear models to examine the sociodemographic, health, other substance use, and cannabis risk perception as correlates of CBD-only use and CBD-cannabis co-use, compared to cannabis-only use. Results: In 2022, 20.6 % and 23.0 % of U.S. adults reported using CBD and cannabis, respectively, in the preceding 12 months, and 63 % of CBD users also used cannabis. CBD use was significantly higher among women (CBD-only vs. cannabis-only use: IRR=1.43, 95 % CI=1.31–1.57), but significantly lower among Black and Hispanic individuals compared to non-Hispanic White individuals (CBD-only vs. cannabis-only use: IRR=0.71, 95 % CI=0.60–0.85 for Black individuals; IRR=0.79, 95 % CI=0.65–0.96 for Hispanic individuals). Older ages, higher SES, chronic medical conditions, mental illness, and high cannabis risk perception were also associated with higher likelihood of CBD-only use versus cannabis-only use. CBD-cannabis co-users were at most risk in terms of chronic illness, mental illness, cannabis use disorder, and other substance use problems. Conclusions: The high prevalence of self-reported CBD use among those with physical and mental health problems warrants public health warnings about potential side effects and drug interactions. The high CBD-cannabis co-use rate also calls for more research on potential benefits and negative effects of the co-use.

Drug and Alcohol Dependence Reports Volume 13, December 2024, 100289