The prevalence of youth vaping of cannabis products is on the rise.
A group of researchers from the University of Queensland in Australia conducted a systematic review and meta-analysis of 17 unique studies from the US and Canada that included nearly 200,000 adolescents. The study was published Monday in JAMA Pediatrics.
Results showed that prevalence of cannabis vaping over the teen’s lifetime doubled between the years 2013 to 2020, jumping from about 6.1% to 13.6%. When researchers looked specifically at the prevalence of cannabis vaping among adolescents in the past 30 days during this same time period, that use increased seven-fold, researchers noted, from 1.6% to 8.4%.
In the United States, the cannabis legalization landscape has changed dramatically since the first legal adult use sales took place in Colorado in 2014. Since then, more than one-third of states have legalized cannabis for adults, and almost every state in the country has legalized medical cannabis in some form. Also during this time, the prevalence of vaping, both cannabis and nicotine, among teenagers rose.
“Preference for cannabis products may be shifting from dried herb to cannabis oil,” researchers noted in the results of the study. “The findings of this study suggest that more effective prevention and response measures are required to mitigate the increasing prevalence of cannabis vaping among adolescents.”
Lead author Carmen C. W. Lim, a biostatistician and a PhD candidate at the National Centre for Youth Substance Use Research in Queensland, told Cannabis Wire that “these findings are concerning but not surprising” because the pace of legalization is picking up, and a wider variety of cannabis products are on shelves, including vapes.
“The concern is, many cannabis products now also contain three to four times more THC,” Lim said, adding that in areas where cannabis remains illegal, ”the cannabis market remains heavily unregulated.”
This fact was front and center during the electronic cigarette–or vaping–associated lung injury (EVALI) vaping health crisis that sickened nearly 3,000 and was linked to 60 deaths in late 2019 and early 2020. A JAMA Network Open study published in April 2020, which Cannabis Wire covered, concluded that the “data suggest that EVALI cases were concentrated in states where consumers do not have legal access to recreational marijuana dispensaries.”
Lim said that this latest research on youth vaping was prompted for a few reasons: more jurisdictions are legalizing cannabis for adult use; cannabis products with high concentrations of THC are “easily accessible and adolescents seeking for more ‘high’ could achieve this via vaping;” and, multiple nationally-representative surveys based in the U.S. have shown that cannabis vaping has “increased significantly” since 2017.
“I think it is important to examine the trend over time, and in which region and age group. Knowing that cannabis vaping in this age group is quite prominent in North America and Canada, I was also keen to see if there were related studies from other countries,” Lim said.
Lim compared the U.S. cannabis market to that in Australia, where the government legalized access to medical cannabis through prescription in 2016. Most products are oils or capsules meant to be taken orally. In Australia, Lim said, use of vaporizers remains low because vapes “cannot be sold and used as consumer products.” Meanwhile, looking to, for example, rules around tobacco and harm reduction as it pertains to youth, marketing and advertising is an important part of the conversation. In the US, rules around cannabis advertising are, at best, a patchwork that cannabis companies often circumvent through social media.
“Cannabis marketing and advertising of THC products to adolescents is quite prevalent in the US. I think targeted ads on the internet through social media platforms should be strictly regulated,” Lim told Cannabis Wire. “Plain packaging and health warnings are another example that may reduce brand appeal and increase health knowledge among young adults.”
Lim said that she will next seek to expand on this youth cannabis vaping research by exploring correlations, from ethnicity to socioeconomic factors, as they pertain to behavioral outcomes associated with cannabis vaping in adolescents.
