Citation

Kerr DCR, Levy NS, Bae H, Boustead AE, Martins SS. Am. J. Prev. Med. 2023; ePub(ePub): ePub.

Copyright

(Copyright © 2023, Elsevier Publishing)

DOI

10.1016/j.amepre.2023.06.009

PMID

37331488

Abstract

INTRODUCTION: Young adults' cannabis and alcohol use patterns have changed following state recreational cannabis legalization (RCL) according to studies based on college samples but not nationally representative samples. Associations between RCL and changes in cannabis and alcohol use outcomes among young adults were examined, including differences by college enrollment and minor status (ages 18-20 vs. 21-23 years).

METHODS: Repeated cross-sectional data (2008-2019) were collected from 18-23 year-old college-eligible participants in the National Survey on Drug Use and Health. Self-reported past-month cannabis use and frequent use (≥20 days), and a proxy for past-year DSM-5 cannabis use disorder (CUD) were primary outcomes; past-month frequent alcohol use and binge drinking were secondary outcomes. Multilevel logistic regression models quantified changes in outcome prevalence from the study years before to after RCL adjusting for secular trends. Analyses were conducted March 22, 2022.

RESULTS: Prevalence increased from before to after RCL for past-month cannabis use (21% to 25%) and past-year proxy CUD (11% to 13%); these increases were 20% [adjusted odds ratio (AOR) (95% CI) = 1.20 (1.08-1.32)] and 14% [AOR (95% CI) = 1.14 (1.003-1.30)] greater, respectively, post-RCL vs. pre-RCL. Increases were detected for young adults who were not in college, and who were ages 21-23 years. RCL effects were not detected for secondary outcomes.

CONCLUSIONS: Some young adults appear sensitive to state RCL, including in terms of CUD risk. Additional prevention efforts should be directed to young adults who are not in college, and timed to occur before age 21 years.

Language: en

Keywords

alcohol; binge drinking; young adult; Cannabis use disorder; college student; cannabis legalization