Modes of cannabis use among Canadian youth in the COMPASS study; using LCA to examine patterns of smoking, vaping, and eating/drinking cannabis

Risky cannabis use is associated with varying modes of cannabis consumption: Gender differences among Canadian high school students

BACKGROUND

Our objective was to explore associations between indicators of more risky cannabis use (i.e., solitary use, frequent use, and younger age of initiation) and different modes of cannabis use (i.e., smoking, vaping and/or edibles).

METHODS

Data were gathered from a large sample of Canadian youth in Alberta, British Columbia, Ontario, and Quebec who participated in Year 8 (2019-20) of the COMPASS study, and who reported using cannabis in the past year (n = 4,763). Generalized estimating equations were used to examine associations between risky cannabis use and modes of cannabis use, stratified by gender.

RESULTS

Overall, 38% of students reported using multiple modes of cannabis use. Consistent among both males and females, students who used cannabis alone (35%) and at a higher frequency (55%) were more likely to use multiple modes than smoking only. Among females, those who used cannabis alone were more likely to report using edibles only compared to smoking only (aOR=2.27, 95%CI=1.29-3.98). Earlier cannabis use initiation was associated with lower likelihood of vaping cannabis only among males (aOR=0.25; 95%CI = 0.12-0.51), and lower likelihood of using edibles only among females (aOR=0.35; 95%CI = 0.13-0.95), than by smoking only.

CONCLUSIONS

Our findings suggest that multiple modes of use may be an important indicator or risky cannabis use among youth, given associations with frequency, solitary use, and age of onset.

Cannabis Vaping Among Youth and Young Adults: a Scoping Review

Purpose of Review

The purpose of this review was to describe the state-of-the-literature on research specific to cannabis vaping among youth and young adults.

Recent Findings

Out of 1801 records identified, a total of 202 articles met eligibility criteria for inclusion in this review. Most of this literature (46.0% of studies) was specific to the health effects of cannabis vaping, particularly EVALI (e-cigarette and vaping associated lung injury). Other research areas identified in the review included the etiology (24.3%) and epidemiology (24.8%) of cannabis vaping, in addition to articles on regulation (8.4%) and marketing (5.5%) of the same.

Summary

Cannabis vaping is increasingly common among youth and young adults and more prevalent is settings where recreational use for adults has been legalized. The literature documents a number of negative health effects of cannabis vaping for young people, along with risk factors and reasons for the same.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40429-022-00413-y.

Patterns of Cannabis Use among Canadian Youth over Time; Examining Changes in Mode and Frequency Using Latent Transition Analysis

Background: Historically substance use literature has focused on smoking as the main mode of cannabis consumption, so there are knowledge gaps surrounding current understanding of edibles and vaping. These alternative modes of cannabis use are already common among Canadian youth; however, little is known about how these cannabis use patterns change over time. Methods: This study examined the mode (smoking, eating/drinking, vaping) and frequency of cannabis use among a large sample of Canadian youth who participated in 2017-2018 and 2018-2019 data collection waves of the COMPASS study. Using latent transition analysis, this sample consisting of 18,824 youth in grades 9-12 were categorized into cannabis use classes stratified by sex, and their transition between these classes over the one-year period was examined. Results: Three cannabis use classes were identified (occasional multimode, regular multimode, and smoking) alongside one nonuse class. Among youth who reported cannabis use at baseline, transitioning to a multimode group, and/or increasing frequency of multimode use was likely over the one-year period. Conclusions: These findings may highlight a key leverage point for harm-reduction strategies which aim to prevent cannabis related harms associated with high frequency use.

Changes in cannabis use modes among Canadian youth across recreational cannabis legalization: Data from the COMPASS prospective cohort study

INTRODUCTION

Canadian youth consume cannabis in multiple ways, including by smoking, vaping, and eating or drinking. Existing evidence suggests that these behaviours may change after law liberalization, though data regarding youth are scarce. We investigated changes in cannabis modes of use and associated factors across the federal legalization of recreational cannabis use for adults in Canada, among a large sample of underage youth before alternative products were made legally available.

METHODS

Data were available from 2953 longitudinally linked Canadian high school students who reported on their cannabis use during the 2017/2018 and 2018/2019 school years. We explored whether students maintained a single or multiple cannabis use mode(s), contracted, or expanded the number of modes used. We then used generalized estimating equations to analyse associations of baseline characteristics with use mode trajectory.

RESULTS

Expansion of cannabis use modes (42.3%) was more common than maintenance of a single mode (31.3%), maintenance of multiple modes (14.3%), or reduction (12.1%). Students who maintained multiple modes were significantly more likely to have high amounts of weekly spending money (AOR 1.68), to binge drink (AOR 2.25) or vape (AOR 1.99), to use cannabis regularly (AOR 2.67), and to endorse more symptoms of depression (AOR 1.06). School support for quitting tobacco, drug, or alcohol use appeared to have no effect.

CONCLUSIONS

Multi-modal cannabis use increased among Canadian youth in our sample. Its association with other substance use and depressive symptoms may indicate clustering of additional harms. Screening for this use pattern may assist in identifying high-risk substance use and should be considered in the design of harm reduction programming.

Does how you use matter? The link between mode of use and cannabis-related risk

OBJECTIVES

With the recent legalization of cannabis there are more cannabis products available to consumers today than ever before. However, little is known about the relation of distinct modes of use to cannabis-related risks. The current study estimated the prevalence of different modes of use among a sample of university students, and quantified the magnitude of association between modes of use (type and number) and cannabis-related risks (i.e., dependence, negative consequences, simultaneous use with alcohol).

METHODS

The sample included 368 undergraduate students (71% female) who reported using cannabis in the last 6 months.

RESULTS

Joints were the most commonly reported primary mode (39%), followed by bongs/water pipes (33%), hand pipes (14%), edibles (7%) and vaporizers (5%). The majority of participants were multi-mode users (88%). On average, participants reported using 2.72 (sd = 1.04) modes of cannabis regularly. Bong users had more cannabis related harms (B = 1.85, p < .001), dependence symptoms (B = 1.87, p < .001) and were twice as likely to use alcohol and cannabis simultaneously (OR = 2.09; 95% CI: 1.17-3.74) compared to joint users. However, these associations were attenuated after adjusting for sex, age and cannabis frequency. Multi-modal users reported significantly more cannabis-related harms and misuse symptoms compared to single mode users.

CONCLUSION

Few differences in cannabis risks were found across modes of use. Frequency of use remains the most significant predictor of cannabis related risks. However, findings suggest that multimodal may be indicative of high risk cannabis use patterns and is an important target for screening and intervention.