Usual Modes of Marijuana Consumption Among High School Students in Colorado

Adolescents' Cannabis Knowledge and Risk Perception: A Systematic Review

To systematically review evidence evaluating cannabis-related knowledge and perception of risk in children and adolescents. We systematically searched Medline, PsycINFO, and EMBASE using Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology. 133 studies from around the world (including ages 10-18 yrs) met inclusion criteria, with 70% meeting grade 2C quality. Increased knowledge and perception of risk of cannabis frequently correlated with lower levels of current use and intent to use. Studies examining correlations over time generally demonstrated increased adolescent cannabis use and decreased perception of risk. Included prevention-based interventions often enhanced knowledge and/or perception of risk in adolescents exposed to the intervention. Studies exploring outcomes relating to legislative changes for recreational marijuana use demonstrated considerable heterogeneity regarding knowledge and perception of risk whereas studies that focused on medicinal marijuana legislative changes overwhelmingly demonstrated a decrease in perception of risk post legalization. Increased knowledge and perception of risk of cannabis in adolescents often correlate with lower levels of current use and intention to use in the future. Further study and implementation of public health and clinically-oriented strategies that seek to increase knowledge among youth about the potential health harms of cannabis use should continue and be prioritized.

The impact of recreational cannabis legalization on youth: the Colorado experience

Over the past two decades, cannabis policies have liberalized in the United States, culminating in the legalization of recreational cannabis in Colorado and Washington state in 2012. This review will focus on the impact of recreational cannabis legalization in Colorado. While the prevalence of past-year and past-month cannabis use has remained relatively steady among adolescents post-legalization, the prevalence of young adult use has continued to rise. Cannabis products with increased potency have become more prevalent and widely used. There are concerns that the use of products with increased potency will increase risk for cannabis use and comorbid mental health disorders, particularly cannabis-induced psychosis and suicidal behavior, although more research is needed to fully understand the impact of high-potency products. Since the legalization of recreational cannabis, numerous additional public health concerns have emerged: unintentional overdoses requiring acute care visits, electronic vaping-associated lung injury, increased motor vehicle collisions related to cannabis consumption, and higher rates of cannabis use during pregnancy. Lessons learned from the first decade of cannabis legalization emphasize the need for research efforts to provide evidence-based guidelines, inform prevention strategies, and implement selective interventions for at-risk populations including youth, individuals with comorbid mental health disorders, and individuals who are pregnant.

Comparison of perceptions in Canada and USA regarding cannabis and edibles

BACKGROUND

Canada took a national approach to recreational cannabis that resulted in official legalization on October 17, 2018. In the United States (US), the approach has been more piecemeal, with individual states passing their own laws regulating adult use. The objective of this study was to compare the two jurisdictions.

METHODS

Two exploratory, quantitative surveys were administered in May of 2021 in both Canada and the US. One thousand forty-seven Canadian and 1037 US residents (age 19 and older) were surveyed on approaches to and attendant regulations of consumer cannabis. Tests of significance were performed to analyze differences between two groups.

RESULTS

No statistically significant differences exist between the two countries in terms of cannabis legalization acceptance. Usage rates among adults was similar with 45% of Canadians and 42% of Americans confirming they consume cannabis. Respondents maintain that they intend to increase their usage, with edibles attracting a rising level of interest from consumers.

CONCLUSIONS

Results suggest that public policy in both Canada and the USA needs to change to reflect rapidly evolving acceptance of cannabis products in North America to realize potential economic returns.

Regular Use of Cannabis in Female Athletes Is Associated With a Reduction in Early Anaerobic Power Production

ABSTRACT

Lisano, JK, Flores, VA, Kisiolek, JN, and Stewart, LK. Regular use of cannabis in female athletes is associated with a reduction in early anaerobic power production. J Strength Cond Res 37(3): 616-622, 2023-Despite a growing number of claims related to the ability of cannabis use to affect health and performance, there is limited research available, especially in female athletes. This cross-sectional study aimed to determine whether chronic cannabis use in physically active female athletes is related to altered health and performance. Healthy, physically active, female cannabis users (CU: n = 12) and noncannabis users (NU: n = 12) with an average age of 23.8 ± 3.7 years and 19.3 ± 4.2% body fat completed athletic performance and health assessments. Significance was set at alpha = 0.05. The age of onset of regular cannabis use was 20.1 ± 2.8 years in CU with an average duration of cannabis use of 5.8 ± 3.1 years. There were no differences between groups with respect to body size, body composition, pulmonary function, cardiorespiratory function, or muscular strength. Cannabis users produced significantly less power in the first 2 stages of the Wingate assessment, but CU experienced significantly less anaerobic fatigue. Although body composition and cardiovascular fitness were comparable, average C-reactive protein concentration classified CU with higher risk for cardiovascular disease (CVD). Athletes and coaches who rely heavily on anaerobic performance should consider these findings because they indicate that regular cannabis use may affect early power production and CVD risk.

Trends in intentional abuse and misuse ingestions in school-aged children and adolescents reported to US poison centers from 2000-2020

CONTEXT

Childhood and adolescent misuse and abuse exposures remain a serious public health challenge in the United States. This study aimed to describe recent trends and patterns of intentional substance misuse and abuse exposures among school-aged children and adolescents in the United States.

METHODS

This study was a retrospective cohort study of intentional misuse and abuse exposures in children 6 through 18 years reported to the National Poison Data System (NPDS) from January 1, 2000, through December 31, 2020. Demographic trends, reported clinical effects, treatments, management sites, and health outcomes were assessed overall and within four age categories: 6-9, 10-12, 13-15, and 16-18.

RESULTS

Between 2000 and 2020, there were 338,727 cases regarding intentional misuse and abuse exposures for children ages 6 through 18 years old. Overall, misuse/abuse ingestions fluctuated over time, with a peak in 2011. The majority of intentional misuse/abuse ingestions occurred in males (58.3%), and more than 80% of all reported exposure cases occurred in youth aged 13 to 18. 32.6% of ingestions resulted in worse than minor clinical outcomes. Older age groups had a greater number of severe medical outcomes compared to younger age groups. Major or life-threatening exposures (including those resulting in death) were more common in males. Overall, deaths were rare (n = 450), 0.1%). Male sex, older age, abuse ingestions, exposure site of a public area or other residence, and multiple ingested substances were other factors associated with increased mortality. Marijuana exposure rates had the highest average monthly increase overall, with the most dramatic rise occurring from 2017 to 2020. Edible marijuana preparations accounted for the highest increase in call rates compared with all other forms of marijuana.

DISCUSSION AND CONCLUSION

With over 330,000 poison center cases reported during the 20-year study period, intentional substance misuse and abuse exposures substantially impact the pediatric population. The substances most commonly misused/abused are more widely available substances such as over-the-counter medications, household products and pharmaceuticals commonly prescribed to youth. Differences in age and sex were evident, with males and adolescents more likely to abuse and misuse substances. Our study describes an upward trend in marijuana misuse/abuse exposures among youth, especially those involving edible products. These findings highlight an ongoing concern about the impact of rapidly evolving cannabis legalization on this vulnerable population.

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.

E-cigarettes and Vaping: A Smoking Cessation Method or Another Smoking Innovation?

The prevalence of using e-cigarettes (vaping) has risen rapidly since its introduction in 2007, mostly among male youth. Although research on the health risks of e-cigarettes is still limited, there is growing evidence of debilitating pulmonary conditions and general immune weakness from e-cigarettes, leading to various infections. Moreover, there are concerns that vaping could be used as a new model of cannabis consumption, increasing cannabis addiction among adolescents. With well-known health risks from traditional smoking, e-cigarettes are viewed as a safe way of smoking, appealing more to youth. Additionally, extensive e-cigarette marketing boosted by the internet and fame has resulted in worries that e-cigarettes can lead to a renormalization of cigarette smoking and can be used as a new method to consume vaporized drugs. Although the concern that e-cigarettes are as harmful as traditional smoking has been raised, youth and most healthcare providers remain relatively unaware. Therefore, this review explored the association between e-cigarettes and traditional smoking. With the introduction of e-cigarettes in the last two decades, the topic is still new and less studied. Therefore, this review will help us understand the topic to better care for e-cigarette smokers and reduce the increasing public health burden from vaping.

Age groups differences in the prevalence and popularity of individual tobacco product use in young adult and adult marijuana and tobacco co-users and tobacco-only users: Findings from Wave 4 of the population assessment of tobacco and health study

BACKGROUND

Tobacco use is high among marijuana and tobacco users, compared to tobacco-only users. This study examined the relative ranking (based on prevalence) of past 30-day tobacco product use separately across young adult and older adult past 30-day marijuana and tobacco co-users and tobacco-only users.

METHOD

Prevalence and relative ranking of past 30-day use of eight different tobacco products and blunts were examined in young adult (ages 18-24) and adults (ages 25 +) tobacco users who did and did not report past 30-day marijuana use (unweighted n = 33,644) from Wave 4 of the Population Assessment of Tobacco and Health study. Multiple logistic regressions examined increased odds of using each product in the past 30-days by marijuana and tobacco co-use.

RESULTS

Nearly half (47.9%) of past 30-day young adult tobacco users reported past 30-day marijuana use (e.g., co-use); 27.7% of adult tobacco users reported past 30-day co-use. Cigarettes were the most popular product used in the past 30-days across tobacco-only and co-users of both age groups. Rankings of all other tobacco products differed between the age groups. Among young adult co-users, blunts were ranked the second most popular product used in the past 30-days, followed by e-cigarettes, and then cigarillos/filtered cigars. Among adult co-users, blunts were ranked the fourth most popular product used in the past 30-days. Adult co-users reported significantly higher prevalence of past 30-day use of all combustible products compared to tobacco only users.

CONCLUSIONS

Co-users may be at increased risk of health consequences given high rates of combustible tobacco use.

Effects of High-Potency Cannabis on Psychomotor Performance in Frequent Cannabis Users

Background: Recently increased access to cannabis products in the United States has been associated with increased rates of driving after cannabis use. Although numerous studies indicate that cannabis impairs psychomotor and neurocognitive functions that can affect driving ability, the determination of cannabis-impaired driving risk is complicated by the extent to which frequent cannabis users develop tolerance to THC's subjective, cognitive, and psychomotor effects, and by the fact that there is no validated behavioral or biological marker of recent cannabis use or cannabis-related impairment. This study examined the psychomotor impairment-related effects experienced by frequent cannabis users in Colorado after naturalistic consumption of smoked cannabis, both immediately and 1 h postuse. Results were then validated in a smaller replication sample from Washington state. Methods: In the primary Colorado study, participants (n=70) used the DRUID^® mobile app, a brief measure of psychomotor and cognitive domains that are sensitive to the effects of cannabis. First, participants used DRUID to establish a sober baseline impairment score. During a second appointment, they used DRUID at three time points: preuse, immediately after acutely using cannabis, and 1 h postuse. In the Washington replication sample, participants (n=39) used DRUID before acute cannabis consumption and then every half hour for 2.5 h. Results: In both studies, peak DRUID impairment effects were seen immediately after cannabis use, with recovery of performance at 1 h postuse. Specifically, significant quadratic effects of time emerged for both studies (Colorado study: (β=-0.935, SE=0.204, p<0.001); Washington study: β=3.0299, SE=1.3085, p<0.01). Domain-specific effects were tested in the larger Colorado study and were observed for reaction time within a complex divided attention task and a postural-stability balance task. Conclusions: These findings demonstrate that psychomotor impairment emerges immediately after acute cannabis use even in regular users, but decreases significantly 1 h postuse. These results underscore the potential utility of the DRUID app for assessing acute cannabis-related psychomotor impairment. Further research is needed to explore whether the DRUID app and/or the specific psychomotor functions it assesses might serve as a tool for measuring cannabis-related driving impairment. Clinical trials registration number for the Colorado Study: NCT03522103.

Prevalence of Adolescent Cannabis Vaping: A Systematic Review and Meta-analysis of US and Canadian Studies

IMPORTANCE

Vaping products were initially designed to deliver nicotine as a tobacco cigarette substitute (eg, electronic cigarettes) but are now frequently used to deliver psychoactive substances, such as cannabis and its derivatives. Large, nationally representative surveys, such as Monitoring the Future, found that approximately 1 in 3 grade-12 students vaped cannabis in 2018 alone.

OBJECTIVE

To summarize the findings of epidemiological studies that reported the global prevalence of cannabis vaping in adolescents by survey year and school grades.

DATA SOURCES

PubMed, PsycINFO, Scopus, and Web of Science were searched systematically on August 19, 2020, for studies published globally between January 1, 2003, and August 19, 2020.

STUDY SELECTION

Publications that reported the prevalence of cannabis vaping in adolescents in the general population were included.

DATA EXTRACTION AND SYNTHESIS

Study characteristics and prevalence estimates were extracted from each article. Random-effects meta-analysis based on the DerSimonian and Laird method and meta-regression were performed on lifetime, 12-month, and 30-day prevalence estimates. Meta-regression was also conducted using survey year and school grades as moderators.

MAIN OUTCOMES AND MEASURES

Prevalence of cannabis vaping.

RESULTS

Seventeen studies met the eligibility criteria (n = 198 845 adolescents). Although no restrictions were imposed on study location, all 17 studies were from the US and Canada. Across all school grades, the pooled prevalence increased for lifetime use (6.1% in 2013-2016 to 13.6% in 2019-2020), use in the past 12 months (7.2% in 2017-2018 to 13.2% in 2019-2020), and use in the past 30 days (1.6% in 2013-2016 to 8.4% in 2019-2020). Heterogeneity across studies was large. The limited evidence from studies using similar survey and study designs suggested that adolescents' preference for cannabis products other than dried herbs, which usually contain higher Δ9-tetrahydrocannabinol levels, may have shifted over time.

CONCLUSIONS AND RELEVANCE

The findings of this study suggest that the prevalence of cannabis vaping has increased among adolescents in the US and Canada and that more effective preventive and response measures are required.

TRIAL REGISTRATION

PROSPERO Identifier: CRD42020219644.

Demographic and substance use-related differences among high school adolescents who vape cannabis versus use other cannabis modalities

BACKGROUND

Vaping is the second most common modality of using cannabis following smoking. We examined differences in demographics and substance use behaviors between adolescent cannabis vapers and those exclusively using other cannabis modalities.

METHODS

In 2019, 4875 students from six Connecticut high schools completed school-wide, online surveys. Past-month cannabis users (n = 931; 52.8% female, 16.38(1.27) years old, 44.9% non-Hispanic White) reported on cannabis modalities used (e.g., combustible, vaporizable, edible) and were classified as cannabis vapers or non-vapers. Cannabis vapers reported on device type used to vape cannabis: a cannabis-specific device or modified/hacked e-cigarette. Unadjusted and adjusted relationships were examined to identify demographic and substance-related differences between cannabis vapers and non-vapers.

RESULTS

56.3% of past-month cannabis users reported vaping cannabis. Cannabis vapers reported using both cannabis-specific vaporizers (91.9%) and modifying/hacking e-cigarettes (23.7%). Cannabis vapers, relative to other cannabis users, were more likely to be male, White, initiate cannabis use at a younger age; endorse past-month use of all cannabis modalities, alcohol, and e-cigarettes; and report smoking and dabbing cannabis more frequently; consuming more drinks per drinking day; and using e-cigarettes at a younger age and more frequently.

CONCLUSIONS

Relative to other cannabis modalities, vaping was associated with increased use of several cannabis products and other substances. Adolescent past-month cannabis users reported modifying e-cigarettes to vape cannabis. Findings suggest that regulations should be implemented to prevent e-cigarettes from being modifiable for use with cannabis and highlight the importance of assessing different cannabis use modalities, as vaping was associated with distinct substance-related risks.

Cannabis use and obesity-traits: A Mendelian randomization study

BACKGROUND

Observational studies suggested that cannabis use is associated with decreased body fatness; however, observational studies are subject to confounding, making causal inference and determining the direction of these associations difficult. We performed Mendelian randomization (MR) using summary statistics from genome-wide association studies (GWAS) to investigate the potential causal association of cannabis use and obesity-related traits.

METHODS

We used 51 single nucleotide polymorphisms (SNPs) associated with lifetime cannabis use at P 1<×  10^-5 from a GWAS of 184,765 individuals of European descent and 27 SNPs genome-wide associated with cannabis use disorder as instrumental variables. The GWAS for body mass index (BMI) was derived from a meta-analysis of up to 322,154 individuals, and the GWAS for waist circumference (WC) and waist-hip ratio (WHR) included 210,088 participants.

RESULTS

MR showed that lifetime cannabis use (beta = - 0.018, 95 % confidence interval (CI): - 0.05-0.015; P-value = 0.279, Q-value = 0.279) and cannabis use disorder (beta = 0.023, 95 % CI: 0.023-0.045; P-value = 0.034, Q-value = 0.092) were not associated with BMI. Considering WC and WHR as indicators of obesity, our findings did not support a causal association. Leave-one out analyses and pleiotropy-robust methods did not indicate bias in any of the estimates.

CONCLUSIONS

Overall, the MR study provides little evidence that cannabis influences obesity related traits.

Heterogeneities in administration methods among cannabis users by use purpose and state legalization status: findings from a nationally representative survey in the United States, 2020

BACKGROUND AND AIMS

Different cannabis administration methods have differential impacts on health. This study aimed to describe administration methods among cannabis users in the United States categorized by (1) use purpose and (2) state legalization status.

DESIGN

Cross-sectional, probability-based online survey in 2020.

SETTING

All 50 states and Washington DC in the United States.

PARTICIPANTS

A total of 21 903 adults (18+) were recruited from a probability-based online panel to provide nationally representative estimates.

METHODS

Eleven administration methods were grouped into combustion, vaporization, ingestion and topicals. Weighted prevalence was reported among (1) medical-only, recreational-only and dual-purpose users based on self-reported purposes and (2) users in states that legalized both recreational and medical cannabis (RCL states), legalized medical cannabis only and did not legalize cannabis.

FINDINGS

Among past-year users, the proportions of medical-only, recreational-only and dual-purpose users were 25.55, 43.81 and 30.64%, respectively. The most common primary methods were combustion (42.08%) and topicals (28.65%) for medical purposes and combustion (72.07%) and ingestion (15.05%) for recreational purposes. Dual-purpose users were more likely to report combustion and vaporization but less likely to report ingestion and topicals as primary methods for medical use than medical-only users (P < 0.001) and more likely to report combustion and topicals but less likely to report ingestion as primary methods for recreational use than recreational-only users (P < 0.041). A higher proportion of dual-purpose users (82.82%) used more than one method than medical-only (40.52%) and recreational-only users (63.91%) (P < 0.001). For both medical and recreational purposes, RCL states had the lowest rate of combustion and the highest rates of ingestion and topicals reported as primary methods (P < 0.033). The rate of using more than one administration method did not differ across states (P > 0.05).

CONCLUSION

Cannabis users whose purposes are medical, recreational or both tend to differ in their selected administration methods.

Cannabis-Related Perceptions as Mediators of the Association Between Trait Impulsivity and Cannabis Outcomes

OBJECTIVE

Normative perceptions have been shown to mediate the effect of personality traits on cannabis outcomes. We examined descriptive norms, injunctive norms, and the role of cannabis in college life as possible mediators of the association between impulsivity-related traits (i.e., negative urgency, positive urgency, sensation seeking, perseverance, and premeditation) and cannabis outcomes (i.e., frequency of cannabis use and negative consequences) among college students from five countries.

METHOD

A total of 1,175 college students (United States, n = 698; Argentina, n = 153; Spain, n = 178; Uruguay, n = 79; and Netherlands, n = 67) who were also cannabis users (i.e., reported cannabis use at least once within the previous month) completed an online survey. We used path analysis to test whether the proposed double-mediated paths (impulsivity-like traits→perceived cannabis norms→cannabis use frequency→negative cannabis-related consequences) were invariant across countries/cultures.

RESULTS

Cannabis-related perceptions, particularly college cannabis beliefs and injunctive norms, significantly mediated the association between impulsivity and cannabis outcomes. Two significant double-mediated paths, which were invariant across sex and countries, were found: (a) higher positive urgency→higher endorsement of internalized norms→higher cannabis use frequency→more negative cannabis-related consequences and (b) higher sensation seeking→higher endorsement of injunctive norms→higher cannabis use frequency→more negative cannabis-related consequences.

CONCLUSIONS

The study corroborates previous findings on normative perceptions mediating the effects of impulsivity-like traits on cannabis outcomes and suggests that these processes may operate similarly among college student cannabis users in different legal and cultural contexts. The findings highlight the need to address internalized norms and suggest these normative perceptions may be a good intervention candidate to reduce cannabis use/consequences.

Emissions from Heated Terpenoids Present in Vaporizable Cannabis Concentrates

Vaporizable cannabis concentrates (VCCs) consumed as a liquid (vaping) or a waxy solid (dabbing) are becoming increasingly popular. However, their associated emissions and impacts have not been fully described. Mixtures containing different proportions of 12 VCC terpenoids and high MW compounds were heated at 100-500 °C inside a room-sized chamber to simulate emissions. Terpenoids, thermal degradation byproducts, and ultrafine particles (UFPs) were quantified in the chamber air. Air samples contained over 50% of emitted monoterpenes and less than 40% of released sesquiterpenes and terpene alcohols. Eleven degradation byproducts were quantified, including acrolein (1.3-3.9 μg m^-3) and methacrolein (2.0 μg m^-3). A large amount of UFPs were released upon heating and remained airborne for at least 3 h. The mode diameter increased from 80 nm at 100 °C to 140 nm at 500 °C, and particles smaller than 250 nm contributed to 90% of PM_1.0. The presence of 0.5% of lignin, flavonoid, and triterpene additives in the heated mixtures resulted in a threefold increase in the particle formation rate and PM_1.0 concentration, suggesting that these high-molecular-weight compounds enhanced aerosol inception and growth. Predicted UFP emission rates in typical consumption scenarios (6 × 10¹¹-2 × 10¹³ # min^-1) were higher than, or comparable with, other common indoor sources such as smoking and cooking.

Past 30-Day Marijuana Vaping: Prevalence and Predictors of Use in a Nationally Representative Study of U.S. Youth

INTRODUCTION

Vaping has become an increasingly common mode of administration for marijuana among youth, but there are limited data on its prevalence. There is a need to better understand youth prevalence of past 30-day marijuana vaping and its predictors.

METHODS

Data were from a nationally representative sample of students from the Monitoring the Future survey in 2018 (N=9,131). This study examined past 30-day prevalence of marijuana vaping, and for a subset with complete data (n=5,755), the predictors of marijuana vaping among respondents asked about that behavior. Bivariate chi-square tests and multivariable logistic regression estimated the extent to which various factors were associated with marijuana vaping. These factors included the current use of various substances, school-related risk behaviors, attitude and risk behaviors related to substance use, and selected sociodemographic variables.

RESULTS

Past 30-day prevalence of marijuana vaping was higher among 10th graders, male youth, and those in the Other race/ethnicity category. Students who engaged in current past 30-day alcohol use, cigarette use, binge drinking, and nonmedical use of prescription drugs had significantly greater odds of past 30-day marijuana vaping. Past 30-day use was more common among students with a lower perceived risk of marijuana use, those who claimed that it was easy to obtain a vaporizer or marijuana, students with a lower grade point average, and those with recent truancy.

CONCLUSIONS

Past 30-day marijuana vaping is prevalent among U.S. students, and there are robust associations between use and school- and substance-related risk behaviors. These results suggest that the emergence of vaping products might redefine populations at risk, which should be taken into account by marijuana regulatory policies or prevention programs.

Characterizing the predictive validity of measures of susceptibility to future use of combustible, vaporized and edible cannabis products in adolescent never-users

BACKGROUND AND AIMS

The construct of susceptibility to substance use initiation (i.e. cognitive proclivity to future use) is critical for prevention efforts in adolescent populations. This study aimed to provide empirical evidence for the validity of the susceptibility construct for different cannabis products (i.e. combustible, edible or vaporized cannabis), and evaluate whether susceptibility measures are predictive of subsequent initiation.

DESIGN

Prospective cohort study including baseline data (Spring 2015) and four follow-up surveys administered every 6 months through Spring 2017.

SETTING

Ten schools in the Los Angeles, California metropolitan area.

PARTICIPANTS

Adolescents [n = 2100; mean age = 16.1; standard deviation (SD) = 0.41; 54% female] who reported never having used any cannabis product at baseline.

MEASUREMENTS

We assessed five indices of a susceptibility to use cannabis composite index at baseline, adapted from a validated tobacco use index (intention to use, willingness, curiosity and positive/negative cannabis use outcome expectancies, with four response categories, definitely not [1] to definitely yes [4]), by cannabis product (combustible, edible or vaporized). A composite index was created for each product by averaging responses across the five susceptibility items. Subsequent initiation of use of each cannabis product was assessed at each follow-up wave.

FINDINGS

Factorial validity for unidimensionality for each five-item index (by product) was confirmed. The composite index for susceptibility to cannabis use was greatest for combustible (mean = 1.44; SD = 0.58), moderate for edible (mean = 1.37; SD = 0.53) and lowest for vaporized cannabis (mean = 1.30; SD = 0.44). The associations of each composite susceptibility index with subsequent initiation of that product and each of the other cannabis products over follow-up (i.e. cross-product associations) were statistically significant, with hazard ratios ranging from 2.30 to 2.80 across 24 months of follow-up (all Ps < 0.05).

CONCLUSIONS

A five-item susceptibility to cannabis use composite index (by product) appears to be useful for characterizing and predicting youth at risk for cannabis use initiation across a spectrum of cannabis products.

Trends in Marijuana Vaping and Edible Consumption From 2015 to 2018 Among Adolescents in the US

This survey study investigates trends in noncombustible marijuana use from 2015 to 2018 among US adolescents.

Interpol review of controlled substances 2016-2019

This review paper covers the forensic-relevant literature in controlled substances from 2016 to 2019 as a part of the 19th Interpol International Forensic Science Managers Symposium. The review papers are also available at the Interpol website at: https://www.interpol.int/content/download/14458/file/Interpol%20Review%20Papers%202019.pdf.

Modes of Marijuana Consumption Among Colorado High School Students Before and After the Initiation of Retail Marijuana Sales for Adults

OBJECTIVE

This study aimed to estimate the prevalence of different modes of marijuana consumption (e.g., smoking, ingesting) overall and by sociodemographic factors, marijuana-related perceptions, and other substance use among adolescents, as well as to characterize differences in the usual mode of consumption before and after the initiation of retail marijuana sales in 2014.

METHOD

Data are from the 2013 and 2015 administrations of the Healthy Kids Colorado Survey, a cross-sectional, school-based survey. We included 9th-12th grade students who reported past-30-day marijuana use in 2013 (n = 2,792; 44.8% female) or 2015 (n = 1,664; 48.9% female). We estimated the prevalence of any past-month use of each mode in 2015 and usual mode of consumption the past month in both years. We tested differences by year, sociodemographics, marijuana-related perceptions, and other substance use using Rao-Scott chi-square tests and multivariable logistic regression.

RESULTS

The prevalence of past-month marijuana use was 20.7% in both years. In 2015, 39.8% of students reported using multiple modes in the past month. Use of any mode other than smoking and use of multiple modes differed by sociodemographics, marijuana-related perceptions, and other substance use. Smoking remained the most common usual mode in 2015. The prevalence of usually ingesting significantly decreased from 4.7% to 2.1% between years, whereas "other mode(s)" significantly increased from 4.0% to 6.0%.

CONCLUSIONS

The use of multiple modes of marijuana consumption was prevalent among adolescents in Colorado. The usual mode of consumption changed in years before and after the implementation of retail marijuana sales, suggesting the need for continued surveillance.

Enhancing Efficacy, Performance, and Reliability of Cannabis Edibles: Insights from Lipid Bioavailability Studies

The legal sale of cannabis-enriched foods and beverages for medical or recreational purposes is increasing in many states and countries, especially in North America and Europe. These food-based cannabis delivery systems vary considerably in their compositions and structures, ranging from low-viscosity watery beverages to solid fatty chocolates. The rate and extent of release of the bioactive components in cannabis within the human gastrointestinal tract (GIT) affect their health and psychoactive effects. Studies with other types of hydrophobic bioactives, such as nutraceuticals and vitamins, have shown that food composition and structure have a major impact on their bioaccessibility, transformation, and absorption within the GIT, thereby influencing their bioavailability and bioactivity. This review outlines how insights on the bioavailability of other lipophilic bioactives can be used to facilitate the design of more efficacious and consistent cannabis-enriched products intended for oral consumption. In particular, the importance of food-matrix composition (such as fat type and level) and structural organization (such as fat domain dimensions) are discussed.

Methods for Population Research on Substance Use and Consequences

This chapter reviews the array of methods used in contemporary research on population-level research on substance use and its consequences. We argue that there are critical questions that can best - or in some cases, only - be addressed at the level of a population. We then describe the major categories of data collection methods used in population research, including surveys, ecological momentary assessment, administrative data, audit methods, and unobtrusive assessment of substance use. Two categories of measures are then discussed: measures of an individual's use of substances and related problems and measures of harm to others caused by one's use. We then review factors that may be considered causes or correlates of substance use and consequences, including both individual and environmental factors. We close with a few thoughts on the accumulation of knowledge and its translation to policy and practice.

Electronic Cigarettes to Vaporize Cannabis: Prevalence of Use and Associated Factors among Current Electronic Cigarette Users in Germany (DEBRA Study)

Background: In Germany, cannabis is the most widely used illicit drug, and inhalation together with tobacco is most popular. However, it has been described that electronic cigarettes (ECs) are being used to vaporize cannabis (extract). No current data on EC cannabis use in the German population are yet available. Objectives: This study examines the prevalence of EC cannabis consumption for mood changing effects among current EC users, and associated consumer characteristics in Germany. Methods: We used data from the German Study on Tobacco Use (period: 8/2016-01/2019, DEBRA, www.debra-study.info), a nationally representative household survey. EC cannabis use for mood-changing effects was assessed in 504 current EC users (aged ≥ 18 years) of the total sample (N = 32,678). Ever use was defined by: (1) occasional or regular use, or (2) experimental consumption. Associations with socio-demographic consumer characteristics and tobacco smoking were analyzed using multivariable regression analyses. Results: Amongst current EC users, 7.2% had ever vaporized cannabis: 2.3% (95%CI = 1.2-3.9) reported occasional or regular use (1) and 4.8% (95%CI = 3.2-7.1) reported experimental use (2). Age was associated with ever EC cannabis use: highest prevalence rates were found among 18-24-year-olds: 6.5% (95%CI = 2.3-13.1) (1) and 8.0% (95%CI = 3.7-15.8) (2), respectively. The majority (90.2%) of ever EC cannabis users were current tobacco smokers. Conclusions: One in 14 current EC users in Germany has ever vaporized cannabis for mood-changing reasons, and almost all EC cannabis consumers also smoke tobacco. Highest usage rates can be observed among young adults. Hence, trends of EC drug misuse need to be monitored consequently, particularly in young people.

Trends in marijuana edible consumption and perceptions of harm in a cohort of young adults

BACKGROUND

Rates of marijuana legalization have increased rapidly in recent years resulting in the marketing of alternative products like edibles that do not involve inhaling smoke. Edibles however pose unique public health challenges due to their greater risk for over-intoxication.

METHODS

1858 young adults were surveyed every six months from 2016 to 2018. Logistic regression models examined trends in use and perceptions of harm. Chi-squared tests compared demographic and behavioral characteristics of edible users and non-users by frequency of marijuana use.

RESULTS

Perceptions of no harm from edibles increased (25.4%, 27.3%, 26.7%, 28.4%, 29.6%; p = 0.006) while it declined for smoking marijuana (12.2%, 13.5%, 11.7%, 10.6%, 9.1%; p < 0.001). Among non-daily marijuana users, edible use increased (20.3%, 24.8%, 30.5%, 36.2%, 36.6%; p < 0.001) while smoking marijuana declined for both daily and non-daily users. Among daily users, edible users were more likely to use all modes of consumption than non-edible users. Among non-daily users, edible users were less likely to smoke marijuana and perceive harm from edibles and were more likely to perceive harm from smoking marijuana and have visited a dispensary than non-edible users.

CONCLUSIONS

Edibles are increasingly consumed and perceived to not be harmful, despite the greater danger of over-intoxication. However, daily use of edibles alone is uncommon. The finding that edible users were more likely to have visited a dispensary provides a potential intervention point for consumer education. Strong scientific evidence is needed to guide policymakers in best practices for communicating knowledge and potential harms of these products.

Age, period and cohort effects in frequent cannabis use among US students: 1991-2018

BACKGROUND AND AIMS

As the legal status of cannabis changes across the United States and modes of administration expand, it is important to examine the potential impact on adolescent cannabis use. This study aimed to assess changes in prevalence of frequent cannabis use in adolescents in the United States and how far this varies by age and cohort.

DESIGN

Analysis of Monitoring the Future, a nationally representative annual survey of 8th-, 10th- and 12th-grade students in the United States conducted from 1991 to 2018.

SETTING

In-school surveys completed by US adolescents.

PARTICIPANTS

A total of 1 236 159 8th-, 10th- and 12th-graders; 51.5% female, 59.6% non-Hispanic white, 12.3% non-Hispanic black, 13.4% Hispanic and 14.7% other race/ethnicity.

MEASUREMENTS

Frequent cannabis use (FCU), defined as six or more occasions in the past 30 days, stratified by sex, race/ethnicity and parental education.

FINDINGS

FCU among US adolescents increased over the study period; the peak in 2010-18 was 11.4% among 18-year-old students. This increase was best explained by both period and cohort effects. Compared with respondents in 2005, adolescents surveyed in 2018 had period effects in FCU that were 1.6 times greater. Adolescents in younger birth cohorts (those born > 1988) had a lower increase in FCU than those born prior to 1988. Results were consistent across sex, parent education and race/ethnicity, with period effects indicating increasing FCU after 2005 and cohort effects indicating a lower magnitude of increase in more recent birth cohorts. Age and parental education disparities in FCU have increased over time, whereas race/ethnicity differences have converged over time; black students were 0.67 [95% confidence interval (CI) = 0.64-0.70] times as likely to use cannabis frequently as white students from 1991 to 2000, and 1.03 (95% CI = 0.98-1.09) times as likely from 2011 to 2018 (P-value for time interaction < 0.001).

CONCLUSIONS

The prevalence of frequent cannabis use (FCU) increased from 1991 to 2018 among older adolescents in the United States. Racial/ethnic differences in FCU converged, whereas parental education differences have diverged.

Changes in Prevalence of Marijuana Consumption Modes Among Colorado High School Students From 2015 to 2017

This study examines data from the Health Kids Colorado Survey to assess changes in modes of marijuana consumption among high school students in Colorado from 2015 to 2017.

Assessment of Acute Motor Effects and Tolerance Following Self-Administration of Alcohol and Edible ∆9 -Tetrahydrocannabinol in Adolescent Male Mice

BACKGROUND

Cannabinoids and their principle psychoactive target, the cannabinoid type 1 receptor (CB1R), impact a number of alcohol-related properties, and although alcohol and cannabis are often co-used, particularly in adolescence, few animal models of this phenomenon exist. We modeled the co-use of alcohol and ∆⁹ -tetrahydrocannabinol (THC) in adolescent mice using ingestive methods popular during this developmental period in humans, namely binge-drinking and edible THC. With this model, we assessed levels of use, acute effects, and tolerance to each substance.

METHODS

Adolescent male C57BL/6J mice had daily, limited access to 1 of 2 edible doughs (THC or control), to 1 of 2 fluids (ethanol (EtOH) or water), and in 1 of 2 orders (dough-fluid or fluid-dough). Home cage locomotor activity was recorded both during access and after access. On the day following the final access session, a subset of mice were assessed for functional and metabolic tolerance to alcohol using accelerating rotarod and blood EtOH concentrations, respectively. The remaining mice were assessed for tolerance to THC-induced hypothermia, and whole-brain CB1R expression was assessed in all mice.

RESULTS

EtOH intake was on par with levels previously reported in adolescent mice. Edible THC was well-consumed, but consumption decreased at the highest dose provided. Locomotor activity increased following EtOH intake and decreased following edible THC consumption, and edible THC increased fluid intake in general. The use of alcohol produced neither functional nor metabolic tolerance to an alcohol challenge. However, the use of edible THC impaired subsequent drug-free rotarod performance and was associated with a reduction in THC's hypothermic effect.

CONCLUSIONS

Adolescent mice self-administered both alcohol and edible THC to a degree sufficient to acutely impact locomotor activity. However, only edible THC consumption had lasting effects during short-term abstinence. Thus, this adolescent co-use model could be used to explore sex differences in self-administration and the impact substance co-use might have on other domains such as mood and cognition.

Illicit drug use and prescription drug misuse among young adult medical cannabis patients and non-patient users in Los Angeles

INTRODUCTION

Young adults have the highest rates of cannabis and other drug use, as compared to other age groups, and contribute a significant proportion to the total population of medical cannabis patients (MCP). However, little is known about the relationships between various cannabis practices and illicit drug use/prescription drug misuse among young adult cannabis users with and without legal access to medical cannabis.

METHODS

210 MCP and 156 non-patient cannabis users (NPU) aged 18-26 were recruited in Los Angeles in 2014-15 for a longitudinal study assessing the impact of medical cannabis on health and substance use among emerging adults. For the present analysis, only quantitative baseline survey data were used. Logistic regression was used to examine the associations between past 90-day cannabis practices and other drug use, including illicit drug use and prescription drug misuse.

RESULTS

Illicit drug use was associated with being non-Hispanic white (AOR = 3.0, 95% CI 1.8-5.1), use of cannabis concentrates (AOR = 2.8, 95% CI 1.6-4.9), while self-reported medical cannabis use was associated with lower probability of illicit drug use (AOR = 0.5, 95% CI 0.3-0.9). The odds of prescription drug misuse were increased for participants who reported use of cannabis edibles (AOR = 2.0, 95% CI 1.1-3.5), and decreased with age (AOR = 0.9, 95% CI 0.8-1.0) and for those who used cannabis alone (AOR = 0.5, 95% CI 0.3-0.9).

CONCLUSION

Use of alternative cannabis forms, but not cannabis use frequency, were associated with greater odds of other drug use. Self-reported medical cannabis use, but not MCP status, decreased probability of illicit drug use.

Does Marijuana Use at Ages 16-18 Predict Initiation of Daily Cigarette Smoking in Late Adolescence and Early Adulthood? A Propensity Score Analysis of Add Health Data

Given the declining trend in adolescent cigarette smoking and increase in general access to marijuana, it is important to examine whether marijuana use in adolescence is a risk factor for subsequent cigarette smoking in late adolescence and early adulthood. Preliminary evidence from a very small number of studies suggests that marijuana use during adolescence is associated with later smoking; however, to control confounding, previously published studies used regression adjustment, which is susceptible to extrapolation when the confounder distributions differ between adolescent marijuana users and non-users. The current study uses propensity score weighting, a causal inference method not previously used in this area of research, to weight participants based on their estimated probability of exposure given confounders (the propensity score) to balance observed confounders between marijuana users and non-users. The sample consists of participants of Add Health (a nationally representative dataset of youth followed into adulthood) who were 16-18, with no history of daily cigarette smoking at baseline (n = 2928 for female and 2731 for male sub-samples). We assessed the effect of adolescent marijuana use (exposure, ascertained at wave 1) on any daily cigarette smoking during the subsequent 13 years (outcome, ascertained at wave 4). Analyses suggest that for females (but not males) who used marijuana in adolescence, marijuana use increased the risk for subsequent daily smoking: OR = 1.71, 95% CI = (1.13, 2.59). We recommend that adolescent marijuana use be viewed as a possible risk factor for subsequent initiation of daily cigarette smoking in women.

Adolescent Marijuana Use, Marijuana-Related Perceptions, and Use of Other Substances Before and After Initiation of Retail Marijuana Sales in Colorado (2013-2015)

Due to the recentness of changes to marijuana policies in a number of states, the effect on adolescent use and perceptions is not yet well understood. This study examines change in adolescent marijuana use and related perceptions in Colorado, before and after the implementation of legal commercial sale of recreational marijuana for adults starting on January 1, 2014. The data are from a repeated cross-sectional survey of a representative sample of Colorado high school students, with separately drawn samples surveyed in fall 2013 (prior to implementation) and fall 2015 (18 months after implementation). We examined change in the prevalence of adolescent marijuana use, measured by lifetime use, past 30-day use, frequent use, and use on school property. To consider the possibility of heterogeneity in the change in marijuana use, we examined change in past 30-day marijuana use by demographic characteristics (sex, grade, race/ethnicity), school characteristics (poverty, percent minority), urbanicity of the school district, and whether the city or county permitted retail marijuana stores. There was an absence of significant effects for change in lifetime or past 30-day marijuana use. Among those reporting past 30-day use, frequent use and use on school property declined. There was a significant decline in the perceived harm associated with marijuana use, but we did not find a significant effect for perceived wrongfulness, perceived ease of access, or perceived parental disapproval. We did not find significant variability in past 30-day use by demographic characteristics or by school and community factors from 2013 to 2015. We did not find a significant effect associated with the introduction of legal sales of recreational marijuana to adults in Colorado on adolescent (illegal) use, but ongoing monitoring is warranted, including consideration of heterogeneity in the effects of marijuana policies.

The Relationship Between Tobacco and Cannabis Use: A Review

BACKGROUND

Based on the prevalence and health implications of tobacco and cannabis use, aiming to reduce their use, especially among youth, is a sound objective at both the individual and public health level. A proper understanding of the relationships between tobacco and cannabis use may help to achieve this goal.

OBJECTIVES

To review the relationships between tobacco and cannabis use.

METHODS

A selective review of the literature.

RESULTS

We present an overview of the motivations for tobacco and cannabis use, and their perceived harmfulness. The article then reviews the gateway theory, reverse gateway theory, route of administration theory, and common liability theory. We describe the link between co-use and dependence symptoms, and the substitution phenomenon between tobacco and cannabis use. Three forms of simultaneous use-mulling, blunt smoking, and chasing-and their impacts are explained. We summarize the impact of tobacco use on cannabis (and vice versa) treatment outcomes, and, finally, review new treatments that simultaneously target tobacco and cannabis dependence. Most of the literature reviewed here relates to substance use among adolescents and young adults.

CONCLUSIONS

The use of tobacco and cannabis-two of the most widely used substances around the world-are strongly intertwined in several respects. Both health professionals and researchers should have well-informed views on this issue to better evaluate, understand, inform, and provide care to their patients.

E-cigarettes-An unintended illicit drug delivery system

Since the introduction of electronic cigarettes (e-cigarettes) in 2003, the technology has advanced allowing for greater user modifications, with users now able to control voltage, battery power, and constituents of the e-cigarette liquid. E-cigarettes have been the subject of a growing body of research with most research justifiably focused on the chemical makeup and risk analysis of chemicals, metals, and particulates found in e-cigarette liquids and vapor. Little research to date has focused on assessing the risks associated with the drug delivery unit itself and its potential for use as an illicit drug delivery system. In light of this, a range of illicit drugs was researched focusing on pharmacodynamics, usual method of administration, the dosage required for toxicity, toxic effects, and evidence of existing use in e-cigarettes in both literature and online illicit drug forums. A systematic literature search found evidence of current use of e-cigarettes to vape almost all illicit drug types analyzed. This presents both a potential population health risk and a management issue for clinicians. It also raises the issue of policing illicit drugs due to potential altered characteristic smells and storage within e-cigarette fluids. E-cigarettes are a viable illicit drug delivery system with evidence both inside and outside of the formal medical literature detailing their potential use for drug delivery of a wide range of illicit and legal drugs.

Initiation of vaporizing cannabis: Individual and social network predictors in a longitudinal study of young adults

BACKGROUND

A trend has recently emerged of individuals using electronic nicotine delivery systems (ENDS) or similar devices to vaporize cannabis, either in the form of high-potency THC concentrates or cannabis plant material. Peer use is central to the adoption of substance use behaviors in young adulthood, but little is known about peer influence for initiating cannabis vaping.

METHODS

A longitudinal investigation of first-year college students (N = 1313) using social network methods was conducted to determine the prevalence of vaping cannabis, differences in networks between individuals who initiate vaping cannabis, and predictors of initiation of vaping cannabis across two time points. The surveys were available for two weeks beginning in the sixth week of each semester.

RESULTS

We found that 9.4% vaped in their lifetime but not since the first survey, 7.5% vaped in their lifetime and since the first survey, and 5.9% reported vaping cannabis at the second survey. Lifetime cannabis use, lifetime ENDS use, and number of peers who initiated vaping cannabis from Time 1 to Time 2 were significantly associated with increased odds of the initiation of vaping cannabis; the number of any-cannabis-using or any-ENDS-using peers was not associated with increased odds of initiating vaping cannabis.

CONCLUSIONS

Individuals with the greatest risk of initiation of vaping cannabis during the first year of college are those with a prior history of other cannabis use and ENDS use and who have peers in their network who initiate cannabis vaping.

The Association Between Religiosity and Substance Use Patterns Among Women Involved in the Criminal Justice System

A growing body of research is exploring the association between religiosity and drug use. Thus, this analysis examines the association between religiosity and substance use patterns among females in the criminal justice system. Data derived from 318 women recruited from a Municipal Drug Court System in St. Louis, Missouri, were used to determine the association between religiosity and substance use patterns. Results indicate that religiosity decreased the odds of cocaine use, observed for both crack/cocaine (CC) use alone (adjusted odds ratio [AOR] = 0.41) and crack/cocaine + marijuana (CC + MJ) (AOR = 0.32). Interestingly, this association was not found for MJ use alone. Other variables that were significantly associated with CC + MJ use included being non-Black (CC + MJ: AOR = 0.46; MJ: AOR = 0.28), 4+ arrests (CC + MJ: AOR = 4.66; CC: AOR = 2.64), and <30 years of age (CC + MJ: AOR = 0.37; CC: AOR = 0.16; MJ: AOR = 2.84). Future drug prevention and interventions should consider the potential protective effects of religiosity on substance use.

Correlates of cannabis vape-pen use and knowledge among U.S. college students

INTRODUCTION

The proliferation of electronic devices, such as vape-pens, has provided alternative means for cannabis use. Research has found cannabis-vaping (i.e., vape-pen use) is associated with lower perceived risks and higher cannabis use. Knowledge of these products may increase likelihood of subsequent use. As policies for cannabis shift, beliefs that peers and family approve of this substance use (injunctive norms) increase and there has been an increase in vape-pen use among young adults (18-35 year olds); however, correlates thereof remain unknown. Young adults often engage in cross-substance use with cannabis and alcohol, making alcohol a potential correlate of cannabis vape-pen use and knowledge. Therefore, we examined alcohol use and other potential correlates of vape-pen use and knowledge among a sample of university students.

METHODS

This secondary data analysis utilized surveys at multiple colleges in the U.S. (N = 270). Alcohol use, social anxiety, cannabis expectancies, injunctive and descriptive norms and facets of impulsivity were examined as correlates of vape-pen use and knowledge using bivariate correlations and logistic regressions.

RESULTS

Alcohol use was correlated with cannabis vape-pen use and knowledge. Frequency of cannabis use, peer injunctive norms, and positive expectancies were associated with increased likelihood of vape-pen use. Lack of premeditation, a facet of impulsivity, was associated with cannabis vape-pen knowledge.

CONCLUSIONS

Given the unknown nature and consequences of cannabis vape-pens, the present findings offer valuable information on correlates of this behavior. Further, correlates of knowledge of vape-pens may point to areas for education and clinical intervention to prevent heavy cannabis vape-pen use.

Medical marijuana in pediatric oncology: A review of the evidence and implications for practice

Medical marijuana (MM) has become increasingly legal at the state level and accessible to children with serious illness. Pediatric patients with cancer may be particularly receptive to MM, given purported benefits in managing cancer-related symptoms. In this review, we examine the evidence for MM as a supportive care agent in pediatric oncology. We describe the current legal status of MM, mechanism of action, common formulations, and potential benefits versus risks for pediatric oncology patients. We offer suggestions for how providers might approach MM requests. Throughout, we comment on avenues for future investigation on this growing trend in supportive care.

How Is Marijuana Vaping Portrayed on YouTube? Content, Features, Popularity and Retransmission of Vaping Marijuana YouTube Videos

The purpose of the study is to investigate how vaping marijuana, a novel but emerging risky health behavior, is portrayed on YouTube, and how the content and features of these YouTube videos influence their popularity and retransmission. A content analysis of vaping marijuana YouTube videos published between July 2014 to June 2015 (n = 214) was conducted. Video genre, valence, promotional and warning arguments, emotional appeals, message sensation value, presence of misinformation and misleading information, and user-generated statistics, including number of views, comments, shares, likes and dislikes, were coded. The results showed that these videos were predominantly pro-marijuana-vaping, with the most frequent videos being user-sharing. The genre and message features influenced the popularity, evaluations, and retransmission of vaping marijuana YouTube videos. Theoretical and practical implications are discussed.

How four U.S. states are regulating recreational marijuana edibles

BACKGROUND

Sales of edible marijuana products have been strong in Colorado and Washington State since the legalization of recreational marijuana. Initially, these states did not have comprehensive labelling or packaging requirements in place. In response to increases in marijuana-related emergency room visits and poison control centre calls, additional regulations were implemented. Currently, Alaska, Colorado, Oregon, and Washington each have passed into law various labelling and packaging requirements for edibles.

METHODS

This article presents the primary legal research findings of relevant statutes and regulations for edibles in Alaska, Colorado, Oregon, and Washington. These laws were identified by using Boolean terms and connectors searches in these states' legal databases in LexisNexis.

RESULTS

Alaska, Colorado, Oregon, and Washington vary greatly in how they regulate labelling and packaging. Colorado, Oregon and Washington require a Universal Symbol to be affixed to edibles, but only Oregon and Washington require that the use of pesticides be disclosed on the label. Only Colorado and Oregon require that the packaging for edibles bear a Nutrition Facts Panel on the label. Δ⁹-Tetrahydracannabinol (THC) in a single serving or single edible product as Alaska and Oregon. All four states prohibit the manufacture or packaging of edibles that appeal to youth.

CONCLUSION

State laws governing recreational marijuana edibles have evolved since the first recreational edible products were available for sale. Alaska, Colorado, Oregon, and Washington now require edible product labels to disclose a variety of product information, including risk factors associated with consumption. However, there still remain concerns about the regulatory gaps that exist in each of these states, inherent difficulties in enforcing laws around the labelling, packaging, and manufacturing of edibles, and the outstanding question of whether these edible laws are actually informing consumers and keeping the public safe.