Elsevier

Drug and Alcohol Dependence

Volume 155, 1 October 2015, Pages 8-15
Drug and Alcohol Dependence

Past 15-year trends in adolescent marijuana use: Differences by race/ethnicity and sex

https://doi.org/10.1016/j.drugalcdep.2015.08.025Get rights and content

Highlights

  • Male–female differences in adolescent marijuana use have decreased since 1999.

  • Despite policy changes, marijuana use among adolescents has largely declined since 1999.

  • In 2013, marijuana use among Black adolescents surpassed that of White adolescents.

Abstract

Background

The potential for increases in adolescent marijuana use is an important concern given recent changes in marijuana policy. The purpose of this study was to estimate trends in marijuana use from 1999 to 2013 among a national sample of US high school students. We examine changes over time by race/ethnicity and sex.

Methods

Data are from the National Youth Risk Behavior Survey (YRBS), which involves biennial, school-based surveys that generate nationally representative data about 9th–12th grade students in the United States. Students self-reported sex, race/ethnicity, and marijuana use (i.e., lifetime use, past 30-day use, any use before age 13). We generated national estimates of the prevalence of marijuana use for the time period, and also tested for linear and quadratic trends (n = 115,379).

Results

The prevalence of lifetime marijuana use decreased modestly from 1999 to 2009 (44% to 37%), and has increased slightly since 2009 (41%). Other marijuana use variables (e.g., past 30-day use) followed a similar pattern over time. The prevalence of past 30-day use from 1999 to 2013 for all groups and both sexes was 22.5%, and it was lowest among Asians and highest among American Indian/Alaska Natives. Although boys have historically had a higher prevalence of marijuana use, results indicate that male–female differences in marijuana use decreased over time.

Conclusion

Despite considerable changes in state marijuana policies over the past 15 years, marijuana use among high school students has largely declined. Continued surveillance is needed to assess the impact of policy changes on adolescent marijuana use.

Introduction

After alcohol and tobacco, marijuana has been consistently the most commonly used drug of abuse in the US. In 2012, 42.6% of Americans aged 12 and older reported lifetime marijuana use, whereas 61.9% reported lifetime cigarette use and 82.3% reported lifetime alcohol use (SAMHSA, 2014). Adolescence is the developmental period during which most people first use marijuana (Schulden et al., 2009). National data show that 23.4% of high school students report past 30-day marijuana use and that 40.1% report lifetime marijuana use in 2013 (Kann et al., 2014).

The US has undergone significant social change regarding marijuana policy in the past 15 years. Since 1996, 34 states have passed legislation removing criminal sanctions for medical use of marijuana. Twenty states have passed legislation to “decriminalize” marijuana use and possession, nine in the late 1970s and the remainder since 2001. Additionally, since 2012, statutes that effectively end sanctions for recreational marijuana use by adults (≥21 years) have been passed in four states (National Conference of State Legislatures [NCSL], 2015). There is increasingly widespread public support for loosening laws prohibiting marijuana, particularly among those younger than 30 (Palamar, 2014, The Pew Research Center, 2013, Swift, 2013).

Given the current political climate, it is important to examine patterns of adolescent marijuana use and consider how they may change if marijuana were to become legally available for recreational use. Some have argued that it will result in an increase in use among youth, because: (1) the price would likely fall dramatically – making it more affordable to young people, (2) it would be more widely available to youth (i.e., diversion from legal outlets to adolescents is likely), and (3) use will be normalized (Anderson and Rees, 2014, Friese and Grube, 2013, Pacula et al., 2014, Palamar et al., 2014). Additionally, in the absence of strong public health regulations, adolescent use could increase in response to targeted advertising and promotion efforts by corporations (D’Amico et al., 2015, Pacula et al., 2014).

Conversely, others suggest that adolescent use will remain stable or increase only marginally. A primary reason for this assertion is that existing and proposed statutes prohibit selling to minors, and selling a product illegally to minors is a risk for businesses (Anderson et al., 2014, Anderson and Rees, 2014, Pacula et al., 2014). Secondarily, the scientific evidence on changes in adolescent marijuana use following medical marijuana legislation does not suggest an increase, although additional studies with longer follow-up periods are needed to draw more definitive conclusions (Choo et al., 2014, Hasin et al., 2015). A third reason that adolescent marijuana use may increase only marginally, if at all, relates to the fact that adolescents already report that they have easy access to marijuana. National data from 2013 show that 70% of 10th graders and 81% of 12th graders say that it would be fairly easy or very easy to obtain marijuana (Johnston et al., 2014). Thus, a large portion of youth abstainers is likely doing so by choice, rather than because they lack access.

There is uncertainty about how adolescent marijuana use will change in response to policy changes, underscoring the importance of closely monitoring patterns of use. The best information about the prevalence of adolescent marijuana use comes from large, nationally representative surveillance systems. The three most widely used such datasets are the NSDUH (SAMHSA, 2014), Monitoring the Future (MTF; Johnston et al., 2014), and the National Youth Risk Behavior Survey (YRBS; Kann et al., 2014). Although direct comparisons are difficult to make given differences in the methodology of the three systems, taken together the data demonstrate that adolescent marijuana use was highest in the 1970s, declined throughout the 1980s and was lowest in 1992, and has remained somewhat stable over the past 20 years (Johnston et al., 2014, Kann et al., 2014, Lanza et al., 2015, Schulden et al., 2009, SAMHSA, 2014). MTF data show that 51% of twelfth graders reported past 12-month use of marijuana use in 1979, compared to 22% in 1992 (Johnston et al., 2014). Although adolescent marijuana use has increased since the early 1990s, the prevalence of use has not reached the peak levels seen in the 1970s (Johnston et al., 2014, Kann et al., 2014, Lanza et al., 2015, Schulden et al., 2009).

The goal of this article is to investigate trends in adolescent marijuana use since 1999. Data are from the national YRBS, which is a biennial, school-based survey that generates nationally representative estimates about health and risk behaviors, including substance use, among high school students (Kann et al., 2014). First, we examine the prevalence and trends in adolescent marijuana use for the past 15 years overall, and by race/ethnicity and sex. We examine lifetime use, past 30-day use, early use (i.e., any use before age 13), and frequent use (i.e., three or more instances of use over the past 30 days). Second, we examined the lifetime prevalence of seven additional substances (i.e., alcohol, tobacco, cocaine, ecstasy, methamphetamine, heroin, and hallucinogens) to evaluate how observed trends in adolescent marijuana use compare to those for other drugs of abuse. Third, we examine whether there were sex differences in past 30-day marijuana use within each race/ethnicity group.

We selected to use data from the YRBS rather than from other, nationally-representative and methodologically-rigorous datasets for two reasons. First, because it is administered in schools (vs. in the home), youth are less likely to underreport marijuana use (Kann et al., 2002, SAMHSA, 2012). Second, because 9th-12th graders are surveyed, grade-pooled estimates represent students in US high school students as a whole, versus just specific grades. Thus, the results we present can be used to summarize the prevalence of marijuana use in US high schools.

Section snippets

National Youth Risk Behavior Survey (YRBS)

The YRBS was initiated by the Centers for Disease Control and Prevention (CDC) in 1990 to monitor the incidence and prevalence of priority health risk behaviors among adolescents in the US (Kann et al., 2014). The CDC uses a three-stage, cluster random sampling design to obtain the YRBS samples. All 50 US states and the District of Columbia are invited to participate. The primary sampling unit (PSU) consists of counties or analogous geographic units, and the secondary sampling unit (SSU)

Trends in marijuana use among US high school students, 1999–2013

Table 1 presents national estimates of the percentage of 9th–12th graders who report marijuana use, and the first column shows the prevalence of lifetime use. Over the 15-year time period, 40.5% reported lifetime marijuana use. The annual prevalence of lifetime use decreased over time (test for linear trend: β = −0.10, p < 0.001). It was 47.2% in 1999, hit its lowest level for the time period in 2009 (36.8%), and then increased to 40.7% by 2013. The increase from 2009 to 2013 is not statistically

Discussion

The purpose of this study was to examine past 15-year trends in adolescent marijuana use among US high school students. We examined the prevalence of lifetime and past 30-day marijuana use from 1999 to 2013, overall and by sex, race/ethnicity, and year. Our rationale was that describing patterns of adolescent marijuana use will contribute to our understanding of how changes in marijuana legislation may impact future use. This is particularly important given how quickly state marijuana policies

Financial disclosure

No financial disclosures were reported by the authors of this paper.

Role of funding source

Funding for this study was provided by grants from NIH: K01DA031738 (PI: Johnson), K01AA017630 (PI: Rothman), R01AA023376 (PI: Xuan), and T32DA007292 (PI: Furr-Holden; Fairman). The study sponsor had no role in determining study design; data collection, analysis, or interpretation; writing the report; or the decision to submit the report for publication.

Contributors

Renee M Johnson drafted the entire manuscript, Ziming Xuan conducted the analysis. Brian Fairman, Tamika Gilreath, Emily Rothman, Taylor Parnham and Debra Furr-Holden assisted with writing and data interpretation.

Acknowledgement

None.

References (44)

  • M.C. Roebuck et al.

    Adolescent marijuana use and school attendance

    Econ. Educ. Rev.

    (2004)
  • M.L. Van Etten et al.

    Comparative epidemiology of initial drug opportunities and transitions to first use: marijuana, cocaine, hallucinogens and heroin

    Drug Alcohol Depend.

    (1999)
  • American Civil Liberties Union [ACLU]

    The War on Marijuana in Black and White: Report. ACLU: Marijuana Law Reform

    (2013)
  • D. Anderson et al.

    The legalization of recreational marijuana: how likely is the worst-case scenario?

    J. Policy Anal. Manage.

    (2014)
  • D. Anderson et al.

    Medical marijuana laws and teen marijuana use

    CATO Institute: Research Briefs in Economic Policy No. 11.

    (2014)
  • F. Bernas et al.

    Uruguay Cannabis Market Still Struggles for Legitimacy a Year After Historic Ruling

    (2015)
  • J.W. Bray et al.

    The relationship between marijuana initiation and dropping out of high school

    Health Econ.

    (2000)
  • N.D. Brener et al.

    Methodology of the Youth Risk Behavior Surveillance System – 2013

    MMWR Recomm. Rep.

    (2013)
  • Centers for Disease Control Prevention [CDC]

    Health risk behaviors among adolescents who do and do not attend school-United States, 1992

    MMWR

    (1994)
  • Centers for Disease Control Prevention [CDC]

    Trends In The Prevalence Of Marijuana, Cocaine, and Other Illegal Drug Use. National YRBS: 1991–2011

    (2011)
  • Centers for Disease Control Prevention [CDC]

    Conducting Trend Analyses of YRBS Data. Youth Risk Behavior Surveillance System (YRBSS)

    (2014)
  • C. Chapman et al.

    Trends in High School Dropout and Completion Rates the United States: 1972–2009 (NCES 2012-006)

    (2011)
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