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Prevalence of Adolescent Cannabis Vaping: A Systematic Review and Meta-analysis of US and Canadian Studies.
JAMA Pediatr. Published online October 25, 2021. doi:10.1001/jamapediatrics.2021.4102
Key Points
Question: What is the prevalence of adolescent cannabis vaping in the US and Canada?
Findings: This systematic review and meta-analysis reviewed 17 unique studies from the US and Canada, with a total of 198 845 adolescents, and found that the lifetime prevalence of cannabis vaping doubled from 2013 to 2020 (6.1% to 13.6%), past 12-month use doubled from 2017 to 2020 (7.2% to 13.2%), and the 30-day prevalence of cannabis vaping increased 7-fold from 2013 to 2020 (1.6% to 8.4%). Preference for cannabis products may be shifting from dried herb to cannabis oil.
Meaning: 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.
Abstract
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.
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.
(D
algarno Institute Comment – Again, a ‘harm reduction’ product that not only ‘isn’t’, yet one that is easily hijacked by pro-drug actors to enable and equip illicit drug use, and most tragically, among the now ‘propagandized’ young.)
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This study examined high-risk health behaviors in marijuana-users among a diverse college population in Southern California, post legalization of marijuana for recreational use.
Study design: A cross-sectional research design was employed utilizing existing data via the 2018 National College Health Assessment (NCHA) from a large Minority-Serving Institution (MSI) population [n = 1345 (Hispanic/Latino/a, n = 456; White, n = 353; Asian Pacific Islander (API), n = 288; Multiracial/Biracial, n = 195; Other, n = 53)].
Methods: Chi square and t-tests assessed differences in descriptive characteristics (age, gender, race/ethnicity and GPA) and high-risk behaviors (alcohol, tobacco and sexual behaviors) among marijuana users and non-users. Logistic regression analyses examined the relationship between race/ethnicity and high-risk behaviors with marijuana use (dependent variable).
Results: Among marijuana-users, significant (p = 0.004) differences were observed between race/ethnicity with Whites reporting using most (32.7%), followed by Hispanics (27.6%) and then APIs (17.8%). Marijuana-users compared with non-users consistently reported high-risk alcohol behaviors (p < 0.0001), were more likely to smoke tobacco (p < 0.0001) and engaged in more high-risk sexual behaviors (p < 0.0001). Logistic regression showed after adjusting for demographic characteristics and high-risk behaviors, race/ethnicity was borderline significantly associated with marijuana use, specifically for Whites (OR = 1.53; 95% CI: (−0.01, 0.86), p = 0.06) and the Other race/ethnicity category (OR = 2.32; 95% CI: (0.12, 1.56), p = 0.02) compared with APIs.
Conclusion: Our findings clearly demonstrate deleterious high-risk behaviors such as alcohol use, tobacco use, and certain sexual behaviors occur more among marijuana-users compared to non-users, post legalization of marijuana for recreational use. Further, race-ethnic differences were observed. Therefore, continued examination of marijuana use trends and high-risk behaviors is critical in monitoring the implications of marijuana policy changes, specifically in diverse populations
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The link between tobacco smoke and lung cancer is well-known. Studies show that marijuana smoke has many of the same harmful substances as tobacco, and often more of them. Among the hazards are:
- Benzo(a)pyrene
- Benz(a)anthracene
- Phenols
- Vinyl chlorides
- Nitrosamines
- Reactive oxygen species
People also smoke marijuana in a different way than tobacco, possibly posing greater danger to the lungs:
- You usually inhale marijuana smoke deeply and hold it in, which gives the toxins more contact with your lung tissue and more chance to stick there.
- You generally a smoke a joint all the way to the end. Tar, the sticky stuff left after burning, has high levels of harmful substances, and it’s concentrated at the end of a joint.
When scientists looked at lung tissue of some people who smoked weed regularly, they found changes that are known to signal the future growth of cancer. For complete article go to Does Marijuana Cause Lung Cancer? (webmd.com)
For more evidence based science on harms of Cannabis to lungs
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October 9, 2021
Legalising and commercialising cannabis is well underway from Uruguay to Canada and in at least 10 states in the US. Paradoxically, this shift towards the toleration of cannabis as more-or-less harmless is taking place just as scientists conclusively prove the link between cannabis and psychosis (a less shocking word than “madness” or “insanity”, but the meaning is the same). Cause and effect is today as well established as it is between cigarette smoking and lung cancer.
“Numerous prospective studies have shown that cannabis use carries an increased risk of later schizophrenic-like psychosis,” says an article by Sir Robin Murray of the Institute of Psychiatry, Psychology and Neuroscience at King’s College London and Wayne Hall of the National Centre for Youth Substance Use Research at the University of Queensland. They cite a study showing that, though Portugal is held up as a pioneer in dealing with drugs, the rate of hospitalisation for psychotic disorders has increased 29-fold since decriminalisation 15 years ago. Another study calculates that between 30 per cent and 50 per cent of new cases of psychosis in London and Amsterdam would not have occurred if the individual affected had not been smoking high-potency cannabis.

Personal observation confirms this: doctors in mental hospitals have told me that they scarcely bother anymore to ask patients if they have taken cannabis, but simply assume it is the case. The situation has deteriorated as the proportion of THC, the psychoactive substance in cannabis producing the “high”, has risen precipitately. Once as low as 3 per cent it has risen to 10 to 15 per cent in Europe and North America, though in Colorado, the first state to legalise recreational use, the THC can reach as high as 70 per cent. Those taking cannabis daily, particularly if they are young, face an escalating risk of permanent mental breakdown.
But if cannabis has already had its “tobacco moment”, when the damage it does is scientifically proven, why do celebrities like Justin Bieber want to destigmatise it and persuade consumers that it will improve their mental health?
The cigarette industry did this a century ago, funding “independent” experts that sought to blur or discredit evidence that smoking caused cancer. Governments were seduced by high tax revenues from tobacco sales and reluctant to do anything to curtail them. Hollywood stars like John Wayne, Clark Gable and Spencer Tracy happily – and profitably – glamourised cigarettes, much as is happening to cannabis now.
Businesses seeking to emulate the tobacco companies at the height of their profitability have formed a bizarre de facto alliance with liberals and progressives, who are appalled by the disastrous mess created by government drug policy. The so-called “war on drugs” has demonstrably inflicted more misery in the US, certainly on the black community, than real military conflicts.
But an over-reaction to government failure provoking a dash in the opposite direction has equal dangers. Those in favour of greater tolerance towards drugs are almost invariably thinking of cannabis as much less nasty than heroin and cocaine. But I have met psychiatrists, with long experience of dealing with drug victims of all sorts, who believe that cannabis is more dangerous than the other drugs because it has the potential to damage many more people.
The legalisation of cannabis will do nothing to hurt organised crime groups, but it will make the drug much more widely available. The idea by proponents of legalisation that the government will tightly regulate its quality and sale is naïve. If the authorities cannot control it when it is illegal, they will be even less able to do so when it is legal. But legalisation – and even limited decriminalisation – will send a message that taking cannabis is a benign activity and does not do you or anybody else much harm. The deterrent effect of illegality will evaporate and the drug becomes no different than alcohol and tobacco.
Once commercially available, all the old persuasive tools formerly used by the cigarette industry swing into action as is happening unstoppably in the US. Celebrities like Justin Bieber will “destigmatise” the drug and give it the gloss of youth and fashion. Once the victims of the tobacco companies coughed up their lungs unnoticed by the wider community, and this time round the victims of cannabis will disappear into mental hospitals without anybody taking much notice.
- Cannabis users at 'much higher' risk of developing poor mental health
- Dual Use of Alcohol & Cannabis a Real Problem for Young Adults – Greater Risk of Alcohol Use Disorder?
- USA: Marijuana Use Soars, Alcohol Use Drops Among College Students
- Marijuana & Impaired Driving – What the Data Shows (North American Cannabis Summit 2019)