Trends in Marijuana Vaping and Edible Consumption From 2015 to 2018 Among Adolescents in the US | Adolescent Medicine | JAMA Pediatrics | JAMA Network
[Skip to Navigation]
Sign In
Research Letter
April 6, 2020

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

Author Affiliations
  • 1Institute for Translational Research in Children’s Mental Health, University of Minnesota, Minneapolis
  • 2Institute of Child Development, University of Minnesota, Minneapolis
  • 3Institute for Social Research, University of Michigan, Ann Arbor
JAMA Pediatr. 2020;174(9):900-902. doi:10.1001/jamapediatrics.2020.0175

There is growing evidence associating adolescent marijuana use with developmental and societal consequences. Noncombustible marijuana use products are more accessible, but data on use trends compared with smoking marijuana have not been available. Vaping has increased rapidly among adolescents,1 and although pot brownies are not new, commercially manufactured marijuana edibles are now available. The extent to which these products are used by adolescents nationally is unknown. Regional data suggest boys vape more than girls.2-4 There are conflicting reports of sex differences in edible use4,5 and differences across modes of use for race/ethnicity2,4 and socioeconomic status (SES).3,4 We document prevalence and trends from 2015 to 2018 in noncombustible marijuana use and differences by use frequency and sociodemographic characteristics (ie, sex, race/ethnicity, SES, and school urbanicity).

Methods

Monitoring the Future data from 2015 to 2018 included 9097 responses from students in 12th grade on relevant forms; 2989 (32.9%) reported using marijuana in the past 12 months, and of these, 2412 (80.7%) had complete data on modes of use and covariates.6 The study was approved by the University of Michigan Institutional Review Board, and informed consent (either passive consent or active [ie, written] consent, per school policy) was obtained from parents for students younger than 18 years and from students 18 years or older. A school in more than 90% of the geographic units selected each year to be nationally representative was surveyed; 54 354 of 67 312 selected students (80.7%) responded. Methods of use included smoking, vaping, and edibles. Frequency of past 30-day use was dichotomized to regular/daily marijuana use (20 or more occasions) or less.6 Sex (male or female), race/ethnicity (black, white, Hispanic, Asian, or other), parent education as an SES proxy (at least 1 parent has a college degree vs less education), and school urbanicity (urban, suburban, or rural) were examined.

All analyses were conducted in SAS version 9.4 (SAS Institute) using the survey procedures to incorporate the complex sample design and sampling weight, accounting for the differential probability of selection. Wald tests were used to calculate the P values, and significance was set as a 2-tailed P value less than .05.

Results

In 2018, students reported consuming marijuana through smoking (666 of 746 past-year users [89.3%]; 666 of 2428 students overall [27.4%]), eating (295 of 746 [39.5%]; 295 of 2428 [12.1%]), and vaping (254 of 746 [34.1%]; 254 of 2428 [10.5%]). Among past-year marijuana users from 2015 to 2018, smoking decreased (2015, 643 of 679 [94.7%]; 2018, 666 of 746 [89.3%]), while eating (2015, 217 of 679 [32.0%]; 2018, 295 of 746 [39.5%]) and vaping (2015, 179 of 679 [26.4%]; 2018, 254 of 746 [34.1%]) increased (Figure). In 2018, consuming marijuana through dabbing (227 of 746 past-year users [30.5%]; 227 of 2428 students overall [9.4%]) and drinking (31 of 746 [4.2%]; 31 of 2428 [1.3%]) were also reported.

Figure.  Prevalence of Methods of Marijuana Use in the Past 12 Months Among US 12th Graders, 2015-2018
Prevalence of Methods of Marijuana Use in the Past 12 Months Among US 12th Graders, 2015-2018

Error bars indicate 95% CIs.

Most noncombustible users also smoked marijuana. Only 31 of 254 of vapers (12.3%) and 24 of 295 edible consumers (8.1%) did not smoke marijuana in the past year. Daily use was reported by 112 of 639 smokers (17.6%), 69 of 242 vapers (28.5%), and 77 of 288 edible consumers (26.7%).

In multivariable logistic regression analyses (Table), boys had greater odds than girls of vaping and eating marijuana. White adolescents had greater odds than Hispanic adolescents of smoking marijuana, greater odds than black adolescents of vaping and eating marijuana, and lower odds than Asian adolescents of eating marijuana. Youth with lower (compared with higher) SES had lower odds of vaping marijuana. Compared with rural areas, students in urban areas had greater odds of eating and vaping marijuana, and those in suburban areas had greater odds of eating marijuana. Smoking marijuana was less prevalent and eating and vaping marijuana were more prevalent in 2018 than previous years.

Table.  Results of Multivariable Logistic Regression Models for Modes of Marijuana Use Among Past-Year Marijuana Users
Results of Multivariable Logistic Regression Models for Modes of Marijuana Use Among Past-Year Marijuana Users

Discussion

From 2015 to 2018, smoking marijuana decreased and vaping and edible use increased among adolescent users. Similar increases have been reported for vaping across substances, although levels of marijuana use overall remained steady.6 Modes of use differed by subgroup. As the legal status of marijuana changes, changes in youth behaviors and attitudes should continue to be monitored.

This study has limitations. Monitoring the Future data represent high school seniors, so students who are absent or dropped out are not included. In 2018, response options changed from “in a vaporizer” to “vaping” and “dabbing” became an option, possibly altering response patterns.

Daily use was more common among vape and edible users than smokers. More than one-quarter of students who vaped or used edibles in the past year used marijuana daily in the last month. Health care professionals should consider asking adolescent patients about noncombustible marijuana use to identify heavy users.

Back to top
Article Information

Accepted for Publication: October 2, 2019.

Corresponding Author: Megan E. Patrick, PhD, Institute for Translational Research in Children’s Mental Health, University of Minnesota, 1100 Washington Ave S, Ste 101, Minneapolis, MN 55415 (mpatrick@umn.edu).

Published Online: April 6, 2020. doi:10.1001/jamapediatrics.2020.0175

Author Contributions: Dr Patrick and Ms Kloska had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Study concept and design: Patrick.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: Patrick, Kloska, Wagner.

Critical revision of the manuscript for important intellectual content: Patrick, Miech, Wagner, Johnston.

Statistical analysis: Patrick, Miech, Kloska.

Obtained funding: Patrick, Miech, Johnston.

Administrative, technical, or material support: Patrick, Miech, Johnston.

Study supervision: Patrick.

Conflict of Interest Disclosures: Dr Johnston has received grants from the US Department of Health and Human Services. No other disclosures were reported.

Funding/Support: Data collection and manuscript preparation were supported by research grant R01DA001411 (Drs Miech and Johnston) and development of the manuscript was supported by research grant R01DA037902 (Dr Patrick) from the National Institute on Drug Abuse.

Role of the Funder/Sponsor: The funder had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Disclaimer: The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Drug Abuse.

References
1.
Johnston  LD, Miech  RA, O’Malley  PM, Bachman  JG, Schulenberg  JE, Patrick  ME. 2018 Overview: key findings on adolescent drug use. Accessed August 1, 2019. http://www.monitoringthefuture.org/pubs/monographs/mtf-overview2018.pdf
2.
Johnson  RM, Brooks-Russell  A, Ma  M, Fairman  BJ, Tolliver  RL  Jr, Levinson  AH.  Usual modes of marijuana consumption among high school students in Colorado.   J Stud Alcohol Drugs. 2016;77(4):580-588. doi:10.15288/jsad.2016.77.580PubMedGoogle ScholarCrossref
3.
Mammen  G, Rehm  J, Rueda  S.  Vaporizing cannabis through e-cigarettes.   Can J Public Health. 2016;107(3):e337-e338. doi:10.17269/CJPH.107.5747PubMedGoogle ScholarCrossref
4.
Peters  EN, Bae  D, Barrington-Trimis  JL, Jarvis  BP, Leventhal  AM.  Prevalence and sociodemographic correlates of adolescent use and polyuse of combustible, vaporized, and edible cannabis products.   JAMA Netw Open. 2018;1(5):e182765. doi:10.1001/jamanetworkopen.2018.2765PubMedGoogle Scholar
5.
Friese  B, Slater  MD, Battle  RS.  Use of marijuana edibles by adolescents in California.   J Prim Prev. 2017;38(3):279-294. doi:10.1007/s10935-017-0474-7PubMedGoogle ScholarCrossref
6.
Miech  RA, Johnston  LD, O’Malley  PM, Bachman  JG, Schulenberg  JE, Patrick  ME. Volume I: secondary school students. Accessed August 1, 2019. http://www.monitoringthefuture.org/pubs/monographs/mtf-vol1_2018.pdf
Limit 200 characters
Limit 25 characters
Conflicts of Interest Disclosure

Identify all potential conflicts of interest that might be relevant to your comment.

Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.

Err on the side of full disclosure.

If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.

Not all submitted comments are published. Please see our commenting policy for details.

Limit 140 characters
Limit 3600 characters or approximately 600 words
    ×