The last ten years have seen significant changes in the landscape of cannabis reform and adult-use legalization, altering perceptions and improving availability. With this shift, concerns about increased availability to minors have been vocalized by critics. However, recent studies continue to show that legal availability does not necessarily correlate with increased usage among teens and young adults, and a new study takes a broader look at this issue.
Researchers at the University of Oklahoma studied over 8,000 young adults aged 18 to 24 over a six-year period to determine their initial substance use choices. Their findings indicate that most young adults first experience alcohol and/or tobacco prior to trying cannabis.
Research Investigates Early Substance Use in Emerging Cannabis Markets
This study, titled “First use of cannabis compared to first use of alcohol and tobacco: Associations with single and poly-substance use behavior,” appeared in the journal Drug and Alcohol Dependence.
The study highlights that in 2022, approximately 145 million Americans resided in states where recreational or medical cannabis was legal, making up 45% of the nation’s population. It notes that these legal cannabis environments are of significant relevance to the 18-24 age group, which exhibits the highest rates of cannabis consumption both in the past year and the past month.
The sequence of alcohol, tobacco, and cannabis use among young adults often starts with alcohol, which previous research has shown to potentially lead to further substance use. The study explores whether legal access to cannabis has altered these patterns.
“No existing studies have specifically analyzed whether initiating cannabis use before alcohol and tobacco, or at the same age, increases the likelihood of poly-substance use and other drug use challenges,” the researchers explain.
The study analyzed data from the first five waves of the Population Assessment of Tobacco and Health (PATH) study, spanning from September 2013 to November 2019.
Most Young Adults Still Start With Alcohol and Tobacco Before Cannabis
The data revealed that a small percentage (6%) of young individuals began their substance use with cannabis, and these individuals were typically less likely to engage in alcohol use or suffer from substance abuse and mental health issues later. Most of those who started with cannabis were males, predominantly non-Hispanic white, with the majority holding a high school diploma or GED, and a significant portion having some college education.
Additionally, about 22% of the participants who began using cannabis at the same time as alcohol and tobacco were more prone to use multiple drugs in later life.
The study reaffirms that alcohol remains the most common first substance, with 52% of the participants starting with it.
“Alcohol is primarily tried before either tobacco or cannabis,” the authors summarized. “Starting cannabis at a younger age than alcohol and tobacco is rare. Those who do start with cannabis appear less likely to face a range of substance use and mental health issues compared to those who begin using cannabis at the same age as other substances.”
Reinforcing Earlier Studies and Challenging the ‘Gateway Drug’ Label
The researchers emphasized that their findings support earlier research and reflect the present conditions of the growing cannabis market more accurately.
A 2016 study also concluded that alcohol is often the initial substance for those who later report polydrug use. This evaluation was based on a national sample of 2,835 high school seniors, confirming that earlier initiation of alcohol consumption correlates with higher chances of future illicit substance use.
Numerous other studies have addressed the long-held view that cannabis acts as a “gateway drug” leading to more severe drug use, though studies consistently challenge this assertion.
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