Harlow Alyssa F, Miech Richard A, Leventhal Adam M
Department of Population and Public Health Sciences, University of Southern California, Los Angeles.
Institute for Addiction Science, University of Southern California, Los Angeles.
JAMA. 2024 Mar 12;331(10):861-865. doi: 10.1001/jama.2024.0865.
Gummies, flavored vaping devices, and other cannabis products containing psychoactive hemp-derived Δ8-tetrahydrocannabinol (THC) are increasingly marketed in the US with claims of being federally legal and comparable to marijuana. National data on prevalence and correlates of Δ8-THC use and comparisons to marijuana use among adolescents in the US are lacking.
To estimate the self-reported prevalence of and sociodemographic and policy factors associated with Δ8-THC and marijuana use among US adolescents in the past 12 months.
DESIGN, SETTING, AND PARTICIPANTS: This nationally representative cross-sectional analysis included a randomly selected subset of 12th-grade students in 27 US states who participated in the Monitoring the Future Study in-school survey during February to June 2023.
Self-reported sex, race, ethnicity, and parental education; census region; state-level adult-use (ie, recreational) marijuana legalization (yes vs no); and state-level Δ8-THC policies (regulated vs not regulated).
The primary outcome was self-reported Δ8-THC and marijuana use in the past 12 months (any vs no use and number of occasions used).
In the sample of 2186 12th-grade students (mean age, 17.7 years; 1054 [48.9% weighted] were female; 232 [11.1%] were Black, 411 [23.5%] were Hispanic, 1113 [46.1%] were White, and 328 [14.2%] were multiracial), prevalence of self-reported use in the past 12 months was 11.4% (95% CI, 8.6%-14.2%) for Δ8-THC and 30.4% (95% CI, 26.5%-34.4%) for marijuana. Of those 295 participants reporting Δ8-THC use, 35.4% used it at least 10 times in the past 12 months. Prevalence of Δ8-THC use was lower in Western vs Southern census regions (5.0% vs 14.3%; risk difference [RD], -9.4% [95% CI, -15.2% to -3.5%]; adjusted risk ratio [aRR], 0.35 [95% CI, 0.16-0.77]), states in which Δ8-THC was regulated vs not regulated (5.7% vs 14.4%; RD, -8.6% [95% CI, -12.9% to -4.4%]; aRR, 0.42 [95% CI, 0.23-0.74]), and states with vs without legal adult-use marijuana (8.0% vs 14.0%; RD, -6.0% [95% CI, -10.8% to -1.2%]; aRR, 0.56 [95% CI, 0.35-0.91]). Use in the past 12 months was lower among Hispanic than White participants for Δ8-THC (7.3% vs 14.4%; RD, -7.2% [95% CI, -12.2% to -2.1%]; aRR, 0.54 [95% CI, 0.34-0.87]) and marijuana (24.5% vs 33.0%; RD, -8.5% [95% CI, -14.9% to -2.1%]; aRR, 0.74 [95% CI, 0.59-0.94]). Δ8-THC and marijuana use prevalence did not differ by sex or parental education.
Δ8-THC use prevalence is appreciable among US adolescents and is higher in states without marijuana legalization or existing Δ8-THC regulations. Prioritizing surveillance, policy, and public health efforts addressing adolescent Δ8-THC use may be warranted.
软糖、调味电子烟设备以及其他含有具有精神活性的大麻衍生δ⁸-四氢大麻酚（THC）的大麻产品在美国市场上越来越常见，它们宣称是联邦法律允许的，且与大麻类似。目前美国缺乏关于青少年使用δ⁸-THC的流行率及其相关因素的数据，也缺乏与青少年使用大麻情况的对比数据。
估计美国青少年在过去12个月中自我报告的δ⁸-THC和大麻使用的流行率，以及与之相关的社会人口学和政策因素。
设计、背景和参与者：这项具有全国代表性的横断面分析包括从美国27个州随机抽取的一部分12年级学生，他们于2023年2月至6月参加了“监测未来”研究的校内调查。
自我报告的性别、种族、民族和父母教育程度；人口普查区域；州级成人用（即娱乐用）大麻合法化情况（是与否）；以及州级δ⁸-THC政策（受监管与否）。
主要结局是自我报告在过去12个月中使用δ⁸-THC和大麻的情况（使用过与未使用过，以及使用次数）。
在2186名12年级学生的样本中（平均年龄17.7岁；1054名[加权后48.9%]为女性；232名[11.1%]为黑人，411名[23.5%]为西班牙裔，1113名[46.1%]为白人，328名[14.2%]为多种族），过去12个月自我报告使用δ⁸-THC的流行率为11.4%（95%CI，8.6%-14.2%），使用大麻的流行率为30.4%（95%CI，26.5%-34.4%）。在报告使用过δ⁸-THC的295名参与者中，35.4%在过去12个月中至少使用过10次。与南部人口普查区域相比，西部人口普查区域的δ⁸-THC使用流行率较低（5.0%对14.3%；风险差异[RD]，-9.4%[95%CI，-15.2%至-3.5%]；调整风险比[aRR]，0.35[95%CI，0.16-0.77]）；δ⁸-THC受监管的州与不受监管的州相比（5.7%对14.4%；RD，-8.6%[95%CI，-12.9%至-4.4%]；aRR，0.42[95%CI，0.23-0.74]）；有合法成人用大麻的州与没有合法成人用大麻的州相比（8.0%对14.0%；RD，-6.0%[95%CI，-10.8%至-1.2%]；aRR，0.56[95%CI，0.35-0.91]）。对于δ⁸-THC，西班牙裔参与者在过去12个月中的使用率低于白人参与者（7.3%对14.4%；RD，-7.2%[95%CI，-12.2%至-2.1%]；aRR，0.54[95%CI，0.34-0.87]），大麻使用情况也是如此（24.5%对33.0%；RD，-8.5%[95%CI，-14.9%至-2.1%]；aRR，0.74[95%CI，0.59-0.94]）。δ⁸-THC和大麻的使用流行率在性别或父母教育程度方面没有差异。
美国青少年中δ⁸-THC的使用流行率相当可观，在没有大麻合法化或现有δ⁸-THC法规的州更高。可能有必要优先开展针对青少年使用δ⁸-THC的监测、政策和公共卫生工作。
