Patterns of Cannabis Use and Perceived Accessibility Among Underage U.S. Young Adults: Implications for Policy and...

Using a national U.S. underage young adult sample, we examined the prevalence of smoking, vaping, eating, drinking, and dabbing cannabis; perceived accessibility by product type; and perceived accessibility correlates (adolescent cannabis use, state cannabis policy context, sociodemographic characteristics).

Data were obtained from adults younger than age 21 years participating in the U.S. national Monitoring the Future Panel study from 2019 to 2023. Cannabis use prevalence by smoking, vaping, edibles, drinking, and dabbing was measured (n = 3,075; 52.9% female). Perceived accessibility was measured for smoking, vaping, and edibles (n = 1,227; 52.1% female). Covariate and accessibility associations were modeled using logistic regression.

Multiple cannabis use modalities were reported by 23.3% of all respondents and 63.5% of those reporting past-12-month use. Among all respondents, smoking (30.7%), vaping (19.7%), and edibles (18.2%) were the most prevalent; fewer reported dabbing (10.4%) or drinking (2.8%). Perceiving easy access to smoking, vaping, and edibles was reported by 95.0%, 91.3%, and 86.7% of those reporting past-12-month use (77.5%, 71.2%, and 71.8% of those reporting no use). Among those reporting no 12-month use, state recreational use policy was associated with perceiving easier access for smoking and edibles; full-time 4-year college attendance was associated with easier perceived access across modalities (vs. part-time/2-year college or not attending).

Underage U.S. young adults are not legally able to purchase cannabis but reported easy access across products; those who used cannabis typically used multiple products. Among those reporting no past-12-month use, state policy and college attendance were strongly associated with perceived accessibility across products.