Cannabis Vaping in Youth: A Systematic Review and Meta-Analysis of Risk Factors in Adolescents and Young Adults

The use of electronic vaporizers to deliver cannabis ("cannabis vaping") has increased rapidly among young people. This systematic review and meta-analysis aimed to summarize current evidence on the psychosocial characteristics of adolescents and young adults who vape cannabis.

PubMed, PsycINFO, Scopus, and Web of Science were searched for original publications since 2003. We summarized and meta-analyzed studies on adolescents (12-18 years) and young adults (19-34 years) that reported sociodemographic, mental health, and other substance use correlates of cannabis vaping.

Thirty-one studies from the United States, Canada, England, New Zealand, and Switzerland met the eligibility criteria (n = 568,304): 26 focused on adolescents (12-18 years; n = 554,934), and 5 on young adults (19-34 years; n = 13,370). Among adolescents who currently used cannabis (n = 114,595), the odds of cannabis vaping were significantly higher in males than females (7 studies; pooled odds ratio [OR] = 1.79, 95% CI [1.38, 2.34]), in older than younger adolescents (3 studies; pooled OR = 1.26, 95% CI [1.07, 1.50]), and in adolescents who currently use tobacco (3 studies; pooled OR = 1.62, 95% CI [1.11, 2.36]) or alcohol (3 studies; pooled OR = 2.52, 95% CI [1.27, 5.01]), but significantly lower in non-Hispanic Blacks than Whites (4 studies; pooled OR = 0.55, 95% CI [0.39, 0.77]). The relationship between adolescent cannabis vaping and mental health, and factors among young adults, was inconclusive because of an insufficient number of studies.

Adolescents who were male, older, non-Hispanic White, and currently using alcohol or tobacco had higher odds of vaping cannabis. Findings highlighted the need to tailor prevention initiatives for these populations and to conduct further research on the association between cannabis vaping and mental health disorders.