How Cannabis Advertising and Price-Based Sales Promotion Shape Early Use: A National Study of Adolescents and Young...

To examine associations between cannabis advertising and price-based promotions and cannabis initiation among U.S. adolescents and young adults (AYAs).

We used two-wave panel data (2024-2025) from a nationally representative sample of U.S. AYAs aged 15-20 who were current cannabis users or susceptible to cannabis use. Initiation was defined as: recent use initiation (past 30-day use in wave 2, no past-30-day use in wave 1) and lifetime initiation (ever use in wave 2, never use in wave 1). Advertising and price-based promotion exposure were measured over the past six months. Logistic and split-population survival models were estimated to examine associations with initiation.

Exposure to any advertising was positively associated with initiation (logistic: β = 2.25, p < 0.05; split-population: β = 1.90, p < 0.05). When exposure was measured by number of advertising channels, exposure through one channel (logistic: β = 1.73; split-population: β = 1.42; both p < 0.01) and three or more channels (logistic: β = 2.02; split-population: β = 1.73; both p < 0.05) were significantly associated with higher initiation risk. Price-based promotion exposure was not significantly associated with recent initiation but was positively associated with lifetime initiation (logistic: β = 1.09, p < 0.05; split-population: β = 0.84, p < 0.05).

Cannabis advertising and price-based promotions are linked to initiation among AYAs. As cannabis commercialization expands amid limited marketing oversight, these findings highlight the need for policies that limit AYAs' exposure to cannabis advertising and price promotion.