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The Role of Shifting Marijuana Policies in Adolescent Substance Use

Fri, March 22, 7:45 to 9:15am, Baltimore Convention Center, Floor: Level 1, Exhibit Hall B

Integrative Statement

Recent state-level marijuana policy shifts have been highly publicized and debated in the U.S. In the past decade, twenty-one states have implemented decriminalization policies (Gerber, 2004), and since the 1990s, twenty-nine states have enacted some degree of medical marijuana legalization (MML; Clark, Cappuzzi, & Fick, 2011). Findings have been mixed regarding the link between such policies and adolescent marijuana use (e.g. Ammerman et al., 2015; Anderson, Hansen & Rees, 2015; Harper, Strumpf & Kaufman, 2012; Miech et al., 2015), and few studies have examined the influence of decriminalization and MML policies simultaneously. Further, limited research exists examining the influence of marijuana-targeted policy shifts on other drug use among adolescents. This is a clear gap in the literature considering the potential for spillover effects: that is, that policy shifts could affect access to or use of other substances (Guttmanova, 2016). Therefore, the present study seeks to explore associations between state-level marijuana policy shifts - both decriminalization and MML policies - and adolescent substance use including marijuana, tobacco, alcohol, and cocaine.
This study utilized Youth Risk Behavior Surveys (YRBS) which collected data on U.S. high school students biennially from 1999-2015. The final analytic sample consisted of 861,082 adolescents across 45 states. Difference-in-difference models were estimated to examine the relationship between decriminalization and MML policy exposure and adolescent substance use. Models controlled for other shifts in the policy landscape (e.g. tobacco tax, beer tax, and smoke free policies) along with adolescent demographic characteristics (age, gender, and race/ethnicity).
Results indicate that MML policy enactment predicted a 0.9% reduction in current marijuana use and a 0.7% decrease in cigar smoking and smokeless tobacco use with effects over time and in relation to more permissive policy components. Decriminalization enactment, on the other hand, was linked with a 1.5% increase in cigarette smoking and a 1.0% increase in cigar smoking with reducing effects over time and mixed effects in relation to more permissive policy enactment. Marijuana policies showed no significant links with alcohol use among adolescents. Overall, these findings largely quell concerns regarding the influence of liberal marijuana policy enactment on adolescent marijuana and other substance use, though indicating some potentially negative outcomes of decriminalization policies with respect to smoking behaviors. Given the importance of marijuana and tobacco products for health and well-being, it is essential to understand the repercussions of marijuana-targeted policy enactment on adolescent substance use.

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