Introduction

Canadian youth consume cannabis in multiple ways, including by smoking, vaping, and eating or drinking. Existing evidence suggests that these behaviours may change after law liberalization, though data regarding youth are scarce. We investigated changes in cannabis modes of use and associated factors across the federal legalization of recreational cannabis use for adults in Canada, among a large sample of underage youth before alternative products were made legally available.

Methods

Data were available from 2953 longitudinally linked Canadian high school students who reported on their cannabis use during the 2017/2018 and 2018/2019 school years. We explored whether students maintained a single or multiple cannabis use mode(s), contracted, or expanded the number of modes used. We then used generalized estimating equations to analyse associations of baseline characteristics with use mode trajectory.

Results

Expansion of cannabis use modes (42.3%) was more common than maintenance of a single mode (31.3%), maintenance of multiple modes (14.3%), or reduction (12.1%). Students who maintained multiple modes were significantly more likely to have high amounts of weekly spending money (AOR 1.68), to binge drink (AOR 2.25) or vape (AOR 1.99), to use cannabis regularly (AOR 2.67), and to endorse more symptoms of depression (AOR 1.06). School support for quitting tobacco, drug, or alcohol use appeared to have no effect.

Conclusions

Multi-modal cannabis use increased among Canadian youth in our sample. Its association with other substance use and depressive symptoms may indicate clustering of additional harms. Screening for this use pattern may assist in identifying high-risk substance use and should be considered in the design of harm reduction programming.

中文翻译：

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加拿大青少年在娱乐性大麻合法化期间大麻使用模式的变化：来自 COMPASS 前瞻性队列研究的数据

介绍

加拿大青年以多种方式消费大麻，包括吸烟、吸电子烟和进食或饮水。现有证据表明，这些行为在法律自由化后可能会发生变化，尽管有关青年的数据很少。我们调查了加拿大成人娱乐大麻使用联邦合法化过程中大麻使用方式的变化和相关因素，在替代产品合法提供之前，对大量未成年青年进行了调查。

方法

数据来自 2953 名纵向关联的加拿大高中学生，他们报告了他们在 2017/2018 和 2018/2019 学年使用大麻的情况。我们探讨了学生是否保持单一或多种大麻使用模式、收缩或扩大使用模式的数量。然后我们使用广义估计方程来分析基线特征与使用模式轨迹的关联。

结果

大麻使用模式的扩展 (42.3%) 比维持单一模式 (31.3%)、维持多种模式 (14.3%) 或减少 (12.1%) 更常见。保持多种模式的学生更有可能每周花费大量金钱 (AOR 1.68)、狂饮 (AOR 2.25) 或电子烟 (AOR 1.99)、定期使用大麻 (AOR 2.67) 并认可更多症状抑郁症（AOR 1.06）。学校对戒烟、戒毒或戒酒的支持似乎没有效果。

结论

在我们的样本中，加拿大青年的多模式大麻使用有所增加。它与其他物质使用和抑郁症状的关联可能表明其他危害的聚集。筛选这种使用模式可能有助于识别高风险物质使用，并应在减少危害计划的设计中加以考虑。