Δ-8-Tetrahydrocannabinol use among US teens climbs in states without regulation

By Dr. Sushama R. Chaphalkar, PhD.Reviewed by Susha Cheriyedath, M.Sc.Mar 13 2024

In a recent study published in the Journal of American Medical Association (JAMA), researchers from the United States of America (US) examined the prevalence of the self-reported use of Δ⁸-tetrahydrocannabinol (THC) and marijuana among adolescents in the US. They found that the prevalence of Δ⁸-THC and marijuana use was remarkable among adolescents and higher in states lacking Δ⁸-THC regulations or marijuana legalization.

Study: Adolescent Δ8-THC and Marijuana Use in the US. Image Credit: Kitreel / Shutterstock

Background

Δ⁸-THC, a psychoactive compound and isomer of Δ⁹-THC found in marijuana, is derived from hemp and legally available since the 2018 Agriculture Improvement Act. Commercially manufactured consumable hemp-derived Δ⁸-THC products such as edibles and vaping devices have proliferated, potentially posing risks to adolescents, such as addiction and neurodevelopmental changes.

There is a dearth of data on the use of Δ⁸-THC among adolescents, hampering policy development. Δ⁸-THC products lack a federal minimum purchasing age and are available online and in stores without stringent age verification, potentially increasing adolescent access. This access may be more pronounced in states lacking Δ⁸-THC regulations or where adult-use marijuana is illegal, as Δ⁸-THC is marketed as a legal alternative. Therefore, researchers in the present study aimed to estimate the self-reported Δ⁸-THC or marijuana use prevalence among 12^th-grade US students, considering state-level cannabis policies and sociodemographic factors. They aimed to provide insights for policymaking in public health.

About the study

As a part of the Monitoring the Future (MTF) survey conducted in 2023, a total of 2,186 randomly selected 12^th-grade students were questioned regarding the use of Δ⁸-THC. The average age of the participants was 17.7 years, and the sample included 48.9% females, 45.8% males, and 5.3% other or unreported sex. The sample represented the following races: Asian (4%), Black (11.1%), Hispanic (23.5%), White (46.1%), multiracial (14.2%), and others (1.1%). Geographically, the participants resided in the following regions of the country: South (36.7%), West (24.5%), Midwest (22%), and Northeast census regions (16.9%). While a majority of participants (44.2%) lived in states with the legalization of adult-use marijuana, 34.8% of them lived in states with Δ⁸-THC regulations.

Participants reported the frequency of Δ⁸-THC and marijuana use in the past year. Data included sex, race/ethnicity, parental education, and school location. State-level policies on Δ⁸-THC and adult-use marijuana were considered and classified. Δ8-THC and marijuana use prevalence were calculated and stratified by sociodemographic and policy variables. Adjusted risk ratios (aRRs) were estimated using log-binomial models, controlling for relevant factors. Sensitivity analyses and weighted analyses were conducted. Differences in aRRs between Δ⁸-THC and marijuana use were evaluated. However, the researchers did not correct for multiple testing in this exploratory study.

Results and discussion

As per the study, in the last year, around 11.4% of adolescents (n= 295) reported using Δ⁸-THC. Among these users, 68.1% used it at least thrice, 35.4% at least 10 times, and 16.8% of participants used Δ⁸-THC at least 40 times. About 90.7% of the participants also reported using marijuana. The prevalence was found to be similar among males (12.3%) and those with other or unreported genders (19.7%), while females showed a slightly lower prevalence (9.6%). However, the sex-based differences were not statistically significant. Hispanic participants showed a significantly lower prevalence compared to White participants (7.3% vs. 14.4%). Additionally, the prevalence was found to be 9.7% among Black participants, 9.6% among Asians, 10.3% among multiracial participants, and 7.2% in other races. No significant differences were observed based on parental education.

Over 12 months, Δ⁸-THC use was found to vary across US census regions: 14.3% in the South, 14.6% in the Midwest, 10.1% in the Northeast, and 5.0% in the West. The prevalence was significantly lower in the West compared to the South (aRR = 0.35). Furthermore, Δ⁸-THC use was found to be significantly higher in the Midwest than in the West. Interestingly, states with adult-use marijuana legalization showed a lower prevalence compared to those without (aRR = 0.56). Similarly, states with Δ⁸-THC regulation showed lower prevalence (5.7%) compared to those without (14.4%).

The overall prevalence of marijuana use in the past year was 30.4%. White participants showed a higher prevalence (33.0%) compared to Hispanic participants (24.5%). No significant differences were observed with respect to sex or parental education. In adjusted models, marijuana use was found to be lower in the South than in the Northeast region. State-level cannabis policies did not show variations in marijuana use. The aRRs for the Census region and cannabis policy were found to be significantly different for Δ⁸-THC and marijuana use. Sensitivity analysis confirmed the main findings of the study.

The study is limited by correlated variables of census region and state-level policy, incomplete state representation in the survey sample, exclusion of non-enrolled or absent students, potential age bias toward older adolescents, and lack of measurement for other hemp-derived products, possibly underestimating adolescent Δ⁸-THC use.

Conclusion

In conclusion, adolescent Δ⁸-THC use is considerable in the US, especially in states lacking marijuana legalization or specific Δ⁸-THC regulations. The study highlights the importance of focusing on surveillance, policy, and public health efforts to urgently address Δ⁸-THC use among adolescents.