New research suggests that patterns of cannabis use among adolescents mirror those previously observed with alcohol, indicating that interventions to curb use should target the broader population rather than focusing solely on high-risk groups. The study, published in the journal Addiction, analyzed decades of data from Swedish adolescents and found that changes in overall cannabis use are reflected across all levels of users – from those who use infrequently to those who use more often.
The research, conducted by scientists at the Swedish Institute for Social Research at Stockholm University and the Karolinska Institutet, examined data from over 250,000 students aged 15-18, collected between 1990 and 2023 through national school surveys administered by the Swedish Council for Information on Alcohol and Other Drugs (CAN). Researchers focused on how frequently adolescents who already used cannabis did so, and how the distribution of that use changed over time.
A central finding was the remarkable stability of the distribution of cannabis use. Whether average use increased or decreased, the change occurred proportionally across all user groups. This challenges the notion that increases in cannabis use are solely driven by a small segment of heavy users. “Increases in average use are not driven solely by a small group of heavy users, but by broader changes in behavior among users in general,” explained Thor Norström, co-author of the study and Professor Emeritus at the Swedish Institute for Social Research.
The study also revealed a correlation between periods of higher average cannabis use and a corresponding increase in the proportion of adolescents who use cannabis very frequently. This suggests that when overall use rises, so does the number of young people potentially at risk of developing cannabis-related problems. This finding underscores the importance of understanding the broader context of adolescent cannabis use.
These findings lend support to the “total consumption model,” a theory prominent in alcohol research. This model posits that preventive efforts should not be limited to identifying and intervening with high-risk individuals. Instead, interventions must address the entire population, recognizing that changes in societal norms, availability, and attitudes impact all users simultaneously. This approach acknowledges the social and environmental factors that contribute to substance use.
“Our results suggest that adolescent cannabis use is characterized by collective changes, in which social networks, norms, and the broader societal climate play an important role,” stated Håkan Leifman, co-author and researcher at the Department of Clinical Neuroscience at Karolinska Institutet. This highlights the interconnectedness of individual behavior and the larger social environment.
The researchers emphasize the particular relevance of these findings given the evolving global attitudes toward cannabis. Even in countries where cannabis remains illegal, such as Sweden, changing perceptions and social norms can influence adolescent behavior. This shift in societal acceptance necessitates a reevaluation of prevention strategies.
“This underscores the importance of a broad public health perspective in preventive efforts targeting cannabis use among young people,” Norström added. A comprehensive approach that considers the social and cultural context is crucial for effective prevention.
Recent research further supports the idea of overlapping patterns between alcohol and cannabis use in young adults. A study published in in the Journal of Adolescent Health examined changes in alcohol and marijuana use among young adults before and during the COVID-19 pandemic. The study found shifts in both substance use patterns and perceptions of peer use, suggesting a complex interplay of factors influencing adolescent substance use.
a study published in PubMed examined longitudinal patterns of alcohol and cannabis use among young adults aged 18-34. This research indicated that co-use of alcohol and cannabis is common and associated with problematic health outcomes, including increased risk of alcohol and cannabis use disorders, as well as symptoms of depression and anxiety. The study highlighted the importance of considering co-use patterns in substance use messaging and interventions.
The Swedish study’s findings align with broader trends observed in other populations. Research indicates that adolescent substance use is not simply a matter of individual choices, but is deeply embedded in social and cultural contexts. Understanding these contexts is essential for developing effective prevention strategies. The stability of the distribution of use suggests that interventions aimed at shifting societal norms and reducing availability may have a more widespread impact than those focused solely on individual risk factors.
While the Swedish study provides valuable insights, it’s important to note that the findings may not be directly generalizable to all populations. Cultural differences and variations in cannabis policies could influence patterns of use. However, the underlying principle – that changes in average use reflect broader shifts in behavior across all user groups – likely holds true across many contexts. Further research is needed to explore these patterns in diverse populations and to develop tailored prevention strategies.
