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Adolescent Marijuana Use, Marijuana-Related Perceptions, and Use of Other Substances Before and After Initiation of Retail Marijuana Sales in Colorado (2013–2015)

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Due to the recentness of changes to marijuana policies in a number of states, the effect on adolescent use and perceptions is not yet well understood. This study examines change in adolescent marijuana use and related perceptions in Colorado, before and after the implementation of legal commercial sale of recreational marijuana for adults starting on January 1, 2014. The data are from a repeated cross-sectional survey of a representative sample of Colorado high school students, with separately drawn samples surveyed in fall 2013 (prior to implementation) and fall 2015 (18 months after implementation). We examined change in the prevalence of adolescent marijuana use, measured by lifetime use, past 30-day use, frequent use, and use on school property. To consider the possibility of heterogeneity in the change in marijuana use, we examined change in past 30-day marijuana use by demographic characteristics (sex, grade, race/ethnicity), school characteristics (poverty, percent minority), urbanicity of the school district, and whether the city or county permitted retail marijuana stores. There was an absence of significant effects for change in lifetime or past 30-day marijuana use. Among those reporting past 30-day use, frequent use and use on school property declined. There was a significant decline in the perceived harm associated with marijuana use, but we did not find a significant effect for perceived wrongfulness, perceived ease of access, or perceived parental disapproval. We did not find significant variability in past 30-day use by demographic characteristics or by school and community factors from 2013 to 2015. We did not find a significant effect associated with the introduction of legal sales of recreational marijuana to adults in Colorado on adolescent (illegal) use, but ongoing monitoring is warranted, including consideration of heterogeneity in the effects of marijuana policies.

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  • Cantrell, J., Anesetti-Rothermel, A., Pearson, J., Haijun Xiao, M. S., & Kirchner, T. R. (2014). The impact of tobacco retail outlet concentration on adult cessation attitudes and behaviors and differences by neighborhood socioeconomic status. Addiction, 110, 152–161.

    Article  PubMed  PubMed Central  Google Scholar 

  • Cantrell, J., Pearson, J., Anesetti-Rothermel, A., Haijun Xiao, M., Vallone, D., & Kirchner, T. R. (2015). Tobacco retail outlet density and young adult tobacco initiation. Nicotine and Tobacco Research, 18, 130–137.

    Article  PubMed  PubMed Central  Google Scholar 

  • Carliner, H., Brown, Q. L., Sarvet, A. L., & Hasin, D. S. (2017). Cannabis use, attitudes, and legal status in the U.S.: A review. Preventive Medicine, 104, 13–23.

  • Cerda, M., Wall, M., Feng, T., Keyes, K. M., Sarvet, A., Schulenberg, J., & Hasin, D. S. (2016). Association of state recreational marijuana laws with adolescent marijuana use. JAMA Pediatrics, 171(2), 142–149.

  • Choo, E. K., Benz, M., Zaller, N., Warren, O., Rising, K. L., & McConnell, K. J. (2014). The impact of state medical marijuana legislation on adolescent marijuana use. Journal of Adolescent Health, 55, 160–166.

    Article  Google Scholar 

  • Fleming, C. B., Guttmannova, K., Cambron, C., Rhew, I. C., & Oesterle, S. (2016). Examination of the divergence in trends for adolescent marijuana use and marijuana-specific risk factors in Washington State. Journal of Adolescent Health, 59, 269–275.

    Article  Google Scholar 

  • Freisthler, B., & Gruenewald, P. J. (2014). Examining the relationship between the physical availability of medical marijuana and marijuana use across fifty California cities. Drug and Alcohol Dependence, 143, 244–250.

    Article  PubMed  PubMed Central  Google Scholar 

  • Grucza, R. A., Agrawal, A., Krauss, M. J., Bongu, J., Plunk, A. D., Cavazos-Rehg, P. A., & Bierut, L. J. (2016). Declining prevalence of marijuana use disorders among adolescents in the United States, 2002 to 2013. Journal of the American Academy of Child and Adolescent Psychiatry, 55, 487–494.

    Article  PubMed  PubMed Central  Google Scholar 

  • Guttmannova, K., Lee, C. M., Kilmer, J. R., Fleming, C. B., Rhew, I. C., Kosterman, R., & Larimer, M. E. (2016). Impacts of changing marijuana policies on alcohol use in the United States. Alcoholism, Clinical and Experimental Research.

  • Hasin, D. S., Wall, M., Keyes, K. M., Cerdá, M., Schulenberg, J., O’Malley, P. M., et al. (2015). Medical marijuana laws and adolescent marijuana use in the USA from 1991 to 2014: Results from annual, repeated cross-sectional surveys. The Lancet Psychiatry, 2, 601–608.

    Article  PubMed  PubMed Central  Google Scholar 

  • Joffe, A. (2017). Understanding the full effect of the changing legal status of marijuana on youth: Getting it right. JAMA Pediatrics, 171, 115–116.

    Article  PubMed  Google Scholar 

  • Johnson, J. K., Johnson, R. M., Hodgkin, D., Jones, A. A., Matteucci, A. M., & Harris, S. K. (2017). Heterogeneity of state medical marijuana laws and adolescent recent use of alcohol and marijuana: Analysis of 45 states, 1991–2011. Substance Abuse, 1–8.

  • Johnson, R. M., Brooks-Russell, A., Ma, M., Fairman, B. J., Tolliver Jr, R. L., & Levinson, A. H. (2016). Usual modes of marijuana consumption among high school students in Colorado. Journal of Studies on Alcohol and Drugs, 77, 580–588.

  • Johnson, R. M., Fairman, B., Gilreath, T., Xuan, Z., Rothman, E. F., Parnham, T., & Furr-Holden, C. D. M. (2015). Past 15-year trends in adolescent marijuana use: Differences by race/ethnicity and sex. Drug and Alcohol Dependence, 155, 8–15.

    Article  PubMed  PubMed Central  Google Scholar 

  • Johnson, R. M., Fleming, C. B., Cambron, C., Dean, L. T., Brighthaupt, S., & Guttmannova, K. (2018). Race/ethnicity differences in trends of marijuana, cigarette, and alcohol use among 8th, 10th, and 12th graders in Washington State, 2004–2016. Prevention Science.

  • Johnston, L. D., Bachman, J. G., O’Malley, P. M., & Schulenberg, J. E. (2016). Monitoring the Future: A continuing study of american youth (12th-Grade Survey), 2016. Retrieved from

  • Kann, L., McManus, T., Harris, W. A., Shanklin, S., Flint, K. H., Hawkins, J., et al. (2016). Youth risk behavior surveillance—United States, 2015. MMWR CDC Surveill Summary, 65, 1–174.

    Google Scholar 

  • Keyes, K. M., Wall, M., Cerdá, M., Schulenberg, J., O’Malley, P. M., Galea, S., et al. (2016). How does state marijuana policy affect US youth? Medical marijuana laws, marijuana use and perceived harmfulness: 1991–2014. Addiction, 111, 2187–2195.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kirchner, T. R., Anesetti-Rothermel, A., Gao, H., Bennett, M., Carlos, H., Scheuermann, S. S., et al. (2016). Tobacco outlet density and converted versus native nondaily tobacco use in a national US sample. Tobacco Control, 26(1), 85–91.

  • Kirchner, T. R., Villanti, A., Cantrell, J., Anesetti-Rothermel, A., Ganz, O., Conway, K., ... Abrams, D. (2014). Tobacco retail outlet advertising practices and proximity to schools, parks and public housing affect Synar underage sales violations in Washington, D.C. Tobacco Control.

  • Martins, S. S., Mauro, C. M., Santaella-Tenorio, J., Kim, J. H., Cerda, M., Keyes, K. M., & Wall, M. (2016). State-level medical marijuana laws, marijuana use and perceived availability of marijuana among the general US population. Drug and Alcohol Dependence, 169, 26–32.

    Article  PubMed  PubMed Central  Google Scholar 

  • Mauro, C. M., Newswanger, P., Santaella-Tenorio, J., Mauro, P. M., Carliner, H., & Martins, S. S. (2017). Impact of medical marijuana laws on state-level marijuana use by age and gender, 2004–2013. Prevention Science.

  • McGinty, E. E., Niederdeppe, J., Heley, K., & Barry, C. L. (2017). Public perceptions of arguments supporting and opposing recreational marijuana legalization. Preventive Medicine, 99, 80–86.

    Article  PubMed  Google Scholar 

  • McGinty, E. E., Samples, H., Bandara, S. N., Saloner, B., Bachhuber, M. A., & Barry, C. L. (2016). The emerging public discourse on state legalization of marijuana for recreational use in the US: Analysis of news media coverage, 2010–2011. Preventive Medicine, 90, 114–120.

    Article  PubMed  PubMed Central  Google Scholar 

  • Miech, R. A., Johnston, L., O’Malley, P. M., Bachman, J. G., Schulenberg, J., & Patrick, M. E. (2015). Trends in use of marijuana and attitudes toward marijuana among youth before and after decriminalization: The case of California 2007–2013. International Journal of Drug Policy, 26, 336–344.

    Article  PubMed  Google Scholar 

  • National Center for Education Statistics. (2017). Common core of data. Retrieved from

  • National Conference of State Legislatures. (2017). Marijuana laws. Retrieved from Accessed 17 July 2018

  • National Student Clearinghouse Research Center. (2015). High School Benchmarks 2015: National College Progression Rates. Retrieved from Herndon: National Student Clearinghouse.

  • Rao, J. N. K., & Scott, A. J. (1987). On simple adjustments to chi-square tests with sample survey data. Annals of Statistics, 15, 385–397.

    Article  Google Scholar 

  • Rusby, J. C., Westling, E., Crowley, R., & Light, J. M. (2017). Legalization of recreational marijuana and community sales policy in Oregon: Impact on adolescent willingness and intent to use, parent use, and adolescent use. Psychology of Addictive Behaviors.

  • Salas-Wright, C. P., Oh, S., Goings, T. C., & Vaughn, M. G. (2017). Trends in perceived access to marijuana among adolescents in the United States: 2002–2015. Journal of Studies on Alcohol and Drugs, 78, 771–780.

    Article  PubMed  PubMed Central  Google Scholar 

  • Salas-Wright, C. P., Vaughn, M. G., Todic, J., Córdova, D., & Perron, B. E. (2015). Trends in the disapproval and use of marijuana among adolescents and young adults in the United States: 2002–2013. The American Journal of Drug and Alcohol Abuse, 41, 392–404.

    Article  PubMed  PubMed Central  Google Scholar 

  • Schuermeyer, J., Salomonsen-Sautel, S., Price, R. K., Balan, S., Thurstone, C., Min, S. J., & Sakai, J. T. (2014). Temporal trends in marijuana attitudes, availability and use in Colorado compared to non-medical marijuana states: 2003–11. Drug and Alcohol Dependence, 140, 145–155.

    Article  PubMed  PubMed Central  Google Scholar 

  • Shi, Y. (2016). The availability of medical marijuana dispensary and adolescent marijuana use. Preventive Medicine, 91, 1–7.

    Article  PubMed  Google Scholar 

  • Shi, Y., Meseck, K., & Jankowska, M. M. (2016). Availability of medical and recreational marijuana stores and neighborhood characteristics in Colorado. Journal of Addiction.

  • Snyder, T., & Musu-Gillette, L. (2015). Free or reduced price lunch: A proxy for poverty? Retrieved from

  • Terry-McElrath, Y. M., O’Malley, P. M., Patrick, M. E., & Miech, R. A. (2017). Risk is still relevant: Time-varying associations between perceived risk and marijuana use among US 12th grade students from 1991 to 2016. Addictive Behaviors, 74, 13–19.

    Article  PubMed  PubMed Central  Google Scholar 

  • Thrul, J., Pabst, A., & Kraus, L. (2016). The impact of school nonresponse on substance use prevalence estimates—Germany as a case study. International Journal of Drug Policy, 27, 164–172.

    Article  PubMed  Google Scholar 

  • Wu, L. T., Swartz, M. S., Brady, K. T., & Hoyle, R. H. (2015). Perceived cannabis use norms and cannabis use among adolescents in the United States. Journal of Psychiatric Research, 64, 79–87.

    Article  PubMed  PubMed Central  Google Scholar 

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Data used for this study were collected under contracts with the Colorado Department of Public Health and Environment (CDPHE; Arnold H. Levinson and Ashley Brooks-Russell, principal investigators). This work was supported by several National Institutes of Health grants (K01DA031738l, Johnson; T32DA007292, Goodell).

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Correspondence to Ashley Brooks-Russell.

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The authors declare that they have no conflict of interest.

Ethical Approval

The study was approved by the Colorado Multiple Institutional Review Board. All procedures performed in studies involving human participants were in accordance with the ethical standards of the Colorado Multiple Institutional Review Board and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

The data collection for this study was approved as exempt, which included a waiver of written parental consent and student assent. Student participation in data collection was voluntary and no personal identifiers were collected. Parents were notified in writing at least 2 weeks in advance of data collection and could opt out their child from data collection. Students were instructed that they could skip questions or chose not to complete the survey.

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Brooks-Russell, A., Ma, M., Levinson, A.H. et al. Adolescent Marijuana Use, Marijuana-Related Perceptions, and Use of Other Substances Before and After Initiation of Retail Marijuana Sales in Colorado (2013–2015). Prev Sci 20, 185–193 (2019).

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