Associations of cannabis product source and subsequent cannabis use among adolescents.
Cannabis is obtained from a variety retail and illicit sources, with unknown implications for youth cannabis use. This study assessed whether source of obtaining cannabis was associated with future cannabis use among adolescents. High-schoolers (N 835) completed 3 semiannual surveys, reporting use of 7 cannabis sources (i.e., free, bought from someone, from an online dispensary, with a validinvalid medical card, self-grown, or other separate dichotomous exposure variables) at wave 1 (n 621 MSD age17.14.40) or wave 2 (n 622 MSD age17.51.39). Past-6-month (yesno) and number of past-30-day (0-30) non-medical use of any cannabis product, combustible, edible, and vaporized cannabis, blunts, and concentrates (i.e., dabs) were reported at waves 2-3. Random-effect time-lagged repeated-measures regression was used to test longitudinal associations of youths cannabis source (waves 1-2 time-varying exposure) with cannabis use outcomes 6 months later (waves 2-3). Most youth (72.1%) received cannabis for free 50.9% bought cannabis from someone, 15.9% used a valid medical card at a brick-and-mortar dispensary, and 3.9% grew cannabis. Buying cannabis from someone (OR1.46, 95% CI 1.07-1.99, p .02) or using a valid medical card (OR1.99, 95% CI 1.20-3.31, p .008) conferred greater odds of any cannabis product use 6 months later. Buying from someone predicted subsequent past-30-day use frequency (RR1.25, 95% CI1.05-1.48, p .01). Some associations between particular cannabis sources and products were observed. Adolescents may access cannabis from several sources. Those who purchase cannabis illicitly from someone or from a brick-and-mortar dispensary using a valid medical card may be at increased risk for more persistent and frequent patterns of non-medical cannabis use.