Tormohlen KN, Schneider KE, Johnson RM, Ma M, Levinson AH, Brooks-Russell A. Changes in Prevalence of Marijuana Consumption Modes Among Colorado High School Students From 2015 to 2017. JAMA Pediatrics. 2019; published August 5, 2019. doi: 10.1001/jamapediatrics.2019.2627.
While smoking remains the most prevalent mode of marijuana use among adolescents, legalization of marijuana in many states has broadened access to non-smoking modes of use such as vaporizing, ingesting and dabbing (inhaling highly concentrated marijuana in a vaporized form). The authors analyzed data from the Healthy Kids Colorado Survey in 2015 and 2017, administered in Colorado public schools to students in 9th through 12th grades. Among adolescents with marijuana use in the last 30 days, smoking decreased by about 10% (adjusted prevalence ratio [aPR] in 2017 vs 2015: 0.89, 95% CI 0.84-0.94). In contrast, marijuana ingestion increased more than 4-fold (aPR 4.55; 2.68-7.74) and dabbing increased nearly two-fold (aPR 1.94; 1.25-3.01).
The Healthy Kids Colorado survey is conducted every other year, using a random sampling of students in public middle and high schools. The survey included 2 questions about modes of marijuana consumption, which were asked of students who reported marijuana use within the last 30 days; 1 question asked “how did you usually use marijuana? (select only 1 response)” and the other question asked, “how did you use marijuana? (select all that apply)”. Multivariable logistic regression was used to examine whether there were differences in the usual mode and/or in any use of each mode of marijuana, adjusted for grade, sex, and race/ethnicity. The overall frequency of marijuana use in the last 30 days was not reported in this article. More than 20% of students reported using a non-smoking mode of marijuana during both years of the survey: ingestion and dabbing were more common modes than vaporizing. It was evident from the any-use data that many students used marijuana in more than one mode. Overall, this article illustrates the importance of asking adolescents about their modes of use of marijuana, especially as more states legalize possession of small amounts of marijuana. With some modes, such as ingestion and dabbing, unintentional overconsumption may present a health risk that can prompt teens and other individuals to see urgent or emergent health care.