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Teen Cannabis Use Has Dropped Since 1999 — But Girls Now Use More Than Boys

Cross SectionalStrong evidence
The takeaway

US adolescent cannabis use peaked in 1999 and has since declined substantially, but a major gender reversal has emerged — girls now report higher rates than boys for the first time.

Parents, school counselors, public health officials, and adolescent health researchers

What the researchers found

Lifetime cannabis use dropped from 47.3% (1999) to 30.1% (2023); recent use from 27.1% to 17.8%; early initiation from 11.5% to 6.5%. In 2023, females surpassed males in lifetime (33.4% vs. 27.0%) and recent use (19.4% vs. 16.4%).

Why it matters

The historic gender reversal challenges decades of assumptions about male-predominant cannabis use and demands updated prevention approaches that address why girls are now using more.

The numbers in context

Lifetime use: 47.3% (1999) → 30.1% (2023); recent use: 27.1% → 17.8%; early initiation: 11.5% → 6.5%; 2023 females: 33.4% lifetime, 19.4% recent vs. males: 27.0%, 16.4%.

How the study worked

Analysis of 1991-2023 Youth Risk Behavior Survey (YRBS) data, a biennial nationally representative school-based survey of US high school students, using cross-tabulations and logistic regression.

What this study cannot tell us

Self-reported data subject to social desirability bias; school-based survey misses out-of-school youth; does not capture mode of use (smoking vs. vaping vs. edibles).

How to read the evidence

Over 30 years of nationally representative survey data (YRBS) provides robust trend analysis with large sample sizes.

When this study was published

Published in 2026 with data through 2023, providing the most current long-term adolescent cannabis trend analysis available.

The bigger picture

Despite legalization fears, teen cannabis use has actually trended downward for over two decades — but the emerging gender gap suggests different risk factors are now driving female adolescent use.

Questions still open

  • What's driving the gender reversal in adolescent cannabis use? Is the female increase related to mental health self-medication, changing social norms, or product accessibility?

Common questions

Is teen cannabis use increasing or decreasing?
Despite legalization concerns, teen cannabis use has actually been declining since peaking in 1999. Lifetime use dropped from 47% to 30%, and early initiation was cut nearly in half.
Do boys or girls use more cannabis now?
In a historic reversal, girls now report higher rates of both lifetime (33.4% vs 27.0%) and recent (19.4% vs 16.4%) cannabis use compared to boys, as of 2023.

Read the original research

Trends in US adolescent cannabis use, 1991-2023.

Addictive behaviors, 176, 108634

Citation

Amrock, Stephen M; Sajkiewicz, Agata J. (2026). Trends in US adolescent cannabis use, 1991-2023.. Addictive behaviors, 176, 108634. https://doi.org/10.1016/j.addbeh.2026.108634

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