Cannabis Legalization Had Mixed Effects on Youth Use but Increased Pediatric Edible Ingestion

Most studies found no significant association between recreational legalization and changes in youth cannabis use across Europe, Uruguay, the U.S., and Canada. Some studies reported increases in adult and youth use that appeared to predate legalization. Unintentional pediatric ingestion of cannabis edibles increased significantly after legalization. Some evidence linked legalization to increased alcohol, vaping, and e-cigarette use among adolescents and young adults.

Narrative review of recent literature on the impact of recreational cannabis legalization on cannabis and other substance use across different population groups including youth and adults.

The most politically charged question about cannabis legalization is whether it increases youth use. This review suggests it largely has not, but the increase in accidental pediatric edible ingestion represents a clear safety concern that needs policy attention.

The evidence suggests that legalization's biggest impact on youth is not through increased intentional use but through accidental edible exposure in young children. This has implications for packaging, storage, and child-proofing regulations.

Narrative review covering multiple jurisdictions with different legalization models. Short follow-up periods in many studies. Self-reported use data may not capture actual changes. Different age groups defined differently across studies.