Among 58,034 Americans, the largest increase in cannabis use probability occurred between ages 12-17 and 18-25 specifically among people who perceived no or low risk from cannabis.
Prevention program designers, school health educators, public health officials
The sharpest cannabis use increase occurred between ages 12-17 and 18-25 among low-risk perceivers
What the researchers found
A significant interaction between age group and perceived risk predicted cannabis use. The sharpest increase in cannabis use probability occurred between adolescents (12-17) and young adults (18-25) among those with no or low risk perception. This suggests that adolescents who perceive cannabis as low-risk are primed for a major usage increase once they reach young adulthood.
Why it matters
Prevention programs that shape risk perception during adolescence could have outsized effects if they reach young people before the transition to adulthood, when low-risk perceiving adolescents appear most likely to start using cannabis.
The numbers in context
58,034 participants; significant age x perceived risk interaction; sharpest usage increase between 12-17 and 18-25 age groups for no/low risk perceivers; population-level nationally representative sample; 2021 data
How the study worked
Secondary analysis of the 2021 National Survey on Drug Use and Health (N=58,034, ages 12+). Binary logistic regression with complex sampling examined the interaction between age group and perceived risk on past 30-day cannabis use.
What this study cannot tell us
Cross-sectional design cannot confirm that low risk perception causes later use, 2021 data from a single year, perceived risk and use measured simultaneously, cannot distinguish between accurate and inaccurate risk perceptions
How to read the evidence
Very large nationally representative sample with appropriate complex survey analysis; cross-sectional limitation but strong population-level data
When this study was published
Published 2025
The bigger picture
As cannabis legalization expands and perceived risk continues declining among young people, this finding suggests a growing pool of adolescents with low-risk perceptions who will sharply increase their use upon reaching adulthood. Prevention efforts targeting risk perception in early adolescence may be the most effective intervention window.
Questions still open
- Does changing risk perception in adolescence actually reduce adult cannabis use? Is the risk perception-use relationship changing over time with legalization? What specific aspects of risk perception (health, legal, social) matter most?
Common questions
When does cannabis use increase the most?
Does thinking cannabis is safe lead to using it?
Read the original research
Past 30-Day Cannabis Use by Perception of Risk and Age Group: Implications for Prevention.
American journal of health promotion : AJHP, 39(4), 619-626
Citation
Burrow-Sánchez, Jason J; Cohen, Allison. (2025). Past 30-Day Cannabis Use by Perception of Risk and Age Group: Implications for Prevention.. American journal of health promotion : AJHP, 39(4), 619-626. https://doi.org/10.1177/08901171241312508
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