In a national study of 26,204 adults, 2.4% of never-users initiated marijuana, 10.4% of former users returned, and 72.5% of current users continued over 12 months, with mental health problems and other substance use predicting transitions.
Read this if you use marijuana and want to understand the likelihood of continuing, quitting, or returning to use.
72.5% of current marijuana users continued using over 12 months
What the researchers found
Using data from the Population Assessment of Tobacco and Health study, researchers tracked marijuana use transitions over one year in over 26,000 US adults.
Among people who had never used marijuana, 2.36% initiated use. Among those who had used in the past but not recently, 10.42% returned to use. And among current users, 72.54% continued using, while 27.46% stopped.
The 18-24 age group was most likely to initiate, resume, or continue use. Mental health problems predicted both initiation among never-users and return to use among former users, suggesting marijuana use may partly reflect self-medication.
For continued use versus quitting, three factors stood out: initiating marijuana before age 18, using weekly or more frequently (2.34 times higher odds of continuing), and reporting use-related problems (1.40 times higher odds of continuing). Marijuana initiation and return to use were also associated with starting other substances during the same period.
Why it matters
Understanding the patterns of marijuana use transitions helps target prevention and intervention efforts. The finding that early initiation, frequent use, and existing problems predict continued use identifies who is most likely to develop persistent patterns, while the link between mental health and initiation suggests a self-medication pathway that could be addressed clinically.
The numbers in context
26,204 adults studied. Initiation among never-users: 2.36%. Return among former users: 10.42%. Continued use among current users: 72.54%. Ages 18-24 most likely to transition. Weekly+ use: AOR = 2.34 for continued use. Use problems: AOR = 1.40 for continued use. Initiation before age 18 predicted continuation.
How the study worked
Two waves of the Population Assessment of Tobacco and Health (PATH) Study were analyzed (N = 26,204 adults aged 18+). Multivariable logistic regression examined associations between Wave 1 characteristics and Wave 2 marijuana use status across three transition types: never-to-initiation, former-to-return, and continued use versus quitting.
What this study cannot tell us
The one-year follow-up may not capture longer-term use trajectories. Self-reported marijuana use may be underreported. The PATH study did not distinguish between medical and recreational use. The analysis cannot determine whether mental health problems cause marijuana initiation or whether both share common causes.
How to read the evidence
This is a large national longitudinal study with over 26,000 participants, providing strong evidence on marijuana use transition patterns.
When this study was published
Published in 2018 using data from the Population Assessment of Tobacco and Health study.
The bigger picture
These data provide a population-level view of marijuana use dynamics. The high continuation rate (73%) among current users, combined with the 10% return rate among former users, paints a picture of marijuana use as a persistent behavior once established, underscoring the importance of prevention before initiation.
Questions still open
- Would treating mental health problems in young adults reduce marijuana initiation rates? What happens to the 27% who quit, do they maintain abstinence long-term? Could brief interventions at the weekly-use threshold prevent escalation to persistent use?
Common questions
How likely am I to keep using marijuana?
What predicts starting marijuana for the first time?
Read the original research
Marijuana use among adults: Initiation, return to use, and continued use versus quitting over a one-year follow-up period.
Drug and alcohol dependence, 182, 19-26
Citation
Choi, Namkee G; DiNitto, Diana M; Marti, C Nathan. (2018). Marijuana use among adults: Initiation, return to use, and continued use versus quitting over a one-year follow-up period.. Drug and alcohol dependence, 182, 19-26. https://doi.org/10.1016/j.drugalcdep.2017.10.006
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