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Study breakdown

Male, older, and White adolescents who use alcohol or tobacco are most likely to vape cannabis

Meta AnalysisStrong evidence
The takeaway

A meta-analysis of 31 studies found adolescent cannabis vaping was nearly twice as likely in males, and significantly more common among older teens, White youth, and those already using alcohol or tobacco.

Youth prevention program designers, school health professionals, pediatricians

Alcohol-using adolescents had 2.52x higher odds of vaping cannabis

What the researchers found

Among adolescent cannabis users, cannabis vaping odds were higher for males (OR 1.79), older adolescents (OR 1.26), current tobacco users (OR 1.62), and alcohol users (OR 2.52); lower for non-Hispanic Black youth (OR 0.55); insufficient evidence for mental health associations.

Why it matters

Identifying who among cannabis-using youth is most likely to vape helps target prevention efforts, as vaping delivers concentrated cannabinoids with unknown long-term effects.

The numbers in context

31 studies; 568,304 participants; among adolescent cannabis users (n=114,595): male OR=1.79, older OR=1.26, tobacco use OR=1.62, alcohol use OR=2.52, non-Hispanic Black OR=0.55.

How the study worked

Systematic review and meta-analysis of 31 studies (n=568,304) from US, Canada, England, New Zealand, and Switzerland; 26 on adolescents, 5 on young adults; pooled odds ratios using random effects.

What this study cannot tell us

Most studies from US; cross-sectional designs; self-reported cannabis vaping; insufficient studies on mental health and young adult correlates; heterogeneity across studies.

How to read the evidence

Large meta-analysis with over 500,000 participants and consistent findings across multiple countries, though mostly cross-sectional studies.

When this study was published

Published 2025

The bigger picture

Cannabis vaping represents a shift in how young people consume cannabis, and the demographic profile of vapers differs from traditional users, requiring updated prevention approaches.

Questions still open

  • Why are White adolescents more likely to vape cannabis? Does alcohol/tobacco co-use drive vaping adoption or vice versa? Will the gender gap narrow as in the NYTS data?

Common questions

Who is most likely to vape cannabis among teens?
Among adolescents who use cannabis, males were nearly twice as likely to vape it. Current alcohol users had the strongest association (2.5x odds), followed by tobacco users (1.6x).
Were there racial differences?
Yes. Non-Hispanic Black adolescents had about half the odds of vaping cannabis compared to White adolescents, even among those who used cannabis.

Read the original research

Cannabis Vaping in Youth: A Systematic Review and Meta-Analysis of Risk Factors in Adolescents and Young Adults.

Journal of studies on alcohol and drugs

Citation

Chung, Jack; Lim, Carmen C W; Leung, Janni; Stjepanović, Daniel; Chiu, Vivian; Hides, Leanne; Connor, Jason P; Hall, Wayne; Chan, Gary C K. (2025). Cannabis Vaping in Youth: A Systematic Review and Meta-Analysis of Risk Factors in Adolescents and Young Adults.. Journal of studies on alcohol and drugs. https://doi.org/10.15288/jsad.24-00464

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