Among nearly 70,000 U.S. adolescents, THC vaping was linked to depressive symptoms while CBD-only vaping was associated with higher anxiety — challenging the notion that CBD is purely calming.
Parents, teens, educators, healthcare providers, and anyone concerned about youth cannabis vaping and mental health.
What the researchers found
Adolescents who vaped THC only (aOR=1.40) or dual CBD/THC (aOR=1.51) were more likely to experience depressive symptoms. Those who vaped CBD only had higher odds of anxiety symptoms (aOR=1.74) compared to non-vapers, and higher anxiety than THC-only vapers (aOR=1.51).
Why it matters
Cannabis vaping is increasingly common among teens. This large national study suggests different cannabinoids may have different mental health associations — THC linking to depression and CBD to anxiety — which challenges simple narratives about either compound.
The numbers in context
69,899 adolescents surveyed. THC-only vapers: 40% higher odds of depressive symptoms (aOR=1.40). Dual vapers: 51% higher odds of depressive symptoms (aOR=1.51). CBD-only vapers: 74% higher odds of anxiety (aOR=1.74). 51.3% of sample was male.
How the study worked
Analysis of three years (2021-2023) of the nationally representative US National Youth Tobacco Survey using a stratified three-stage cluster design, with logistic regression adjusting for covariates. Total sample: 69,899 adolescents aged 11-18.
What this study cannot tell us
Cross-sectional design cannot establish causation — anxious teens may seek CBD products, not the reverse. Self-reported cannabis vaping. Cannot verify actual CBD/THC content of vaped products. No information on dose or frequency.
How to read the evidence
Large nationally representative sample across three years, but cross-sectional design limits causal inference.
When this study was published
Published in 2026, using the most recent available NYTS data (2021-2023).
The bigger picture
The finding that CBD-only vaping was associated with MORE anxiety symptoms than THC vaping is counterintuitive, since CBD is marketed as anxiolytic. It may reflect reverse causation (anxious teens seeking CBD for relief) or unknown factors in CBD vaping products.
Questions still open
- Are anxious teens self-selecting CBD products, creating reverse causation? What are the actual contents of products teens report as CBD-only? Would longitudinal data confirm these associations?
Common questions
Does CBD vaping cause anxiety in teens?
Is THC or CBD vaping worse for teen mental health?
Read the original research
Cannabis vaping and mental health: The association of Δ-9-tetrahydrocannabinol and cannabidiol with anxiety and depressive symptoms-Findings from the United States National Youth Tobacco Survey (2021-2023).
Addiction (Abingdon, England), 121(3), 617-628
Citation
Chung, Jack; Stjepanović, Daniel; Cheng, Brandon; Lim, Carmen C W; Hall, Wayne; Connor, Jason P; Chan, Gary C K. (2026). Cannabis vaping and mental health: The association of Δ-9-tetrahydrocannabinol and cannabidiol with anxiety and depressive symptoms-Findings from the United States National Youth Tobacco Survey (2021-2023).. Addiction (Abingdon, England), 121(3), 617-628. https://doi.org/10.1111/add.70218
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