Cannabis use declined among King County students from 2008-2021, but girls overtook boys in use rates for the first time
Among students in grades 8, 10, and 12 in King County, Washington, cannabis use declined from 2008 to 2021, but a historic shift occurred: by 2021, female students had higher current use prevalence than male students for the first time.
Quick Facts
What This Study Found
During 2008-2021, cannabis use declined among both sexes. In 2008, male students had 4.8% higher prevalence than female students. By 2014-2016, rates were statistically equal. In 2021, current use was 1.3% higher among female students than male students for the first time. Frequent use (6+ days/month) remained similar between sexes. 12th graders had the highest use rates.
Key Numbers
Range: 33,439-39,391 students per cycle. 2008 sex gap: males 4.8% higher. 2021 gap: females 1.3% higher. Frequent use similar between sexes. 12th graders highest, followed by 10th, then 8th.
How They Did This
Analysis of the Healthy Youth Survey administered by Washington State Department of Health, restricted to King County students in grades 8, 10, and 12 across seven survey periods (2008-2021). 33,439-39,391 students per cycle. Weighted generalized linear regression with sex-by-year interaction.
Why This Research Matters
The reversal of the sex gap in cannabis use is a meaningful public health signal. If female students are now more likely to use cannabis than male students, prevention programs designed primarily for boys may be missing the current reality.
The Bigger Picture
This sex-based crossover in cannabis use mirrors similar trends seen with alcohol and may reflect broader shifts in gendered norms around substance use. Prevention strategies may need updating to reflect these changing demographics.
What This Study Doesn't Tell Us
Single county in Washington state; may not generalize to other regions. Self-reported use in school settings may undercount. Students absent from school or who dropped out are missed. 2021 data collected during COVID-19 may reflect unusual patterns.
Questions This Raises
- ?Is the sex crossover unique to King County or a national trend?
- ?What factors are driving increased female relative to male cannabis use?
Trust & Context
- Key Stat:
- Girls surpassed boys in cannabis use for the first time in 2021
- Evidence Grade:
- Large repeated cross-sectional survey with over 33,000 students per cycle. Strong trend data but single-county scope.
- Study Age:
- 2024 study
- Original Title:
- Cannabis Use Among Students in Grades 8, 10, and 12, by Sex - King County, Washington, 2008-2021.
- Published In:
- MMWR. Morbidity and mortality weekly report, 73(2), 27-31 (2024)
- Authors:
- Esie, Precious, Ta, Myduc
- Database ID:
- RTHC-05298
Evidence Hierarchy
Watches what happens naturally without intervening.
What do these levels mean? →Frequently Asked Questions
Did legalization increase youth cannabis use in Washington?
No. Overall use declined from 2008 to 2021, spanning both the pre- and post-legalization periods. The notable change was the shift in sex-based patterns, not overall prevalence.
Why might girls be using more cannabis now?
The study did not investigate reasons. Possible factors include changing social norms, different risk perceptions by sex, marketing influences, or shifts in how cannabis is used (e.g., edibles vs smoking).
Read More on RethinkTHC
Cite This Study
https://rethinkthc.com/research/RTHC-05298APA
Esie, Precious; Ta, Myduc. (2024). Cannabis Use Among Students in Grades 8, 10, and 12, by Sex - King County, Washington, 2008-2021.. MMWR. Morbidity and mortality weekly report, 73(2), 27-31. https://doi.org/10.15585/mmwr.mm7302a1
MLA
Esie, Precious, et al. "Cannabis Use Among Students in Grades 8, 10, and 12, by Sex - King County, Washington, 2008-2021.." MMWR. Morbidity and mortality weekly report, 2024. https://doi.org/10.15585/mmwr.mm7302a1
RethinkTHC
RethinkTHC Research Database. "Cannabis Use Among Students in Grades 8, 10, and 12, by Sex ..." RTHC-05298. Retrieved from https://rethinkthc.com/research/esie-2024-cannabis-use-among-students
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.