Delta-9 THC Users Had 20 Times the Odds of Also Using Delta-8 THC

Past-year Delta-9 THC use was associated with 20 times the odds of Delta-8 use. Risk perception patterns were inconsistent: lower perceived severity of Delta-8 harms and lower perceived susceptibility to Delta-9 harms predicted Delta-8 use, but higher perceived severity of Delta-9 harms and higher perceived susceptibility to Delta-8 harms also predicted use, possibly reflecting reverse causation.

Survey of a convenience sample of 166 young adults aged 18-25. Mixed effects multivariable logistic regression examined whether perceived susceptibility and severity of harms were associated with past-year Delta-8 THC use, adjusting for demographics, student status, and Delta-9 use, with random intercepts for state.

Delta-8 THC exists in a regulatory gap and its use is rising rapidly. Understanding who uses it and why is essential for developing appropriate regulations and public health responses.

The complicated risk perception findings suggest that Delta-8 users may view it as a "safer alternative" to Delta-9 (explaining why higher Delta-9 severity predicts Delta-8 use), while also having generally lower concern about cannabis products (explaining lower Delta-8 severity predicting use).

Very small convenience sample (166). Cross-sectional design cannot determine causation. Self-reported use and perceptions. The inconsistent findings may reflect the early, rapidly changing Delta-8 market.