A clinical review found less than 20% of U.S. youth currently use cannabis, with lifetime use actually decreasing over recent decades, while providing pediatricians with updated guidance on screening and treatment.
Pediatricians, school health providers, parents seeking evidence-based information about teen cannabis use.
Youth lifetime use has decreased over decades
What the researchers found
Despite increasing adult cannabis use and higher-THC products, longitudinal studies show less than 20% of youth report current cannabis use and lifetime use has actually decreased over recent decades. The review covers acute and chronic clinical syndromes, evidence-based screening tools, and treatment modalities specific to adolescents.
Why it matters
The perception that teen cannabis use is exploding does not match the data. While more potent products are available and adult use has risen, adolescent use has not followed the same trajectory. This nuanced picture helps pediatricians calibrate their responses and focus on evidence-based screening and intervention.
The numbers in context
Less than 20% of youth report current use. Lifetime use has decreased over recent decades. Almost half of U.S. states have legalized recreational adult use.
How the study worked
Clinical review published in Pediatrics in Review covering cannabis formulations, THC concentration variations, epidemiological trends in youth use, clinical syndromes (acute and chronic), evidence-based screening tools, and treatment approaches for adolescent cannabis use.
What this study cannot tell us
Narrative clinical review without systematic methodology. Relies on existing epidemiological surveys that may have limitations. U.S.-focused. Does not quantify the impact of higher-potency products on the subset of youth who do use.
How to read the evidence
Moderate: published in a peer-reviewed clinical review journal drawing on epidemiological data, though not a systematic review.
When this study was published
2025 study
The bigger picture
The disconnect between rising adult legalization and stable or declining youth use suggests that regulatory frameworks may be effectively limiting youth access, or that other social factors are at play. However, the increasing potency of available products means that youth who do use may face greater risks per use episode.
Questions still open
- Are youth who use cannabis today exposed to more risk per episode due to higher potency? Do current screening tools adequately capture emerging routes of use like vaping and dabbing? How should pediatrician messaging adapt as more states legalize?
Common questions
Is teen cannabis use increasing with legalization?
What should pediatricians know about cannabis?
Read the original research
Cannabis Use in Adolescents.
Pediatrics in review, 46(9), 482-493
Citation
Rabinow, Lily; Dries, Emily; Hoffman, Neal D. (2025). Cannabis Use in Adolescents.. Pediatrics in review, 46(9), 482-493. https://doi.org/10.1542/pir.2024-006514
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