7% of Adolescents Worldwide Used Cannabis, With Boys and the Americas Leading Rates

Global cannabis use prevalence was 7.02% (95% CI 6.16-7.89). Boys: 9.20% vs. girls: 4.20%. Americas had highest cannabis prevalence (11.31%). Africa had highest amphetamine use (4.34%). High-income countries: 9.45% cannabis prevalence vs. low-income: 3.46%. Higher rates associated with higher homicide rates, better sanitation, and higher health expenditures.

Meta-analysis using Global School-based Student Health Survey data from 47 countries (2009-2018). 220,362 adolescents aged 12-15. Random-effects models estimated prevalence. Stratification by sex, World Bank income category, region, and country characteristics.

This is one of the most comprehensive global assessments of adolescent cannabis use, filling a critical gap in data from low- and middle-income countries that have been underrepresented in previous research.

The finding that cannabis use is more common than amphetamine use globally, and that rates track with national income levels, suggests that cannabis availability increases alongside economic development, creating a global prevention challenge.

School-based surveys miss out-of-school adolescents. Self-reported use may underestimate prevalence. Data from 2009-2018, so more recent trends are not captured. Aggregating across diverse countries may mask important within-country variation.