A longitudinal study following teens from age 13 to 25 identified four cannabis use trajectories, with early-onset escalating users showing the highest rates of depression, anxiety, and cannabis use disorder by age 25.
Pediatricians, school counselors, parents, and adolescent substance use researchers.
What the researchers found
Four trajectories emerged: non/minimal users, late-onset moderate users, early-onset moderate users, and early-onset escalating users. Early-onset escalators had significantly higher rates of CUD (OR=8.2), depression (OR=3.1), and anxiety (OR=2.4) at age 25 compared to non/minimal users. Late-onset moderate users had elevated CUD risk but not mental health problems.
Why it matters
Not all teen cannabis use carries the same risk. Identifying which trajectory patterns predict problems allows for targeted intervention — early-onset escalating use is the red flag, not simply any teen experimentation.
The numbers in context
Ages 13-25 follow-up. Four trajectory groups identified. Early-onset escalators: CUD OR=8.2, depression OR=3.1, anxiety OR=2.4 vs. non-users at age 25.
How the study worked
Prospective cohort study following participants from age 13 to 25. Annual cannabis use assessments. Group-based trajectory modeling. Mental health outcomes assessed at age 25 with validated instruments.
What this study cannot tell us
Observational — trajectories may reflect underlying risk factors rather than causal effects of cannabis. Self-reported use. Attrition over 12 years. Confounders like trauma and family history may not be fully controlled.
How to read the evidence
Prospective cohort with long follow-up and validated outcomes provides strong evidence for trajectory-outcome associations.
When this study was published
2025 longitudinal study with 12 years of follow-up from adolescence to young adulthood.
The bigger picture
Prevention programs often treat all teen cannabis use as equally risky. This study suggests focusing resources on early-onset users whose use escalates over time, rather than on experimenters or late-onset moderate users.
Questions still open
- Can early-onset escalating trajectories be identified early enough for intervention?
- Do these trajectory-outcome relationships hold across different racial and socioeconomic groups?
Common questions
Is teen cannabis use always harmful?
Which teens are most at risk from cannabis?
Read the original research
An integrated behavioral approach to understanding sociocognitive determinants and risk profiles of cannabis use in adolescents.
Adicciones, 37(2), 141-154
Citation
Torrejón-Guirado, María-Carmen; Jolani, Shahab; Lima-Serrano, Marta; Mercken, Liesbeth; De Vries, Hein. (2025). An integrated behavioral approach to understanding sociocognitive determinants and risk profiles of cannabis use in adolescents.. Adicciones, 37(2), 141-154. https://doi.org/10.20882/adicciones.1961
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