Using Multiple Types of Cannabis Products Was the Strongest Predictor of Use Disorder in Teens | Research

The takeaway

Among 420 Southern California adolescents who used cannabis, those who used multiple product types (flower, concentrates, edibles) had 3–4 times the odds of developing probable cannabis use disorder at 6-month follow-up, even after controlling for frequency.

Pediatricians screening for cannabis problems, parents, school counselors, and cannabis policy researchers.

What the researchers found

Each additional mode of cannabis administration used increased odds of probable CUD (AOR range 2.83–4.13). Frequent use (10+ days/month vs 1–2 days/month) also predicted CUD (AOR 2.87). However, specific product type used first or most often, and cannabinoid formulation, were not independently associated with CUD after adjustment.

Why it matters

Rather than focusing on any single product type, this study identifies poly-product use and high frequency as the key red flags for cannabis use disorder in teens. This shifts the conversation from 'which product is most dangerous' to 'how many products and how often.'

The numbers in context

N = 420. 69.8% used >1 mode. Concentrates most common product used most often (37.5%). Each additional product: AOR 2.83–4.13 for CUD. 10+ days/month: AOR 2.87 vs 1–2 days. No association for specific product type or cannabinoid formulation after adjustment.

How the study worked

Two waves of a prospective cohort of 420 Southern California adolescents who used cannabis in the past 6 months (Fall 2022, Spring 2023). Multivariable logistic regression examined baseline cannabis behaviors predicting probable CUD at 6-month follow-up (CAST), adjusting for demographics, other substance use, and baseline CUD.

What this study cannot tell us

Southern California specific — may not generalize to regions with different cannabis markets. Self-reported use and CUD screening (not diagnosis). Short 6-month follow-up. Cannot determine if poly-product use causes CUD or if CUD-prone individuals use more products.

How to read the evidence

Prospective cohort with 6-month follow-up and multivariable adjustment, providing good temporal evidence but limited to Southern California teens.

When this study was published

Published 2025, data from Fall 2022–Spring 2023.

The bigger picture

In regions with developed cannabis markets, adolescents have access to many product types. The finding that product diversity — not any specific product — drives CUD risk suggests that the variety of the legal market itself may increase disorder risk for young users.

Questions still open

Does limiting product availability reduce adolescent CUD rates? Would monitoring the number of product types used be a useful clinical screening question? Does poly-product use reflect higher cannabis involvement overall?

Common questions

Is dabbing or vaping concentrates more addictive than smoking flower?

This study found that no single product type was independently more associated with cannabis use disorder after adjustment. What mattered most was using multiple different types of products and using frequently (10+ days/month).

What's a warning sign of cannabis use disorder in teens?

Using many different types of cannabis products (flower, concentrates, edibles, etc.) and using 10+ days per month were the strongest predictors. If a teen has expanded from one product to multiple types, this may signal increasing involvement.

Read the original research

Cannabis Products and Use Patterns Associated with Cannabis Use Disorder Symptoms Among Youth in Southern California.

Cannabis (Albuquerque, N.M.), 8(3), 89-102

View on PubMed ↗Publisher’s paper ↗

Citation

Walsh, Claire A; Jafarzadeh, Nikki; Whaley, Reid C; Han, Dae Hee; Leventhal, Adam; Pedersen, Eric R; Barrington-Trimis, Jessica; Harlow, Alyssa F. (2025). Cannabis Products and Use Patterns Associated with Cannabis Use Disorder Symptoms Among Youth in Southern California.. Cannabis (Albuquerque, N.M.), 8(3), 89-102. https://doi.org/10.26828/cannabis/2025/000323