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

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.

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.

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.'

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.

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.