A Baseline Review and Assessment of Cannabis Use and Youth: Literature Review and Preliminary Data in Massachusetts. September 2019 Massachusetts Cannabis Control Commission: Steven J. Hoffman, Chairman Kay Doyle, Commissioner Jennifer Flanagan, Commissioner Britte McBride, Commissioner Shaleen Title, Commissioner Shawn Collins, Executive Director Prepared by the Massachusetts Cannabis Control Commission Research Department: Samantha M. Doonan, BA, Research Analyst Jessica R. Hamilton, BA, Research Intern Julie K. Johnson, PhD, Director of Research Acknowledgements Cannabis Control Commission Chief of Staff Erika Scibelli Communications Cedric Sinclair, Director of Communications Maryalice Gill, Press Secretary Kirsten Swenson, Communications Specialist External University of Massachusetts Amherst Jennifer Whitehill, PhD Seth Baker, MPH Boston Children’s Hospital Sion K. Harris, PhD Boston Medical Center Alissa Cruz, MPH 1 Suggested bibliographic reference format: Doonan SM., Hamilton, JR., Johnson, JK (2019, September). A Baseline Review and Assessment of Cannabis Use and Youth: Literature Review and Preliminary Data in Massachusetts. Boston, MA: Massachusetts Cannabis Control Commission. 2 Purpose This report has been prepared in response to the enabling legislation, Chapter 55 section 17a (iii) to assess one item on the Cannabis Control Commissions’ research agenda. This legislation section states: “The commission shall develop a research agenda in order to understand the social and economic trends of marijuana in the commonwealth, to inform future decisions that would aid in the closure of the illicit marketplace and to inform the commission on the public health impacts of marijuana.” One of the research agenda priority items includes: (1) patterns of use, methods of consumption, sources of purchase and general perceptions of marijuana among minors; Chapter 55 additionally asserts the Commission shall incorporate available data, annually report on the results of its research, and make recommendations for further research or policy changes. 3 Table of Contents I. Executive Summary ........................................................................................................... 8 II. Brief History of Cannabis Policies.................................................................................. 10 III. Data Sources and Limitations ......................................................................................... 12 IV. Important Considerations ............................................................................................... 14 V. Baseline Data .................................................................................................................... 16 Youth Risk Behavior Surveillance Survey................................................................................ 16 All Grades (9-12th) Cannabis Use ............................................................................................. 16 Chart V.A.2. MA High Schoolers Lifetime Cannabis and Alcohol Lifetime Use, YRBS 2007-2017 .............................................................................................................................. 17 Chart V.A.3. MA High Schoolers Current Cannabis Use, YRBS 2007-2017 ...................... 18 Chart V.A.5. MA High Schoolers Heavy Cannabis Use, YRBS 2007-2017 ........................ 20 Chart V.A.6. MA High Schoolers Heavy Cannabis and Alcohol Use, YRBS 2007-2017 ... 21 Cannabis Use by Grade ............................................................................................................. 22 Chart V.B.1. MA High Schoolers Lifetime Cannabis Use by Grade, YRBS 2007-2017 ..... 22 Chart V.B.2. MA High Schoolers Lifetime Alcohol Use by Grade, YRBS 2007-2017 ....... 23 Chart V.B.3. MA High Schoolers Current Cannabis Use by Grade, YRBS 2007-2017 ....... 24 Chart V.B.4. MA High Schoolers Current Alcohol Use by Grade, YRBS 2007-2017 ......... 25 Chart V.B.6. MA High Schoolers Heavy Cannabis Use by Grade, YRBS 2007-2017 ........ 26 Chart V.B.7. MA High Schoolers Binge Drinking by Grade, YRBS 2007-2017 ................. 27 Cannabis Use by Gender ........................................................................................................... 28 Chart V.C.1. MA High Schoolers Lifetime Cannabis Use by Gender, YRBS 2007-2017 ... 28 Chart V.C.2. MA High Schoolers Lifetime Cannabis Use by Gender Over Time, YRBS 2007-2017 .............................................................................................................................. 29 Chart V.C.3. MA High Schoolers Lifetime Cannabis and Alcohol by Gender, YRBS 2007- 2017 ....................................................................................................................................... 30 Chart V.C.4. MA High Schoolers Lifetime Cannabis and Alcohol by Gender Over Time, YRBS 2007-2017 .................................................................................................................. 30 Chart V.C.5. MA High Schoolers Current Cannabis Use by Gender, YRBS 2007-2017 ..... 31 4 Chart V.C.6. MA High Schoolers Current Cannabis Use by Gender Over Time, YRBS 2007-2017 .............................................................................................................................. 32 Chart V.C.7. MA High Schoolers Current Cannabis, Alcohol, and Tobacco Use* by Gender, YRBS 2007-2017 .................................................................................................................. 32 Chart V.C.8. MA High Schoolers Current Cannabis, Alcohol, and Tobacco Use* by Gender Over Time, YRBS 2007-2017 ............................................................................................... 33 Chart V.C.9. MA High Schoolers Heavy Cannabis Use by Gender, YRBS 2007-2017 ...... 34 Chart V.C.10. MA High Schoolers Heavy Cannabis Use by Gender Over Time, YRBS 2007-2017 .............................................................................................................................. 35 Chart V.C.11. MA High Schoolers Heavy Cannabis and Alcohol Use by Gender, YRBS 2007-2017 .............................................................................................................................. 35 Chart V.C.12. MA High Schoolers Heavy Cannabis and Alcohol Use by Gender Over Time, YRBS 2007-2017 .................................................................................................................. 36 Cannabis Use by Race/Ethnicity ............................................................................................... 37 Chart V.D.1. MA High Schoolers Lifetime Cannabis Use by Race/Ethnicity, YRBS 2007- 2017 ....................................................................................................................................... 37 Chart V.D.2. MA High Schoolers Lifetime Cannabis Use by Race/Ethnicity Over Time, YRBS 2007-2017 .................................................................................................................. 38 Chart V.D.3. MA High Schoolers Lifetime Cannabis and Alcohol by Race/Ethnicity, YRBS 2007-2017 .............................................................................................................................. 38 Chart V.D.4. MA High Schoolers Lifetime Alcohol by Race/Ethnicity Over Time, YRBS 2007-2017 .............................................................................................................................. 39 Chart V.D.5. MA High Schoolers Current Cannabis Use by Race/Ethnicity, YRBS 2007- 2017 ....................................................................................................................................... 40 Chart V.D.6. MA High Schoolers Current Cannabis Use by Race/Ethnicity Over Time, YRBS 2007-2017 .................................................................................................................. 41 Chart V.D.7. MA High Schoolers Current Cannabis, Alcohol, and Tobacco* Use by Race/Ethnicity, YRBS 2007-2017 ......................................................................................... 41 Chart V.D.8. MA High Schoolers Current Alcohol Use by Race/Ethnicity Over Time YRBS 2007-2017 .............................................................................................................................. 42 Chart V.D.9. MA High Schoolers Current Tobacco Use* by Race/Ethnicity Over Time YRBS 2007-2017 .................................................................................................................. 42 Chart V.D.10. MA High Schoolers Heavy Cannabis Use by Race/Ethnicity, YRBS 2007- 2017 ....................................................................................................................................... 43 5 Chart V.D.11. MA High Schoolers Heavy Cannabis Use by Race/Ethnicity Over Time, YRBS 2007-2017 .................................................................................................................. 44 Chart V.D.12. MA High Schoolers Heavy Cannabis and Alcohol Use by Race/Ethnicity, YRBS 2007- 2017 ................................................................................................................. 44 Chart V.D.13. MA High Schoolers Binge Drinking by Race/Ethnicity Over Time, YRBS 2007-2017 .............................................................................................................................. 45 All Substance Use (“Lifetime”) ...............................................................................................