Regular cannabis use and promotive attitudes among diverse adolescents in the United States: The role of age and intersecting social positions

Purpose: Cannabis use is common in adolescence and has been associated with negative health effects, and higher prevalence has been seen among marginalized youth. Research has not examined regular use or attitudes promoting use, particularly taking an approach grounded in intersectionality and minority stressors. The present study examines how regular cannabis use, perceptions of risk, approval from parents and friends, and peer norms of use differ across multiple social positions. Methods: 82,933 8th, 9th, and 11th grade students provided data on the 2022 Minnesota Student Survey, including past 30-day cannabis use (3 + times vs. fewer) and related attitudes. Exhaustive Chi-square Automatic Interaction Detection models tested how youth with combinations of five social positions (i.e., racial and ethnic identity, sexual orientation, gender identity, access to resources, location type) varied on each cannabis-related dependent variable. Results: 3.8 % reported regular cannabis use, and attitudes were generally not supportive of use. Regular use was higher among older adolescents (7.8 % of 11th, 1.8 % of 8th grade), and the highest prevalence nodes were characterized by marginalized social positions. For example, 24.8 % of 8th grade students who identified as American Indian/Alaska Native or multiracial, gay/ lesbian/bisexual/queer, and high poverty reported regular use – almost fourteen times higher than the prevalence for 8th grade overall. Conclusions: Both typical adolescent development and marginalization may underlie the observed pattern of findings, and cannabis use may be a coping mechanism to deal with oppression. Prevention activities should account for marginalization and act on multiple levels to address this structural issue.