Age

Marijuana is the second most widely used substance, after alcohol, among young

adults in the United States: 32% of 19- to 28-year-olds report having used marijuana in

the past year (Johnston et al., 2015). Marijuana use is associated with negative

consequences for users (Caldeira et al., 2008; Kilmer et al., 2007) and has long-term

risks including addiction (Volkow et al., 2014). Furthermore, 3% of adults in the United

States meet Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition

(DSM-IV; American Psychiatric Association, 1994), criteria for past-year marijuana

abuse or dependence (Hasin et al., 2015). Understanding when marijuana use among

young adults may lead to problematic marijuana use in adulthood is a crucial issue for

addictions research and public health. Identifying patterns of reasons for marijuana use

reported during young adulthood, at the height of marijuana use across the life course

(Johnston et al., 2015), may help identify individuals at risk for later problems.

Moreover, among adolescents who had never used marijuana, reporting more

positive reinforcement motives in adolescence was associated with greater marijuana

use and problems at age 25; reporting more negative reinforcement motives in

adolescence was associated with more marijuana problems when previous marijuana

use and motives were also included in the model (Anderson et al., 2015). Among

nationally representative samples of 12th graders, individual self-reported reasons (e.g.,

using marijuana to get high, relax, or get through the day) were prospectively

associated with more frequent marijuana use at age 35; fewer individual reasons

predicted marijuana problems (Patrick et al., 2011b). Using marijuana to alleviate

boredom at age 18 was associated with higher odds of marijuana problems at age 35
(compared with nonproblem marijuana use), and using to decrease the effects of

another drug was associated with lower odds of marijuana problems (Patrick et al.,

2011b). Across studies, results suggest that self-reported reasons for marijuana use

may be an important predictor of adult marijuana use and problems, although the

patterns of reasons most associated with risk are not yet clear and require additional

study.

Sex

During the plateau stage, which occurs after excitement but before orgasm, the

vasocongestion response is at its peak in both men and women and the man’s penis is

at its full-potential erection (Masters and Johnson 1966). Men are more likely to report

increased duration of intercourse when using cannabis compared to women (Palamar et

al. 2018; Weller and Halikas 1984). However, time may be perceived to last longer

when using cannabis due to the altered time effect of cannabis use (Chopra and Jandu

1976; Kaplan, 1974; Palamar et al. 2018) or this may be due to increased time spent

during foreplay when couples may engage in sexual exploration and try new behaviors

while using cannabis (Palamar et al. 2018). Overall, results indicated that both men and

women perceived that cannabis use increased their sexual functioning and satisfaction,

particularly increased desire and orgasm intensity.

Educational attainment

The current study examines the relationship of age at first use with educational

attainment and employment status among adults who reported ever using marijuana

before the age of 18. This study aims to (a) specifically explore the impact of first
marijuana use on a representative sample of youth in the United States and (b)

exclusively examine persons who have used marijuana only, and focus on use initiation

in adolescence. With the changes in legalization status of medical and recreational

marijuana use, this study contributes to the debate on the impact of adolescent

marijuana use on life course outcomes.

With the increased prevalence of marijuana use among youth, the increase in

state legalization, and changing social norms in the United States, it is important to

understand the long-term impact of marijuana use initiation. This study examined

whether age of first marijuana use is associated with educational attainment and

employment status. Data from 5,988 adults aged 26 to 49 years who participated in the

2015 National Survey on Drug Use and Health were used in the current study. Logistic

regression analyses were used to examine the odds of graduating from high school and

being employed. Controlling for demographics, persons with late-early first use had

significantly higher odds of graduating from high school and being employed compared

with persons with early first use. Results underscore the importance of early prevention

for youth aged 15 and younger and have implications for intervention and policy

development.

A recent analysis using data from three large studies in Australia and New

Zealand found that adolescents who used marijuana regularly were significantly less

likely than their non-using peers to finish high school or obtain a degree. They also had

a much higher chance of developing dependence, using other drugs, and attempting

suicide.54 Several studies have also linked heavy marijuana use to lower income,

greater welfare dependence, unemployment, criminal behavior, and lower life

satisfaction. Considerable evidence suggests that students who smoke marijuana have

poorer educational outcomes than their nonsmoking peers. For example, a review of 48

relevant studies found marijuana use to be associated with reduced educational

attainment (i.e., reduced chances of graduating).

Substance use is a significant concern regarding the health and development of

adolescents in the United States (Wong, Zhou, Goebert, & Hishinuma, 2013). Marijuana

is currently the second most commonly used drug among youth (Cohn, Johnson, Rath,

& Villanti, 2016; Kingery, Alford, & Coggeshall, 1999). About 5.7% of all Americans have

reported marijuana use in the past month, with 18.7% of those being between the ages

of 18 and 25 years old. Approximately 12% of people 12 years of age or older reported

past year use (Popovici, French, Pacula, Maclean, & Antonaccio, 2014; Volkow, Baler,

Compton, & Weiss, 2014). Among youth, 13% of eighth graders, 29% of 10 th graders,

and 36% of 12th graders report ever having used marijuana (Friese & Grube, 2013).

Twenty-nine states and the District of Columbia have passed laws legalizing the

medical use of marijuana (Han, Compton, Blanco, & Jones, 2018; National Conference

of State Legislatures, 2017), and eight states and the District of Columbia have

legalized recreational marijuana use (Cerdá et al., 2017; McGinty, Niederdeppe, Heley,

& Barry, 2017).

There are concerns about the potential effect of the recent wave of marijuana

legalization on youth. According to recent studies, medical marijuana legalization does

not appear to impact adolescent recreational use (Cerdá et al., 2017; Wall et al., 2016).

However, limited evidence suggests that legalization of adult recreational use may be

associated with increased adolescent recreational use (Cerdá et al., 2017; Rusby,
Westling, Crowley, & Light, 2018), increases in intention to use among youth (Rusby et

al., 2018), and decreases in perceived risk of negative consequences from marijuana

use during early adolescence and mid-adolescence (Cerdá et al., 2017). Such findings

further spur considerable debate on the adverse outcomes of marijuana use in

adolescence. Although extant research has focused on the impact of legalization on

youth marijuana use, little is known about the impact of marijuana use in adolescence

on later life outcomes. With the continuous increase of states legalizing marijuana (Wall

et al., 2016), and early evidence suggesting such laws impact risk perception, intention

to use, and use of marijuana, more research is needed on the long-term impact of

marijuana use in adolescence to inform marijuana-related interventions, education, and

policies that will positively impact American youth.

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