Aims

To assess the associations between types of cannabis control policies at country level and prevalence of adolescent cannabis use.

Conclusions

Cannabis liberalization with depenalization and partial prohibition policies was associated with higher levels of regular cannabis use among adolescents. The correlations were heterogeneous between genders and between short- and long-terms.

Discussion

Although cannabis use has been liberalized in many western countries, its association with cannabis use behaviors remains largely unknown. To our knowledge, this is the first study with a global perspective to examine country-level cannabis policy in relation to adolescent cannabis use. Drawing pooled cross-sectional data from over 170,000 adolescents in 38 European and American countries, we assessed whether and how types of cannabis control policies were correlated with ever use, past-year use, and regular use of cannabis.

We found that substantial variation in the prevalence of cannabis use can be attributed to the country-level characteristics. Overall, cannabis...