Cannabis Policy Changes and Adolescent Cannabis Use: Evidence from Europe

Int J Environ Res Public Health. 2021 May 13;18(10):5174. doi: 10.3390/ijerph18105174.

Abstract

Cannabis accounts for the largest share of the illicit drug market, with a high prevalence of use even among adolescents. To tackle this longstanding problem, many kinds of reforms to national cannabis control policies have been implemented in Europe, but their effectiveness is still unclear. This paper analyses the association between selected categories of cannabis policy reforms and changes in perceived cannabis availability and patterns of use among adolescents. Data from 20 European countries across 15 years were drawn from a novel database of the European school Survey Project on Alcohol and other Drugs (ESPAD). Our analysis is based on a Difference-in-Differences design, which application is allowed by the fact that only thirteen out of the twenty countries included implemented policy changes. The results suggest that selected categories of reforms influence the availability and prevalence of cannabis use. In particular, some forms of restrictive intervention reduce the general prevalence of use and more liberal reforms seem linked to an increase in the share of students initiating use of cannabis. We find no evidence of an effect of policy changes on the share of frequent users, which are presumably those more likely to develop use-related health consequences.

Keywords: Differences-in-Differences; ESPAD; adolescents; cannabis use and availability; drug policy.

MeSH terms

  • Adolescent
  • Adolescent Behavior*
  • Cannabis*
  • Europe
  • Humans
  • Policy
  • Students