Regarding ketene that has been suggested to be formed by vaping or pyrolytic heating of VEA,it is not clear whether it is identifiable with our methods or is not formed at the temperatures tested here. Products like duroquinone and durohydroquinone are reported to be formed below a vaping coil temperature of 300 °C; however, we do not observe them with the preparation or detection methods used in this work. The selectivity and solubility of GC-MS extraction solvent could be a reason why products like quinones were not observed in the current study. These results underscore the fact that THC oil is a complex mixture, the complexity of which increases with thermal degradation chemistry and the addition of VEA. Further research on individual components is still needed for a better understanding of aerosol composition from vaping cannabis extracts and their mixtures with diluents.Cannabis is the most commonly used federally illicit drug by U.S. adolescents and young adults . One in five 12th grade students reported past-month use of cannabis and 7% reported daily use . In the last few years, there has been an evolving landscape of cannabis products on the market, including various combustible , blunts , vaporized , and edible products . Although smoking cannabis remains the most popular mode of consumption among AYAs , studies indicate a rise in use of non-smoked cannabis products , particularly vaporized cannabis , among AYAs. As cannabis use in this developmental period poses concerns of negative effects on brain development and mental function , preventing AYA cannabis use in all forms is of public health importance. Research shows that AYAs’ perceptions of cannabis is a major driver of use, with low perceived risks associated with initiation and continued use of cannabis . Concurrent with the rise in use, AYAs’ perceived risks of cannabis have steadily declined over the past decade . The expanding legalization of cannabis nationwide may increase acceptability and ease of access among AYAs . Despite AYAs reporting using various forms of cannabis ,grow rack the extant literature predominately focuses on their perceptions of health risks associated with combustible cannabis, or “marijuana” in general.

Lacking are studies concerning AYAs’ perceptions associated with non-combustible products and with blunts. In addition, prior research has asked about perceptions of more general outcomes rather than of specific risk or benefit outcomes . Such nuanced data on specific perceived risks and benefits regarding both health and social impacts across product types could inform the development of tailored messages and educational content for cannabis use prevention . To address these gaps, we analyzed cross-sectional data collected among 433 California AYAs during 2017–2018. According to the 2019 Youth Risk Behavior Survey, California adolescents had lower prevalence of ever and current use of cannabis compared to national estimates of adolescent cannabis use . However, as California is considered the largest legal cannabis market in the US after legalization occurred in January 2018 , cannabis-related data in this state provide important information since policies pioneered in California are often adopted by other states, and so may reflect and inform future use patterns and drivers. This study examined perceptions of not only risks but also benefits related to short-term and long-term use of different cannabis products . Given that blunts are a well-documented form of co-use of cannabis and tobacco among AYAs, and previous research showing different perceptions related to blunts and other combustible cannabis products , we examined perceptions related to blunts and other forms of combustible cannabis separately. We also compared perceptions between participants who had ever used cannabis and those who had never used cannabis. Understanding AYAs’ perceived risks and benefits across different types of cannabis products and by use status is critical to inform public health and education messaging strategies aimed at preventing and reducing use of all forms of cannabis. Means and standard deviations were computed for each perception item. We used generalized linear models to account for correlation of students’ responses clustered within school and unbalanced group sizes. Outcomes were continuous variables indicating perceived chance of having a given health or social risk if using cannabis.

For each perception outcome, we estimated a model comparing means of that outcome among four cannabis products , and another model of that outcome between ever and never cannabis users . All models were adjusted for age and sex. There were six pairwise comparisons among four cannabis products. The statistical significance across pairwise comparison tests was controlled by using the Tukey-Kramer method with p-values adjusted based on the studentized range distribution . All tests were two-tailed with a significance level of α less than 0.05. Analyses were conducted using SAS v9.4. Among the risks assessed , the most common perceived short-term and long-term risks were “get into trouble” and “become addicted,” respectively. Across the cannabis products, perceived percent chance of experiencing the short- and long-term risks was highest for blunts and combustible cannabis, followed by vaporized cannabis, and the lowest for edible cannabis. Almost all of the pairwise comparisons of perceived health risks among the cannabis products were significantly different. Comparisons between combustible cannabis and blunts were not significantly different for most of the perceived health risks. The only significant difference between the two products was that long-term use of blunts was perceived to have a higher likelihood of resulting in lung cancer and heart attack than long-term use of other combustible cannabis products. Combustible cannabis and blunts were perceived to have greater risks than vaporized cannabis for all the health outcomes, except for having a heart attack. Vaporized cannabis was perceived to have greater health risks than edibles, except for having heart attack. For perceived short-term risk of experiencing social problems if used cannabis, the only significant comparison was between blunts and edible cannabis, indicating that blunts were perceived as more likely than edible cannabis to lead to getting into trouble and having friends upset. Compared to never users, ever cannabis users perceived less risk of getting lung cancer and experiencing social problems for the four cannabis products. Likewise, perceived risk of getting oral cancer was lower among ever users for all types of cannabis products, except combustible cannabis. For edible cannabis, ever users perceived lower short-term health risks and addiction than never users. Likewise, ever users perceived lower risk of having trouble catching breath and getting lung disease for vaporized cannabis, and lower risk of becoming addicted for combustible cannabis.Among the benefits assessed , the most common perceived short-term and long term benefits from using cannabis were “feel high or buzzed” and “feel less anxious,” respectively.

For pairwise comparisons of short-term benefits, combustible cannabis was perceived as having greater benefits of all the short-term benefits than vaporized cannabis, and having greater benefits for short-term mental health outcomes than blunts and edibles. Participants thought that smoking combustible cannabis or blunts would be more likely to result in someone “looking cool” than using vaporized or edible cannabis. Participants perceived feeling high or buzzed from using edible cannabis more than from using vaporized cannabis. Regarding long-term benefits, combustible cannabis was perceived as reducing anxiety and depression better than all other cannabis products. Ever cannabis users perceived greater benefits of using cannabis on reducing mental health problems for using all types of cannabis products. Compared to never users, ever users also perceived greater benefits of having better concentration for all types of cannabis, except for vaporized cannabis. In addition, ever users perceived greater benefits of looking cool for combustible cannabis and blunts, while they perceived greater benefits of feeling high or buzzed for edible cannabis. While combustible cannabis and blunts remain the most common forms of AYA cannabis use, increasing rates of use of vaporized and edible cannabis have been observed . However,greenhouse grow tables most studies on perceptions of cannabis focus on combustible cannabis, or “marijuana” more generally. This study extends the literature by examining AYAs’ perceptions of short-term and long-term risks and benefits of cannabis use, with a focus on different types of cannabis products , and between ever and never users of cannabis. The main finding is that AYAs differently perceive risks and benefits across the four cannabis products, and ever cannabis users generally perceive lower risks and greater benefits of cannabis use than never users. Consistent with previous studies among AYAs , the most common cannabis products used in our sample were combustible cannabis and blunts. Interestingly, these products on average were perceived to have greater short- and long-term risks than vaporized and edible cannabis. However, it should be noted that ever cannabis users perceived less risks of using these products than never users. The paradox between perceived risk and actual use of combustible cannabis and blunts may be explained by another finding that AYAs also had greater perceived benefits related to these products. These findings indicate that AYAs’ use of combustible cannabis and blunts are based on a balance of both their perceived risks and perceived benefits of these products, highlighting the role of these sets of opposite perceptions in AYAs’ behavioral decision-making . Prevention and intervention efforts often focus on communicating health risks related to cannabis use rather than social risks , yet such health outcome-focused strategies may not always be effective for young populations , 2021. Indeed, among the perceptions of risks assessed in our study, the most common perceived short-term and long-term risks were social negative outcomes and addiction, respectively. Likewise, a previous qualitative study found that adolescents expressed a concern about addiction and social impacts of cannabis use . This finding suggests that, along with communicating about health risks, increasing AYAs’ awareness of social risks and the addictive nature of cannabis use may be an additional focus to deter AYA cannabis use, as has been shown with other research including both social and health risks for tobacco prevention .

In addition, our study did not identify whether our participants had experienced any health or social risks related to cannabis. Future research should elucidate actual consequences of specific perceived risks on cannabis use among AYAs. In addition to considering perceived social risks in research and prevention efforts, the perceived benefit construct is also part of many health behavior models , yet rarely included in studies on cannabis use perceptions. We found the most common perceived long-term benefit among AYAs was “feel less anxious.” Beyond recreational purposes, AYAs report using cannabis as self medication to cope with their anxiety and other mental health issues . Our finding that AYAs perceived cannabis use as beneficial to their mental health is particularly important given that recent national data report a concerning trend in poor mental health in this age group . Furthermore, recent reviews indicate that AYA cannabis use is associated with poorer outcomes among those with mood and anxiety disorders and increased risk for developing major depression and suicidality . Our finding highlights a need for correcting AYAs’ misperception regarding benefits of cannabis use and educating AYAs on mental health risks related to use of cannabis. In addition, including screening for mental health problems into routine clinical care and integrating resilience training in prevention programs may offer AYAs better ways to cope with their mental health issues , which in turn may prevent their cannabis use. We also found that AYAs perceive use of edible cannabis as the least harmful to their health compared to other types of cannabis use. Legalization of recreational cannabis use and permission of home cultivation have been associated with a higher likelihood of AYAs using edible cannabis . This changing policy landscape coupled with low perceived risks of edibles call for more attention on preventing use of this product among AYAs. Collectively, our study has implications for public health efforts to prevent cannabis use and its negative health effects on AYAs. Mass media campaigns and educational programs should address both perceived risks and benefits of cannabis use and consider all types of cannabis products. Effective communication strategies may be those that increase perceptions of both health and social risks and correct misperceptions of mental health benefits related to cannabis use. As AYAs’ perceptions differ by cannabis product type, messages should be tailored to specific cannabis products, especially non-combustible products, rather than focus on cannabis use generally. For example, contents on vaporized cannabis could highlight risk of vaping-related lung injuries, while those on edible cannabis could highlight risk for over-consumption and intoxication. This study has several limitations.