Cannabis Use Among Students in Grades 8, 10, and 12, by Sex - King County, Washington, 2008-2021

Cannabis use during adolescence is associated with poor outcomes, including cognitive impairment, cannabis use disorder, and impaired driving. To guide prevention and use reduction strategies, Public Health - Seattle & King County described recent trends in cannabis use by sex among King County, Washington students in grades 8, 10, and 12 and examined trends in sex-based differences. Data collected during seven 2008-2021 survey periods by the Healthy Youth Survey (administered by the Washington State Department of Health) and restricted to King County students in grades 8, 10, and 12 (range = 33,439-39,391 students per cycle) were analyzed. Prevalence estimates were generated and sex-based prevalence differences (PDs) in current use (≥1 day during the previous 30 days) and frequent use (≥6 days during the previous 30 days) were assessed. PD models used weighted generalized linear regression with an interaction between sex and survey year. During 2008-2021, cannabis use declined among both male and female students. During 2008-2014, cannabis use was higher among male students than among female students (e.g., PD in 2008 = 4.8%) and not significantly different during 2014-2016; however, in 2021, current-use prevalence was lower among male students than among female students for the first time (PD = -1.3%). Frequent-use prevalence was similar among males and females. By grade levels, the highest prevalence of both current and frequent cannabis use was observed among 12th grade students, followed by 10th and 8th graders. Sex-specific differences by grade mirrored overall patterns. Developing tailored interventions that consider potential differences in risk and protective factors by sex or gender identity could promote equity in youth (grades 8, 10, and 12) cannabis use reduction measures.