Prevalence and Perceived Accessibility of Cannabis Products among Underage Young Adults, 2019-2023.

Objective: Using a national U.S. underage young adult sample, we examined prevalence of smoking, vaping, eating, drinking, and dabbing cannabis; perceived accessibility by product type; and perceived accessibility correlates (adolescent cannabis use, state cannabis policy context, sociodemographic characteristics).

Methods: Data were obtained from young adults under age 21 participating in the U.S. national Monitoring the Future Panel study from 2019-2023. Cannabis use prevalence by smoking, vaping, edibles, drinking, and dabbing was measured (n=3,075; 52.9% female). Perceived accessibility was measured for smoking, vaping, and edibles (n=1,227; 52.1% female). Covariate and accessibility associations were modeled using logistic regression.

Results: Multiple cannabis use modalities were reported by 23.3% of all respondents and 63.5% of those reporting past-12-month use. Among all respondents, smoking (30.7%), vaping (19.7%) and edibles (18.2%) were the most prevalent; fewer reported dabbing (10.4%) or drinking (2.8%). Perceiving easy access to smoking, vaping, and edibles was reported by 95.0%, 91.3%, and 86.7% of those reporting past-12-month use (77.5%, 71.2%, and 71.8% of those reporting no use). Among those reporting no 12-month use, state recreational use policy was associated with perceiving easier access for smoking and edibles; full-time 4-year college attendance was associated with easier perceived access across modalities (vs. part-time/2-year college or not attending).

Conclusions: Underage U.S. young adults are not legally able to purchase cannabis but reported easy access across products; those who used cannabis typically used multiple products. Among those reporting no past-12-month use, state policy and college attendance were strongly associated with perceived accessibility across products.