Adolescent cannabis use disorder following recreational cannabis legalization in California, USA: A population-based interrupted time series study

Addiction

Adolescent past-year cannabis use trends have remained relatively flat nationally as legalization has spread, but less is known about clinical outcomes such as incident cannabis use disorder (CUD). Researchers evaluated incident CUD case trends among adolescents in California between 2014 and 2020 to assess recreational cannabis legalization (RCL) impact. Incidence of CUD was trending lower between 2014 and 2016 prior to RCL, but post-RCL there was an inflection in the annualized incidence rate , and it started to increase. Notably the increase in incidence trend started after RCL passage, even before implementation of the law. The increasing trend continued after RCL implementation and through 2020. The authors note these findings highlight the importance of monitoring CUD outcomes along with use prevalence to assess public health impacts of cannabis legalization.

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Cannabis use and cannabis use disorder among older adults in the USA

Addiction

Cannabis use has increased among older adults (≥65 years) and to better describe cannabis use and cannabis use disorder (CUD) in this population researchers used the annual National Survey on Drug Use and Health (NSDUH) from 2021 to 2024. Overall, 8.9% of older adults reported past 12-month use and 6.0% reported past 30-day use. Among those who reported past 12-month use, 11.4% met criteria for CUD (76% mild, 20.1% moderate, and 3.9% severe). Those with lifetime arrest, past-year mental illness, tobacco use, other drug use, frequent cannabis use (>300 days in last year), and males were more likely to have CUD. Of note, 19.9% of older adults reporting cannabis use reported it had been recommended by a doctor. The authors suggest clinicians should be screening for unhealthy cannabis use in this population and early intervention could be of benefit as many have mild CUD.

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Nicotine e-cigarettes for cigarette smoking cessation: Recommendations to US-based clinicians

Journal of the American Medical Association

This Special Communication summarizes the evidence on the use of e-cigarettes for smoking cessation and provides recommendations for clinicians on how to engage in conversations with adult patients who currently smoke cigarettes. Specifically, advice is provided on (1) integration of e-cigarettes into patient-centered shared decision-making conversations on the risks and benefits of various pharmacologic smoking cessation treatments; and (2) practical guidance on the use of e-cigarettes for smoking cessation. The authors include one overarching recommendation: integrate e-cigarettes into conversations on the risks and benefits of all evidence-based pharmacologic treatments for smoking cessation. In support of this recommendation, specific guidance is provided regarding how to discuss potential misperceptions and suggested questions are offered to guide patient conversations. Evidence-based best practices are also provided for using e-cigarettes to quit smoking.

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