Association of adolescent cannabis use with poor mental health and suicidality in young adulthood: A cross-sectional study using YRBS 2023 data
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Joseph Ntein Inungu 1 , Jennifer Ifeoma Olofu 2 * , Nirajan Budhathoki 2 , Niki Osakue 1
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1 School of Health Sciences, Central Michigan University, Mount Pleasant, MI, USA2 Department of Public Health Sciences, Henry Ford Health, Detroit, MI, USA* Corresponding Author

Abstract

Introduction: Cannabis is the second most widely used psychoactive substance globally, with increasing use among the US adolescents amid shifting legalization and societal norms. Although cannabis is often perceived as benign, emerging evidence links adolescent use with severe mental health outcomes, including depression and suicidality.
Objective: This study aimed to examine the association between adolescent cannabis use and poor mental health and suicidal behavior among the US high school students.
Methods: This is a secondary data analysis from the 2023 youth risk behavior survey, a nationally representative, cross-sectional survey of the US high school students. The final analytic sample included 8,065 participants with complete data. Mental health outcomes included self-reported poor mental health within the past 30 days and suicide attempts within the past 12 months. The primary independent variable, cannabis use, was categorized as never, former, or current use. Multivariable logistic regression models were used to explore associations between cannabis use and mental health outcomes while adjusting for sociodemographic characteristics, adverse childhood experiences (ACEs), bullying, social media use, and sleep patterns.
Results: Current cannabis users had significantly higher odds of reporting poor mental health (AOR: 1.47, 95% CI: 1.26-1.72) and suicide attempts (AOR: 1.83, 95% CI: 1.34-2.49) compared to non-users. Former users also had elevated odds for suicide attempts (AOR: 1.80, 95% CI: 1.37-2.37). A dose-response relationship was observed with ACEs, where students with four or more ACEs had nearly five times higher odds of poor mental health and tenfold higher odds of suicide attempts compared to those with none.
Conclusion: Adolescent cannabis use is significantly associated with a higher risk of poor mental health and increased suicidality. These findings underscore the need for targeted prevention, early interventions, and trauma-informed public health strategies to reduce cannabis-related mental health risks among youth.

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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Article Type: Original Article

ELECTRON J GEN MED, Volume 23, Issue 1, February 2026, Article No: em712

https://doi.org/10.29333/ejgm/17802

Publication date: 27 Jan 2026

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