Adolescents are less likely to attempt to quit cannabis than tobacco: The potential role of lower risk perception.

Abstract

Adolescents appear to quit cannabis at lower rates than tobacco. However, previous studies have either not assessed cannabis and tobacco cessation within the same sample or have used different quitting measures for the two substances, making direct comparisons difficult. Participants were 25,930 adolescents who reported past-month use of cannabis, nicotine vapes (hereafter, "vapes") and/or cigarettes among 162,675 middle and high school students completing the 2019-2020 California Student Tobacco Survey. Past-year quit attempts were examined in relation to harm perceptions, co-use, and demographic characteristics. The quit attempt rate was lower for cannabis (38.7%) than for vapes (52.9%; p < 0.001) or cigarettes (47.7%; p < 0.01), whereas no significant difference was observed between vapes and cigarettes (p = 0.10). There were no gender differences in quit attempt rates for cannabis, vapes, or cigarettes. Older age predicted a lower quit attempt rate for cannabis, but not for vapes or cigarettes. The effects of race/ethnicity varied across products but were more frequently observed for cannabis. Parental education was negatively associated with quit attempts, but only for cannabis. Harm perceptions consistently predicted quit attempts across products. Cannabis was perceived as the least harmful of the three products. Adolescents consistently attempted to quit cannabis at lower rates than tobacco products. This may be attributable, in part, to perceptions that cannabis is less harmful than vapes or cigarettes, as well as to differing social norms surrounding these products. These factors should be considered in future cannabis prevention efforts targeting this population.