Young‐adult compared to adolescent onset of regular cannabis use: A 20‐year prospective cohort study of later consequences

Introduction This paper compares consequences of cannabis use initiated after high school with those of cannabis initiation in adolescence, with estimates of the proportion of adverse consequences accounted for by adult‐onset and adolescent‐onset cannabis users. Methods A state‐representative sample in Victoria, Australia (n = 1792) participated in a 10‐wave longitudinal study and was followed from age 15 to 35 years. Exposure variable: Patterns of cannabis use across 20 years. Outcomes at age 35: Alcohol use, smoking, illicit drug use, relationship status, financial hardship, depression, anxiety and employment status. Results Substantially more participants (13.6%) initiated regular use after high school (young‐adult onset) than in adolescence (7.7%, adolescent onset). By the mid‐30s, both young‐adult and adolescent‐onset regular users were more likely than minimal/non‐users (63.5%) to have used other illicit drugs (odds ratio [OR] > 20.4), be a high‐risk alcohol drinker (OR > 3.7), smoked daily (OR > 7.2) and less likely to be in relationships (OR