Evaluation of the Effectiveness of Psychosocial, Behavioral, and Educational Interventions for Youth Cannabis Use: A Systematic Review of Randomized Controlled Trials

Cannabis use among adolescents and young adults has increased alongside legalization, commercialization, and higher product potency. However, evidence regarding the effectiveness of interventions to prevent or reduce cannabis use remains heterogeneous. To systematically synthesize evidence from randomized controlled trials (RCTs) evaluating behavioral, educational, psychosocial, family-based, and digital interventions targeting cannabis use among adolescents and young adults. Following PRISMA guidelines, MEDLINE, PsycINFO, CINAHL, Embase, and Web of Science were searched for randomized or cluster-randomized controlled trials involving participants aged 12–25 years. Study characteristics, intervention approaches, outcomes, and effectiveness were synthesized qualitatively. Of 973 records, 15 RCTs met the inclusion criteria. Studies varied in setting, intervention characteristics, delivery modality, and follow-up duration (2 months–7 years). School-based cognitive-behavioral interventions demonstrated the most consistent reductions in cannabis use and related harms by strengthening emotional regulation, problem-solving, coping skills, and social competence. Motivational interviewing, family-based, and digital interventions showed beneficial but variable effects. Behavioral interventions, particularly school-based cognitive-behavioral approaches, provide the strongest and most consistent evidence for reducing cannabis use and related harms among adolescents and young adults. However, methodological heterogeneity limits direct comparisons. Future well-powered RCTs with standardized outcome measures, longer follow-up, and implementation evaluations are needed to strengthen evidence-based prevention strategies.