Routes of cannabis administration among adolescents during criminal prohibition of cannabis in Canada

This report assesses sociodemographic correlates of cannabis routes of administration (ROAs) among adolescents in 2017, one year prior to legalization of cannabis in Canada. We analyze a subsample of 809 students (Grades 9–12) from the Ontario Student Drug Use and Health Survey (OSDUHS) who used cannabis in the previous year. Pipes/bongs/waterpipes (81.8%) are the most prevalent ROA, followed by joints (73.8%) and edibles (42%). Approximately 70% of students report 2+ ROAs. Alcohol use in the previous year is associated with 2.28 (1.3–5.58 OR; 95% CI) times the odds of food/drink ROA and 2.91 (1.10–3.89; 95% CI) times the odds of joint ROA. Tobacco use is associated with 1.60 (1.07–2.41 OR; 95% CI) times the odds of blunt ROA, 2.07 (1.10–3.89; 95% CI) times the odds of pipe/bong/waterpipe ROA, and 1.75 (1.03–2.95 OR; 95% CI) times the odds of e-cigarette/vape pen/vaporizer ROA. Students who used alcohol have a rate 1.59 (1.08–2.36 IRR; 95% CI) times greater for total ROA count, and students who used tobacco have a rate 1.24 (1.09–1.40 IRR; 95% CI) times greater. Given young people’s vulnerability to adverse outcomes associated with cannabis use, it is important to track ROA trends to inform harm reduction and educational programing and to evaluate impacts of policy changes.