State Marijuana Laws and Marijuana Use Among Sexual and Gender Minority Youth in the United States

Purpose: The purpose of this study was to explore the association between state-level marijuana policies and marijuana use among sexual and gender minority (SGM) adolescents.Methods: A secondary analysis was conducted using a nonprobability sample, the 2017 LGBTQ National Teen Survey, based on 10,027 youth who reported their marijuana use behaviors and state of residence. Random intercept multilevel models were estimated to account for between- and within-state variability.Results: State marijuana possession laws were not associated with lifetime use; however, the odds of current marijuana use were 50% greater among youth living in states with legalized marijuana possession for recreational use (adjusted odds ratio [aOR] = 1.50; 95% confidence interval [CI]: 1.21-1.86) compared with states that prohibit any possession. Lesbian, gay, bisexual, transgender, and queer victimization was associated with greater odds of lifetime (aOR = 1.98; 95% CI: 1.78-2.20) and current (aOR = 1.99; 95% CI: 1.74-2.27) marijuana use.Conclusions: State-level policies governing recreational marijuana possession are associated with current marijuana use among SGM youth. Public health approaches to control underage access to legal marijuana and mitigate substance use-related health disparities are needed.