Cannabis Use Behaviors and Associations with Home Cultivation and Perceived Accessibility among Secondary School Students in Songkhla, Thailand
Abstract
Objective: The objectives of this study are: 1) to describe the prevalence and pattern of cannabis use; 2) to describe the extent to which home cultivation of cannabis was associated with cannabis use; and 3) to describe the extent to which perceived accessibility of cannabis was associated with cannabis use among secondary school students in Thailand.
Material and Methods: We conducted a cross-sectional study at 15 schools in Songkhla Province, Thailand. We selected the schools using stratified cluster random sampling and invited all students present in the selected classroom to answer an anonymous self-administered questionnaire. We analyzed the data using descriptive statistics and logistic regression with sampling weight adjustments.
Results: A total of 3,663 students (63.6% female, mean age 16.8 years) answered our survey (response rate=100%). Among all participants, 4.4% were current cannabis users, and another 2.4% were former users. Home cultivation was significantly associated with lifetime history (current or former) vs. never used cannabis (24.4% vs. 5.3%, Adjusted Odds ratio (OR)=5.64; 95% confidence interval (CI)=4.21, 7.56). Perceived accessibility was also associated with lifetime history vs. never used (16.9% vs. 4.5%, Adjusted OR=3.89; 95% CI=1.90, 8.00). There were no significant associations between home cultivation or perceived accessibility with current vs. former use of cannabis.
Conclusion: We found associations between perceived and real (cultivated) accessibility to cannabis and cannabis use among adolescents. However, limitations regarding the study design and lack of generalizability should be considered caveats in the interpretation of the study’s findings.
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United Nations Office on Drugs and Crime. World Drug Report 2024 [homepage on the Internet]. New York: United Nations; 2024 [cited 2024 Sep 17]. Available from: https://www.unodc.org/documents/data-and-analysis/WDR_2024/WDR24_Key_findings_and_conclusions.pdf
Ransing R, de la Rosa PA, Pereira-Sanchez V, Handuleh JIM, Jerotic S, Gupta AK, et al. Current state of cannabis use, policies, and research across sixteen countries: cross-country comparisons and international perspectives. Trends Psychiatry Psychother 2022;44:e20210263.
Farrelly KN, Wardell JD, Marsden E, Scarfe ML, Najdzionek P, Turna J, et al. The impact of recreational cannabis legalization on cannabis use and associated outcomes: a systematic review. Subst Abuse 2023;17:11782218231172054.
Matthews AL, Hickey C. More US states are regulating marijuana. See where it’s legal across the country. [homepage on the Internet]. Atlanta: CNN; 2024 [cited 2024 Sep 17]. Available from: https://edition.cnn.com/us/us-states-where-marijuana-is-legal-dg/index.html
Government of Thailand. Notification of the Ministry of Public Health: Identify the name of the narcotics in the category 5 B.E.2565. June 9, 2022.
Juslaws & Consult. Amendment to Cannabis Law on 25 June 2025: Cannabis Still Legal in Thailand? Yes, But... [homepage on the Internet]. Bangkok: Juslaws & Consult; 2025 [cited 2025 Dec 9]. Available from: https://www.juslaws.com/articles/amendment-cannabis-laws-25-june-2025
Jayuphan J, Assanangkornchai S, Wichaidit W. Cannabis use behaviors and related harms among adults in thailand by sex assigned at birth and age groups. J Health Sci Med Res 2024;43:1–15.
Volkow ND, Baler RD, Compton WM, Weiss SRB. Adverse health effects of marijuana use. N Engl J Med 2014;370:2219–27.
Broyd SJ, Van Hell HH, Beale C, Yücel M, Solowij N. Acute and chronic effects of cannabinoids on human cognition—a systematic review. Biol Psychiatry 2016;79:557–67.
Jacobus J, Tapert SF. Effects of cannabis on the adolescent brain. Curr Pharm Des 2014;20:2186–93.
Van Gastel WA, Tempelaar W, Bun C, Schubart CD, Kahn RS, Plevier C, et al. Cannabis use as an indicator of risk for mental health problems in adolescents: a population-based study at secondary schools. Psychol Med 2013;43:1849–56.
Donoghue K, Doody GA, Murray RM, Jones PB, Morgan C, Dazzan P, et al. Cannabis use, gender and age of onset of schizophrenia: Data from the ÆSOP study. Psychiatry Res 2014;215:528–32.
Moore THM, Zammit S, Lingford-Hughes A, Barnes TRE, Jones PB, Burke M, et al. Cannabis use and risk of psychotic or affective mental health outcomes: a systematic review. Lancet 2007;370:319–28.
Fergusson DM, Boden JM, Horwood LJ. Cannabis use and other illicit drug use: testing the cannabis gateway hypothesis. Addiction 2006;101:556–69.
Wichaidit W, Chapakiya I, Waeuseng A, Chumchuen K, Assanangkornchai S. Density of cannabis outlets vs. cannabis use behaviors and prevalent cannabis use disorder: findings from a nationally-representative survey. PeerJ. 2024;12:e17317.
Borodovsky JT, Lee DC, Crosier BS, Gabrielli JL, Sargent JD, Budney AJ. U.S. cannabis legalization and use of vaping and edible products among youth. Drug Alcohol Depend 2017;177:299–306.
Borodovsky JT, Budney AJ. Legal cannabis laws, home cultivation, and use of edible cannabis products: a growing relationship? Int J Drug Policy 2017;50:102–10.
Cristiano N, Pacheco K, Wadsworth E, Schell C, Ramakrishnan N, Faiazza E, et al. An analysis of cannabis home cultivation and associated risks in Canada, before and after legalization. Health Rep 2022;33:21–31.
Wichaidit W, Saingam D, Assanangkornchai S. The fifth surveillance of alcohol, tobacco, substance use and health-risk behaviors among high school students in Thailand in 2020. songkhla: Center for Alcohol Studies; 2021;p.106.
Wadsworth E, Cristiano N, Pacheco K, Jesseman R, Hammond D. Home cultivation across Canadian provinces after cannabis legalization. Addict Behav Rep 2022;15:100423.
Assanangkornchai S, Thaikla K, Talek M, Saingam D. Medical cannabis use in Thailand after its legalization: a respondent-driven sample survey. PeerJ 2022;10:e12809.
Gaete J, Araya R. Individual and contextual factors associated with tobacco, alcohol, and cannabis use among Chilean adolescents: a multilevel study. J Adolesc 2017;56:166–78.
Zarrouq B, Bendaou B, El Asri A, Achour S, Rammouz I, Aalouane R, et al. Psychoactive substances use and associated factors among middle and high school students in the North center of Morocco: a cross-sectional questionnaire survey. BMC Public Health 2016;16:468.
Carrà G, Bartoli F, Canestro A, Capogrosso CA, Bebbington PE, Crocamo C. Influence of intrinsic and extrinsic religiosity on youth cannabis use: A structural equation modelling analysis on national survey on drug use and health (NSDUH) 2015–2019. J Psychiatr Res 2023;166:178–85.
Ford JA, Hill TD. Religiosity and adolescent substance use: evidence from the national survey on drug use and health. Subst Use Misuse 2012;47:787–98.
Phares BA, Driskill CN, Basani H, Rodil ARM, Barr EA. Multilevel risk and protective factors influencing cannabis use among adolescents and young adults in the United States: a systematic review. Compr Child Adolesc Nurs 2025;48:278-306.
Torrejón-Guirado MC, Lima-Serrano M, Mercken L, de Vries H. Which factors are associated with cannabis use among adolescents in Andalusia? an application of the I-Change model. J Nurs Scholarsh 2023;55:739–50.
Batra P, Dhawan A, Pandey RM, Mehta M, Sagar R, Chopra A. Substance use and its associated factors among school students. Natl Med J India 2021;34:79–83.
Kalayasiri R, Boonthae S. Trends of cannabis use and related harms before and after legalization for recreational purpose in a developing country in Asia. BMC Public Health 2023;23:911.
Dilley JA, Richardson SM, Kilmer B, Pacula RL, Segawa MB, Cerdá M. Prevalence of cannabis use in youths after legalization in Washington State. JAMA Pediatr 2019;173:192-8.
Coley RL, Kruzik C, Ghiani M, Carey N, Hawkins SS, Baum CF. Recreational marijuana legalization and adolescent use of marijuana, tobacco, and alcohol. J Adolesc Health 2021;69:41–9.
Midgette G, Reuter P. Has cannabis use among youth increased after changes in its legal status? a commentary on use of monitoring the future for analyses of changes in state cannabis laws. Prev Sci 2020;21:137–45.
Peters EN, Bae D, Barrington-Trimis JL, Jarvis BP, Leventhal AM. Prevalence and sociodemographic correlates of adolescent use and polyuse of combustible, vaporized, and edible cannabis products. JAMA Netw Open 2018;1:e182765.
Manthey J, Jacobsen B, Hayer T, Kalke J, López-Pelayo H, Pons-Cabrera MT, et al. The impact of legal cannabis availability on cannabis use and health outcomes: a systematic review. Int J Drug Policy 2023;116:104039.
Cantor N, Silverman M, Gaudreault A, Hutton B, Brown C, Elton-Marshall T, et al. The association between physical availability of cannabis retail outlets and frequent cannabis use and related health harms: a systematic review. Lancet Reg Health Am 2024;32:100708.
Leatherdale ST, Amores A, Bélanger RE, Battista K, Patte KA, Jiang Y. Youth perception of difficulty accessing cannabis following cannabis legalization and during the early and ongoing stages of the COVID-19 pandemic: repeat cross-sectional and longitudinal data from the COMPASS study. Arch Public Health 2023;81:214.
Elfil M, Negida A. Sampling methods in clinical research; an educational review. Emerg (Tehran) 2017;5:e52.
Pannucci CJ, Wilkins EG. Identifying and avoiding bias in research. Plast Reconstr Surg 2010;126:619–25.
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