How has non-medical cannabis legalization served the health and welfare of under-age (adolescent) youth in Canada?

• prevalence of cannabis use (in the past 12-months) among ages 16–19 years increased from 36% in 2018 to 43% in 2023. 
• implementation of cannabis legalization (2018–2019), compared with pre-legalization (2001–2017) was associated with a 31% increased likelihood of any cannabis use, a 40% increased likelihood of daily cannabis use and a 98% increased likelihood of cannabis dependence among Ontario secondary students
• under-age youth in Alberta (<18 years) and Ontario (<19 years), legalization was associated with a 20% increase-equivalent (2015–2019) for emergency department visits involving cannabis-related disorder/poisoning, and there were (moderate) increases in cannabis-related (e.g., for psychosis, poisoning, withdrawal, harmful use) hospitalizations among young individuals (ages 15–24) in Canada’s four largest provinces
• remained as the respective relative majorities of enforced cannabis offenses in the post-legalization period. Despite a supposed general ‘ban’ on cannabis-related advertisement especially for youth protection, almost two-thirds (63%) of Canadian adolescents reported exposure to cannabis-related advertisements or promotions in 2023.3
• Half-a-decade into legalization and its consequential ‘normalization’ environment for cannabis, we observe a mixed picture of developments for main outcome indicators among underage/adolescent youth in Canada. While cannabis use rates have remained steady at best at comparably high levels, selected adverse cannabis-related health outcomes (e.g., hospitalizations), and some risk-behaviors have increased. 
• With exposure to cannabis commercialization common, adolescents’ cannabis sourcing practices have shifted from predominantly ‘illegal’ to ‘legal’ (albeit so only for adults) and ‘grey’ (e.g., ‘social’) sources. [remember it is illegal for children/youth under the age of 18, (some provinces 19 and 21) to buy or use cannabis] Cannabis-related enforcement has been markedly reduced; however, cannabis (possession) offenses remain disproportionately enforced against underage individuals… [because it is illegal for them to have and use] The—widely promoted—objective of effective cannabis access and use reduction for this particular age group has not been achieved through legalization.

(Source:  The Lancet Regional Health – Americas)