Associations between adolescent cannabis use and young-adult functioning in three longitudinal twin studies

Proc Natl Acad Sci U S A. 2021 Apr 6;118(14):e2013180118. doi: 10.1073/pnas.2013180118.


Observational studies have linked cannabis use to an array of negative outcomes, including psychiatric symptoms, cognitive impairment, and educational and occupational underachievement. These associations are particularly strong when cannabis use occurs in adolescence. Nevertheless, causality remains unclear. The purpose of the present study was thus to examine associations between prospectively assessed adolescent cannabis use and young-adult outcomes (psychiatric, cognitive, and socioeconomic) in three longitudinal studies of twins (n = 3,762). Twins reporting greater cumulative cannabis use in adolescence reported higher levels of psychopathology as well as poorer socioeconomic outcomes in young adulthood. However, cannabis use remained associated only with socioeconomic outcomes (i.e., educational attainment, occupational status, and income) in monozygotic-cotwin control analyses, which account fully for shared genetic and environmental confounding. Follow-up analyses examining associations between twin differences in adolescent cannabis use and longitudinal change in academic functioning during the middle- and high-school years provided a possible mechanism for these associations, indicating that greater cannabis use during this period was associated with decreases in grade point average and academic motivation as well as increases in academic problem behavior and school disciplinary problems. Our findings thus suggest that cannabis use in adolescence has potentially causal, deleterious effects on adolescent academic functioning and young-adult socioeconomic outcomes despite little evidence suggesting a strong, causal influence on adult mental health or cognitive ability.

Keywords: adolescence; cannabis; education; marijuana; twin.

Publication types

  • Research Support, N.I.H., Extramural
  • Twin Study

MeSH terms

  • Adolescent
  • Adult
  • Cannabis
  • Child
  • Cognition
  • Educational Status*
  • Employment*
  • Humans
  • Longitudinal Studies
  • Marijuana Use / epidemiology*
  • Mental Disorders / epidemiology*
  • Minnesota / epidemiology
  • Young Adult