Adolescents are less likely to attempt to quit cannabis than tobacco: The potential role of lower risk perception.

Snow M.; Wang J.; Gamst A.; Li S.; Zhu S. · Drug and alcohol dependence · 2026

**Background & Methods** This cross-sectional study analyzed data from 25,930 adolescents reporting past-month cannabis, nicotine vape, and/or cigarette use among 162,675 middle and high school students completing the 2019-2020 California Student Tobacco Survey. Past-year quit attempt rates were examined in relation to harm perceptions, co-use patterns, and demographic characteristics. **Key Findings** • Cannabis quit attempt rate (38.7%) was significantly lower than vapes (52.9%; p<0.001) and cigarettes (47.7%; p<0.01), with no significant difference between vapes and cigarettes (p=0.10). • Harm perception was the most consistent predictor of quit attempts across all three products, with cannabis perceived as the least harmful substance; notably, older adolescents showed lower quit attempt rates specifically for cannabis but not tobacco products. • Demographic patterns differed by substance: parental education was negatively associated with cannabis quit attempts only, while race/ethnicity effects varied across products with greater frequency for cannabis; no gender differences were observed in quit attempt rates for any substance. **Dosage & Administration** Not reported. **Safety & Adverse Effects** Not reported. **Evidence Quality** This study provides moderate-level evidence with several limitations. The cross-sectional design precludes causal inference regarding the relationship between harm perception and quit attempts. The study relied on self-reported data from a single state survey, potentially limiting generalizability beyond California's adolescent population. Additionally, the survey captured only past-year quit attempts without distinguishing attempt duration, intensity, or success rates. The mechanism by which lower harm perception translates to reduced quit attempts requires further investigation through longitudinal or experimental designs. Strengths include the large, population-based sample with direct comparison of cessation behaviors across substances using identical measures, and the inclusion of multiple demographic and psychosocial variables. The findings suggest that misperception of cannabis harm may be a modifiable target for prevention interventions, though future research should examine whether addressing risk perception causally influences quit behavior in adolescents.

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