In this issue of JAMA Pediatrics, Wang et al1 report a spike in marijuana ingestion among children in Colorado, a state that legalized medical marijuana in 2000 and 1 of the 2 states that legalized marijuana use in November. The finding reignites the debate over whether and how legalized marijuana impacts children and adolescents. The question is critically important to the public. A nationally representative household survey conducted in 2011 found that adults rated drug abuse as the number one health concern for youth, tied only with obesity, among a list of 23 health concerns.2 Reducing adolescent drug use remains a fixture of Healthy People, the blueprint that guides the government’s health priorities. As a nation, we are clearly invested in preventing and reducing drug use by our children. Debates over marijuana policy frequently center on the concern that legalization will increase adolescent use by a combination of reducing perceived harm, increasing supply or access, and “marketing” of marijuana, which could affect adolescent behavior even if campaigns are targeted at adults. The wealth of data on marijuana use rates has been used by marijuana legalization proponents and opponents alike—each side weaving the same numbers into a different story—somehow leaving the public underinformed even as the public is increasingly being called on to decide whether to legalize marijuana.
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