Publication date: Aug 01, 2025

The COVID-19 pandemic may have affected young adult use of cannabis and other drugs. Prior research provides information about these effects, but additional estimates are needed using data collected in a consistent manner across years and in an established legalized cannabis context. The authors assessed changes in substance use among young adults in Washington State during the pandemic relative to prior trends. Data were from young adults aged 18-25 years in 6 annual waves of the statewide Washington State Young Adult Health Survey (N=12,516). In analyses conducted in 2023 and 2024, the authors estimated trends in substance use from 2016 to 2019 and deflections from those trends in 2020 and 2021. Past-month cannabis use increased across years (annual percentage point change in 2016-2019 =1. 6; 95% CI=0. 6, 2. 6), with little deflection from the prepandemic trend in 2020 or 2021. Prevalence of past-month alcohol use, heavy episodic drinking, cigarette use, and nonprescribed pain reliever use decreased across years (annual percentage point change range= -1. 2, -0. 5), with a further downward deflection from the prepandemic trend for cigarette use in 2020 (percentage point change= -3. 8; 95% CI= -6. 2, -1. 4). Prevalence of simultaneous alcohol and cannabis use was stable across the study period. E-cigarette use increased before pandemic (annual percentage point change=1. 8; 95% CI=1. 2, 2. 5) but fell below this trend in 2020 (percentage point change= -2. 9; 95% CI= -4. 8, -1. 1) and 2021 (percentage point change= -3. 2; 95% CI= -5. 3, -1. 0). For those aged

Semantics

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