Household cannabis cessation was linked to a lower level of adolescent mental health problems at follow-up, suggesting that interventions aimed at reducing or eliminating household cannabis exposure may be beneficial for youth well-being.
Key Findings
Results
Household cannabis cessation was associated with lower levels of internalizing problems, externalizing problems, and psychotic-like experiences in adolescents.
Mean ratios for all three outcomes ranged from 0.84 to 0.86, all P < 0.02, after propensity score matching.
Associations were adjusted for baseline scores of the respective mental health outcomes.
Of 1426 adolescents exposed to household cannabis within 12 months, 438 (30.7%) were no longer exposed by wave 3.
Internalizing and externalizing problems were assessed using the Child Behavior Checklist; psychotic-like experiences (PLEs) were evaluated using the Prodromal Questionnaire-Brief Child Version.
Results
The associations between household cannabis cessation and mental health outcomes persisted after adjusting for adolescents' polygenic risk for cannabis use disorder.
This additional adjustment was performed among White participants only.
Genetic predisposition to cannabis use disorder (CUD) was incorporated as a covariate using polygenic risk scores.
The persistence of associations after genetic adjustment suggests the effect is not solely attributable to shared genetic liability.
Results
Family conflict mediated a portion of the associations between household cannabis cessation and both internalizing and externalizing symptoms.
Family conflict mediated 6.8% of the association between cessation and internalizing symptoms.
Family conflict mediated 14.3% of the association between cessation and externalizing symptoms.
Family conflict was assessed using the Family Environment subscale.
Results
Adolescent sleep problems mediated a substantial portion of the associations between household cannabis cessation and both internalizing and externalizing symptoms.
Sleep problems mediated 25.8% of the association between cessation and internalizing symptoms.
Sleep problems mediated 24.8% of the association between cessation and externalizing symptoms.
Sleep problems were assessed using the Sleep Disturbance Scale for Children.
Sleep problems accounted for a larger proportion of mediation than family conflict for both internalizing and externalizing outcomes.
Results
Brain connectivity patterns moderated the association between household cannabis cessation and psychotic-like experiences.
Adolescents with weaker connections between cingulo-parietal and dorsal attention networks showed stronger associations between cessation and PLEs.
Brain connectivity was measured by resting-state fMRI.
This finding suggests neural network characteristics may identify subgroups differentially benefiting from household cannabis cessation.
Methods
The study sample consisted of adolescents aged 10–13 years drawn from the Adolescent Brain Cognitive Development (ABCD) study with household cannabis use within 12 months at wave 2.
Total eligible sample was 1426 adolescents exposed to household cannabis within the prior 12 months.
Household cannabis cessation was defined as absence of cannabis use by household members (excluding the adolescent participant) at wave 3 among households reporting use at wave 2.
Propensity score matching (PSM) was used to balance demographic and psychometric confounders between cessation and non-cessation groups.
Linear regression was applied to investigate associations between cessation and mental health outcomes.
Wang M, Xu Y, Huang R, Sun Y, Zhang L, Zhou W, et al.. (2026). Household cannabis cessation and adolescent mental health outcomes in a prospective cohort study.. BMC medicine. https://doi.org/10.1186/s12916-026-04668-4