Background: Canada legalized recreational cannabis in 2018, and one of the primary objectives was to protect youth. Leading up to legalization, the government emphasized a public health approach aimed at delaying initiation, reducing frequency, preventing problematic use and dependence, increasing access to services and prevention programs, and prioritizing early and ongoing public education. Since legalization, cannabis use has increased across all age groups, particularly among youth and young adults aged 16–24. Youth are especially vulnerable to cannabis-related harms due to ongoing neurobiological development, with risks compounded by increases in cannabis potency. Cannabis use among youth has been associated with several adverse effects, including psychosis, depression, anxiety, and suicidal behaviours. To better understand diverse perspectives on reducing the risks and harms associated with youth cannabis use, this study examined recommendations from three key stakeholder groups: youth, parents, and service providers.

Methods: This qualitative study used a community-based participatory research approach in partnership with Families for Addiction Recovery (FAR), a national charity founded by parents. Participants were eligible if they were Ontario residents and included: youth aged 16–24 who used cannabis regularly, parents/caregivers of youth aged 16–24 who used cannabis regularly, and service providers working with youth aged 16–24 in mental health or addiction services. Using a qualitative descriptive design, we conducted virtual semi-structured interviews and analyzed the data using reflexive thematic analysis.

Results: The study included 88 participants (n = 31 youth, n = 26 parents, n = 31 service providers). Participants identified six recommendations to reduce the risks and harms of cannabis use among youth: (1) reduce cannabis access and availability; (2) increase public education on risks and harms of cannabis use; (3) enhance training and education for service providers; (4) expand mental health and addiction services for youth and families; (5) strengthen family support and involvement; and (6) reduce the stigmatization and normalization of cannabis use.

Conclusions: The findings underscore the need to strengthen a comprehensive public health approach to cannabis and to address the influence of commercial determinants of health (CDoH), which are profit-driven and can have serious impacts on health outcomes.