title: Health Risk Behaviors With Synthetic Cannabinoids Versus Marijuana.
abstract: OBJECTIVE
  Data are limited on the behavioral risk correlates of synthetic cannabinoid use. The purpose of this study was to compare the behavioral risk correlates of synthetic cannabinoid use with those among marijuana users.
  
  
  METHODS
  Data from the 2015 Youth Risk Behavior Survey, a cross-sectional survey conducted in a nationally representative sample of students in grades 9 through 12 (N= 15 624), were used to examine the association between self-reported type of marijuana use (ie, never use of marijuana and synthetic cannabinoids, ever use of marijuana only, and ever use of synthetic cannabinoids) and self-report of 36 risk behaviors across 4 domains: substance use, injury/violence, mental health, and sexual health. Multivariable models were used to calculate adjusted prevalence ratios.
  
  
  RESULTS
  Students who ever used synthetic cannabinoids had a significantly greater likelihood of engaging in each of the behaviors in the substance use and sexual risk domains compared with students who ever used marijuana only. Students who ever used synthetic cannabinoids were more likely than students who ever used marijuana only to have used marijuana before age 13 years, to have used marijuana ≥1 times during the past 30 days, and to have used marijuana ≥20 times during the past 30 days. Several injury/violence behaviors were more prevalent among students who ever used synthetic cannabinoids compared with students who ever used marijuana only.
  
  
  CONCLUSIONS
  Health professionals and school-based substance use prevention programs should include strategies focused on the prevention of both synthetic cannabinoids and marijuana.
authors.affiliation: Division of Adolescent and School Health, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, hhc9@cdc.gov.
authors.forename: Heather B
authors.initials: HB
authors.lastname: Clayton
authors.affiliation: Division of Adolescent and School Health, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention.
authors.forename: Richard
authors.initials: R
authors.lastname: Lowry
authors.affiliation: Division of Adolescent and School Health, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention.
authors.forename: Carmen
authors.initials: C
authors.lastname: Ashley
authors.affiliation: Office of Applied Research, Office of Public Health Preparedness and Response, and.
authors.forename: Amy
authors.initials: A
authors.lastname: Wolkin
authors.affiliation: Office of Noncommunicable Diseases, Injury, and Environmental Health, Office of the Director, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Althea M
authors.initials: AM
authors.lastname: Grant
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D002186:Cannabinoids / Q000009:adverse effects; D002188:Cannabis / Q000009:adverse effects; D003430:Cross-Sectional Studies; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D008385:Marijuana Smoking / Q000453:epidemiology*; D015995:Prevalence; D012309:Risk-Taking; D013334:Students; D019966:Substance-Related Disorders / Q000453:epidemiology*; D011795:Surveys and Questionnaires
chemical_list: D002186:Cannabinoids