A Cross-Sectional Study on Youth and Over-the-Counter CBD Products: Understanding the Current Landscape in Spain

Abstract Background This cross-sectional study characterized the socio-demographic characteristics, substance use patterns, and mental health of young users of past-year over-the-counter CBD products and CBD + smoked cannabis (THC), relative to past-year users of THC-only and those who have never used these substances. Method 6,365 (55.8% female) participants aged 16–30 were assessed from September 2023-April 2024. Results CBD and CBD + THC use was associated with higher prevalence of past-month use of sedatives ( p < .001), past-month use of alcohol ( p < .001), cannabis ( p < .001), combustible tobacco ( p < .001), and e-cigarettes ( p < .001). Risk of psychopathology and substance use disorder (including nicotine dependence, alcohol, and cannabis) was higher among users of CBD + THC. Conclusions The use of CBD products is widespread among young populations, and CBD + THC appears to increase the risk of substance use disorders. Educating on the effects of CBD on health is not sufficient and should be accompanied by environmental prevention efforts.