ImportanceCannabis use during adolescence and young adulthood may affect academic achievement; however, the magnitude of association remains unclear.ObjectiveTo conduct a systematic review evaluating the association between cannabis use and academic performance.Data SourcesCINAHL, EMBASE, MEDLINE, PsycInfo, PubMed, Scopus, and Web of Science from inception to November 10, 2023.Study SelectionObservational studies examining the association of cannabis use with academic outcomes were selected. The literature search identified 17 622 unique citations.Data Extraction and SynthesisPairs of reviewers independently assessed risk of bias and extracted data. Both random-effects models and fixed-effects models were used for meta-analyses, and the Grading of Recommendations Assessment, Development, and Evaluation approach was applied to evaluate the certainty of evidence for each outcome. Data were analyzed from April 6 to May 25, 2024.Main Outcomes and MeasuresSchool grades, school dropout, school absenteeism, grade retention, high school completion, university enrollment, postsecondary degree attainment, and unemployment.ResultsSixty-three studies including 438 329 individuals proved eligible for analysis. Moderate-certainty evidence showed cannabis use during adolescence and young adulthood was probably associated with lower school grades (odds ratio [OR], 0.61 [95% CI, 0.52-0.71] for grade B and above); less likelihood of high school completion (OR, 0.50 [95% CI, 0.33-0.76]), university enrollment (OR, 0.72 [95% CI, 0.60-0.87]), and postsecondary degree attainment (OR, 0.69 [95% CI, 0.62-0.77]); and increased school dropout rate (OR, 2.19 [95% CI, 1.73-2.78]) and school absenteeism (OR, 2.31 [95% CI, 1.76-3.03]). Absolute risk effects ranged from 7% to 14%. Low-certainty evidence suggested that cannabis use may be associated with increased unemployment (OR, 1.50 [95% CI, 1.15-1.96]), with an absolute risk increase of 9%. Subgroup analyses with moderate credibility showed worse academic outcomes for frequent cannabis users and for students who began cannabis use earlier.Conclusions and RelevanceCannabis use during adolescence and young adulthood was probably associated with increases in school absenteeism and dropout; reduced likelihood of obtaining high academic grades, graduating high school, enrolling in university, and postsecondary degree attainment; and perhaps increased unemployment. Further research is needed to identify interventions and policies that mitigate upstream and downstream factors associated with early cannabis exposure.

中文翻译：

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青春期和青年期的大麻使用以及学业成绩


重要性 在青春期和成年早期使用大麻可能会影响学业成绩;然而，关联程度仍不清楚。目的进行系统评价，评估大麻使用与学习成绩之间的关联。数据来源CINAHL、EMBASE、MEDLINE、PsycInfo、PubMed、Scopus 和 Web of Science从建库到 2023 年 11 月 10 日。文献检索确定了 17 622 个独特的引文。资料提取和综合成对的评价员独立评估偏倚风险并提取资料。随机效应模型和固定效应模型均用于meta分析，并采用建议分级评估、开发和评价方法评估每个结局的证据质量。主要结果和措施学校成绩、辍学率、旷课率、成绩保留率、高中毕业率、大学入学率、高等教育学位获得率和失业率。结果包括 438 329 名个体在内的 63 项研究证明符合分析条件。中等质量证据表明，青少年和青年期使用大麻可能与较低的学校年级有关（比值比 [OR]，B 级及以上为 0.61 [95% CI，0.52-0.71]）;高中毕业 （OR， 0.50 [95% CI， 0.33-0.76]）、大学入学 （OR， 0.72 [95% CI， 0.60-0.87]） 和高等教育学位获得 （OR， 0.69 [95% CI， 0.62-0.77]）的可能性较低;以及辍学率 （OR， 2.19 [95% CI， 1.73-2.78]） 和缺勤率 （OR， 2.31 [95% CI， 1.76-3.03]） 增加。绝对风险影响范围为 7% 至 14%。 低质量证据表明，大麻使用可能与失业率增加有关（OR，1.50 [95% CI，1.15-1.96]），绝对风险增加 9%。具有中等可信度的亚组分析显示，经常使用大麻的人和较早开始使用大麻的学生的学业成绩较差。结论和相关性 青少年和青年期使用大麻可能与旷课和辍学率的增加有关;获得高学术成绩、高中毕业、进入大学和获得高等教育学位的可能性降低;也许还有失业率增加。需要进一步的研究来确定减轻与早期大麻暴露相关的上游和下游因素的干预措施和政策。