“…Although NSDUH is one of the largest nationwide surveys, it is limited to the U.S. Youth perception and use of alcohol and cannabis is greatly impacted by factors such as social norms, legal practices, and cultural differences ( Anthony et al., 2017 ; Carpenter and Dobkin, 2015 ; Rafei et al., 2023 ; Room and Mäkelä, 2000 ; Sudhinaraset et al., 2016 ; Tedor, 2021 ; Wanke et al., 2022 ). Therefore, our results may not be generalizable without conducting similar and more sophisticated analyses in other countries/regions or global surveys, ( Saewyc, 2021 ; WHO, Global school-based student health survey ).…”