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. 2026 May 19;16:354. doi: 10.1038/s41398-026-04096-1

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© The Author(s) 2026

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

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Fig. 1 — 648 CARDIA participants at the Year 30 MRI sub-study excluding participants with a history of stroke or TIA. Left: never tobacco smoking, right: ever tobacco smoking. Reference (0) corresponds to the multivariable adjusted hippocampal volume in never cannabis users, and is compared to flexibly modelled cumulative cannabis exposure in ever cannabis users. Results from multivariable adjusted linear regression models, using splines with three knots. Adjusted for total intracerebral volume, demographics (sex, race, age, education years, study center), current and cumulative alcohol use, cumulative cigarette smoking, self-reported lifetime illicit drug use (amphetamines, methamphetamines, cocaine, heroin), depression and BMI. Cumulative exposure to cannabis expressed in cannabis-years, with 1 cannabis-year of exposure equivalent to 365 days of cannabis use.