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Blood tests might be needed as well as special pictures of the body

I would point out that the person was consuming excessive amounts of caffeine and request a trial month off caffeine prior to therapy sessions

21 identified N-nitrosonornicotine in unburned tobacco using gas chromatographymass spectrometry (GCMS) and reported it as a potential carcinogen at concentrations ranging from 0.12 to 3.7 g/cigarette

And I think focusing on cannabis use per se would be not the most effective strategy in trying to work with that young person around what's going on and why aren't things going so well with school