Patterns of marijuana use and physical health indicators among Canadian youth

The Effects of Neighborhood Disorder on Polydrug Use: Examining Depressive Symptoms and Deviant Peer Association as Mediating Mechanisms

Neighborhood disorder is a risk factor for substance use, but research is limited with regard to the effect of such disorder on polydrug use. Further, research on potential mechanisms underlying this relationship is similarly limited. The current study examined the direct effect of neighborhood disorder on drug use variety and examined deviant peer association and depressive symptoms as mediators among a sample of justice-involved youth. The first three waves of the Pathways to Desistance study were analyzed. Generalized structural equation modeling was used to test for direct and indirect effects of interest. A bootstrap resampling process was used to compute standard errors and significance of hypothesized mediation effects. Findings indicated that greater levels of neighborhood disorder were associated with increased drug use variety. This effect was attenuated by 15% when mediating pathways were included in the model. Only deviant peer association significantly mediated this relationship and accounted for the majority of the total mediating effect. These results indicated that justice-involved youth exposed to neighborhood disorder are at elevated risk for polydrug use and that increased deviant peer association helps to explain this relationship.

Recent Cannabis Use and Accelerometer-Measured Physical Activity and Sedentary Behavior Among Young-to-Midlife Adults: An Analysis of the National Health and Nutrition Examination Survey from 2011 to 2014

Introduction: Cannabis use has been associated with reduced physical activity and increased sedentary behavior in adolescents. In adults, however, there is no conclusive evidence of such an association, and existing studies have primarily relied on self-reported activity measures. As cannabis use increases globally, a deeper understanding of its relationship with activity levels may inform clinical counseling and guidelines. This study investigated the association between recent cannabis use and accelerometer-measured activity. Methods: Data were obtained from the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2014. We included adults in the United States who responded to a cannabis questionnaire and had at least 4 days of activity data from an ActiGraph GT3X+ accelerometer, which comprised participants from 18 to 59 years. The primary exposure was any self-reported cannabis use in the past 30 days. The primary outcome was daily sedentary time and secondary outcomes were daily light physical activity (LPA) and moderate-to-vigorous physical activity (MVPA). Analyses were performed with multivariable quasi-Poisson regression models. Results: Of 4666 included adults, 658 (14.1%) reported recent cannabis use. After covariate adjustment, recent cannabis use was not associated with daily sedentary time (adjusted incidence rate ratio [aIRR] 0.99, 95% confidence interval [CI]: 0.98-1.01) or daily MVPA time (aIRR 1.01, 95% CI: 0.98-1.04). Daily LPA time was 4% greater with recent cannabis use (aIRR 1.04, 95% CI: 1.01-1.06). Conclusion: Recent cannabis use in young to midlife adults was not associated with accelerometer-measured sedentary or MVPA time, but it was associated with a marginal increase in LPA time of unclear clinical significance. Our findings provide evidence against existing concerns that cannabis use independently promotes sedentary behavior and decreases physical activity. Future prospective studies are needed to determine if these findings generalize to specific populations using cannabis including chronic pain patients.

Results of a randomized controlled trial of the cannabis eCHECKUP TO GO personalized normative feedback intervention on reducing cannabis use, cannabis consequences, and descriptive norms

BACKGROUND

The prevalence of cannabis use disorder and its negative consequences among young adults has highlighted the need for prevention and early intervention programs. However, low treatment prevalence persists due to factors such as lack of perceived need, concerns about stigma, and limited access to treatment. To address these barriers, web-based cannabis interventions have been developed, but their efficacy remain limited. This study aims to evaluate the cross-site efficacy of the Cannabis eCHECKUP TO GO program, a web-based Personalized Normative Feedback and Protective Behavioral Strategies intervention for reducing cannabis use frequency and consequences in college students with willingness to change.

METHODS

Participants were 781 students from three universities (two in Canada, one in the US) who reported using cannabis in the past month and expressed interest in reducing or engaging in safer cannabis use. The study randomly assigned them to either an experimental group that received personalized normative feedback or a control group that received information on healthy stress management. The study collected follow-up data 4 weeks after the initial intervention and measured participants' frequency of cannabis use, number of cannabis consequences, descriptive and injunctive norms at both time points.

RESULTS

The results showed no significant reductions in cannabis use or negative consequences of use. However, students who received personalized normative feedback experienced a significant reduction in descriptive norms related to cannabis use, to be more in line with actual use.

CONCLUSION

This study suggests that more targeted interventions may be necessary for university students who are already using and seeking help to reduce their use.

Student perceptions of cannabis use

OBJECTIVE

This qualitative study explored post-secondary students' perceptions of cannabis use on students' health, academic pursuits, and social lives, and investigated how these issues have been impacted by the legalization of recreational cannabis.

Participants: 20 undergraduate students at a small liberal arts university in Atlantic Canada participated in this study.

Methods: Semi-structured interviews were used to learn more about student perceptions of cannabis. Interview transcripts were analyzed using general thematic analysis.

Results: Students in this study report using cannabis in thoughtful ways, balancing various considerations in terms of health, social connections, and academics. They were aware that cannabis is not a risk-free drug and took some steps to manage risks.

Conclusion: Knowing why young adults believe they use cannabis is information for university professionals who want to develop effective harm reduction campaigns.

Antisocial personality disorder as a predictor of polydrug use: a longitudinal study of the dual mediating roles of deviant peer association and self-control among juvenile offenders

BACKGROUND

Antisocial personality disorder (APD) has been linked to increased risk for polydrug use (PU). However, there is a dearth of research focusing on the mechanisms underlying this risk.

AIMS

To examine the relationship between APD and PU; to test for the mediating effects of deviant peer association (DVA) and self-control in this relationship; to determine if the magnitudes of observed mediation effects are equivalent.

METHODS

The Pathways to Desistance data were analyzed. Generalized structural equation modeling tested for direct and mediating relationships. Mediation effect equivalence was tested using a Clogg Z test.

RESULTS

Antisocial personality disorder was associated with increased drug use heterogeneity (coefficient = 0.479; CI = 0.107-0.851). This was significantly mediated by self-control and DVA. The magnitude of the mediation was significantly stronger for the self-control path (self-control coefficient = 0.233; CI = 0.044-0.422; DVA coefficient = 0.134; CI = 0.028-0.241).

CONCLUSION

While both self-control and DVA were found to be important for explaining PU in APD, it may be beneficial to focus on self-control to address this problem.

Physical activity and substance use among Canadian adolescents: Examining the moderating role of school connectedness

Physical activity may play a role in promoting or preventing substance use among youth. The purpose of this study was to examine the association between different types of physical activity [i.e., non-competitive school sport, competitive school sport, outside of school sport and minutes of moderate to vigorous physical activity (MVPA) per day] and substance use (i.e., current smoking, e-cigarette, cannabis, binge drinking) among Canadian youth. Interaction effects between physical activity and school connectedness were also examined. Using data from the COMPASS study (2018-19; n = 73,672), four multi-level logistic regression models were developed to investigate whether physical activity lessened or worsened the odds of (1) smoking; (2) e-cigarette use; (3) cannabis use; and (4) binge drinking. Models were stratified by gender to reflect the inherent differences between genders. Models were adjusted for demographic factors and other covariates. Sport participation was consistently associated with substance use, whereas less evidence was found for meeting MVPA guidelines. Non-competitive school sport lessened the odds of cannabis use for males and females. However, non-competitive school sport only lessened the odds of e-cigarette use for females but increased the odds of binge drinking for males. Participation in competitive school sport lessened the odds of cigarette smoking but increased the odds of e-cigarette use and binge drinking for males and females. Outside of school sport lessened the odds of cigarette smoking and cannabis use but increased the odds of e-cigarette use and binge drinking for males and females. A significant moderation effect was found for males participating in sport outside of school and meeting MVPA guidelines who were at a lower risk of e-cigarette use in the presence of high levels of school connectedness. Our study provides evidence for further consideration and provision of extracurricular activities, specifically non-competitive sport, in protecting against substance use. Caution is required in claiming that sport participation or physical activity, in general, is negatively associated with substance use among youth.

Borderline Personality Disorder as a Predictor of Drug Use Variety: Cognitive Vs. Affective Mechanisms

Borderline personality disorder has been identified as a risk factor for polydrug use. Despite this, there remains a lack of understanding of which characteristics of the disorder provide the mechanisms for this relationship. This study examined a set of constructs as mechanisms explaining the borderline personality disorder-polydrug use relationship that are divided into affective and cognitive categories. The Pathways to Desistance data were used in analyses. Generalized structural equation modeling was used to examine the direct relationship between borderline personality disorder and test for attenuation of this direct effect. A bootstrap resampling process was used to estimate standard errors utilized to specify specific and total indirect effects of mechanism variables and their significance level. Results indicated that greater symptom severity of borderline personality disorder predicted increased drug use variety. This relationship was attenuated by 70% when hypothesized mechanisms were included and became nonsignificant. It appeared that this attenuation was mainly due to sensation-seeking. Findings indicate that interventions for individuals suffering from borderline personality disorder with polydrug use issues may find utility in structuring programming around mitigating sensation-seeking.

Critical Consciousness and Wellbeing in Adolescents and Young Adults: A Systematic Review

Youth experiencing systemic oppression(s) face heightened challenges to wellbeing. Critical consciousness, comprised of reflection, motivation, and action against oppression, may protect wellbeing. Wellbeing here refers to mental, socioemotional, and physical health. The aim of this systematic review was to synthesize research on the relationship between critical consciousness and wellbeing among adolescents and young adults (ages 12-29). Five databases (PsycInfo, PsychArticles, ERIC, Sociological Abstracts, and PubMed) were searched systematically using keyword searches and inclusion/exclusion criteria; 29 eligible studies were included. Results demonstrated that the critical consciousness and wellbeing relationship varied by critical consciousness dimension and age. The studies of adolescents most often focused on racial/ethnic marginalization and found critical motivation most strongly associated with better wellbeing. The studies of young adults focused on young adult college students and identified mixed results specifically between activism and mental health. Study methods across age spans were primarily quantitative and cross-sectional. Research on critical consciousness and wellbeing can benefit from studies that consider multiple critical consciousness dimensions, use longitudinal approaches, and include youth experiencing multiple and intersecting systems of privilege and marginalization.

Changes in Cannabis Consumption Among Emerging Adults in Relation to Policy and Public Health Developments

Background: Rates of cannabis use appear to be highest among emerging adults (EA). Evidence suggests that cannabis smoking, as well as alternate methods of cannabis use (e.g., vaping, edibles) have become a prevalent mode of consumption among this population. Substance use or misuse peaks during emerging adulthood and may be influenced by extreme economic, social and community developments, such as policy changes, public health concerns, and significant global events such as pandemics. For instance, it is highly likely that cannabis consumption trends among at-risk populations were influenced by the legalization of recreational cannabis in Canada, the declaration of the "e-cigarette or vaping product use associated lung injury" or "EVALI" outbreak, and the "COVID-19" pandemic. ObjectivesWe aimed to examine self-reported changes in frequency of cannabis use among EA in Canada (N = 312): pre-legalization, post-legalization; pre-EVALI, post-EVALI; pre-COVID-19, since-COVID-19. ResultsThere was a gradual increase in average frequency of smoking and vaping cannabis across the six different time intervals from the pre-legalization period (2018) to the COVID-19 pandemic period (2020). Males reported higher frequencies of cannabis smoking and vaping compared to females. ConclusionsDespite health concerns and expectations that EVALI and COVID-19 events would lead to decreased consumption, our results suggest an average increase in smoking and vaping cannabis, although the most notable increase was after legalization. There are important sex differences in behavioral factors of cannabis use in EA, though it appears that the "gender-gap" in cannabis consumption is closing. These findings may facilitate the development of intervention programs for policy measures to address cannabis-attributable outcomes in the face of contextual factors that promote use, such as public emergencies or changes in policy landscapes.

Predictors of Early-Onset Cannabis Use in Adolescence and Risks for Substance Use Disorder Symptoms in Young Adulthood

Early detection of risks for substance use disorders is essential to lifelong health and well-being for some youth. Very early-onset use is proposed as an indicator of risk for substance use disorders, but risk and protective factors related to early-onset use have not been identified. The current study compared risk and protective factors that distinguish early- and late-onset cannabis users from abstainers using data collected from a large community sample. The study also examined onset-group differences in participants’ reports of substance use disorder symptoms a decade later. Heavy episodic drinking (early-onset: OR = 7.29 CI = [1.60, 33.19]) and engagement with peers involved in deviant behaviors (early-onset: OR = 2.50 CI = [1.50, 4.13]) are risk factors for early-onset cannabis use. Protective factors, including parent monitoring (early-onset: OR = 0.73 CI = [0.58, 0.93]), engagement with peers involved in positive behaviors (early-onset: OR = 0.54 CI = [0.39, 0.76]), school engagement (early-onset: OR = 0.83 CI = [0.72, 0.96]), and academic grades (early-onset: OR = 0.37 CI = [0.21, 0.65]) also predicted early versus later onset-group differences. Early age of onset may be distinctly related to risk and protective factors previously associated with risks for substance use in all adolescents.

Longitudinal cohort study of injury type, settings, treatment and costs in British Columbia youth, 2003-2013

BACKGROUND

In 2010 in British Columbia (BC), Canada, total injury costs per capita were higher among youth aged 15-24 years than in any other age group. Injury prevention efforts have targeted injuries with high mortality (transportation injuries) or morbidity (concussions). However, the profile and health costs of common youth injuries (types, locations, treatment choices and prevention strategies) and how these change from adolescence to young adulthood is not known.

METHODS

Participants (n=662) were a randomly recruited cohort of BC youth, aged 12-18, in 2003. They were followed biennially across a decade (six assessments).

RESULTS

Serious injuries (defined as serious enough to limit normal daily activities) in the last year were reported by 27%-41% of participants at each assessment. Most common injuries were sprains or strains, broken bones, cuts, punctures or animal bites, and severe bruises. Most occurred when playing a sport or from falling. Estimated total direct cost of treatment per injury was approximately $2500. In addition, 25% experienced serious injuries at three or more assessments, indicating possible differences that warrents further investigation.

CONCLUSIONS

The occurence and health cost of common injuries to youth and young adults are underestimated in this study but are nevertheless substantial. Ongoing surveillence, awareness raising, and prevention efforts may be needed to reduce these costs.

Video games and their associations with physical health: a scoping review

Objective

The objective of this scoping review is to investigate the possible links between the practice of video games and physical health. It seeks to answer the following question: What are the physical health consequences of playing video games in healthy video game player? and How is it currently investigated?.

Methods

A scoping review was conducted to identify observational and experimental studies pertaining to our research question. Retrieved papers were screened using a two-phase method first involving a selection based on titles and abstracts. Then, potentially relevant studies were read and triaged. The final set of included studies was analysed, and data were subsequently extracted. Observational studies and experimental studies were assessed using the appropriate Cochrane Risk of Bias Tool and data were synthetised according to specific physical health and related health behaviours.

Results

Twelve peer-reviewed articles were retained for further analyses. Results of this scoping review suggest preliminary evidence that time spent gaming is associated with some health outcomes indicators. Our results indicate preliminary evidence that increased gaming time is associated with higher body mass index and lower self-reported general health status. There is insufficient evidence to conclude on a possible association between gaming time and physical activity or sedentary behaviours, sleep or fatigue, musculoskeletal pain or dietary behaviours.

Conclusion

The results of this sopping review suggest an association between increased video game playing time and a deterioration in some physical health indicators but available evidence is scarce, precluding from any strong conclusion.

PTSD as a Risk Factor Predicting Polydrug Use: A Dual Systems of Self-Control Mediation Model

Post-traumatic stress disorder (PTSD) is associated with increased risk for polydrug use. Low self-control is a key characteristic of the disorder and is predictive of polydrug use. However, there is a dearth of research focused on the relevance of a dual systems model delineation of self-control into the constructs of risk-seeking and impulsivity as it pertains to polydrug use and PTSD. This study tested dual systems mediation of this relationship. Generalized structural equation modeling was used to test for mediation effects. Results indicated that more PTSD symptoms predicted increased drug use variety (coefficient = 0.024; confidence interval [CI] = [0.001, 0.046]). Inclusion of dual systems constructs fully attenuated this relationship. The total indirect effect achieved marginal significance (coefficient = 0.005; CI = [>−0.001, 0.009]). Sensitivity analyses of the specific indirect effect of impulsivity as the sole mediator indicated significant mediation. These results provide some indication that impulsivity-based programming may help to treat polydrug use among those with severe PTSD.

Onset of regular cannabis use and young adult insomnia: an analysis of shared genetic liability

STUDY OBJECTIVES

Estimate the genetic and environmental influences on the relationship between onset of regular cannabis use and young adult insomnia.

METHODS

In a population-based twin cohort of 1882 twins (56% female, mean age = 22.99, SD = 2.97) we explored the genetic/environmental etiology of the relationship between onset of regular cannabis use and insomnia-related outcomes via multivariate twin models.

RESULTS

Controlling for sex, current depression symptoms, and prior diagnosis of an anxiety or depression disorder, adult twins who reported early onset for regular cannabis use (age 17 or younger) were more likely to have insomnia (β = 0.07, p = 0.024) and insomnia with short sleep on weekdays (β = 0.08, p = 0.003) as young adults. We found significant genetic contributions for the onset of regular cannabis use (a2 = 76%, p < 0.001), insomnia (a2 = 44%, p < 0.001), and insomnia with short sleep on weekdays (a2 = 37%, p < 0.001). We found significant genetic correlations between onset of regular use and both insomnia (rA = 0.20, p = 0.047) and insomnia with short sleep on weekdays (rA = 0.25, p = 0.008) but no significant environmental associations between these traits.

CONCLUSIONS

We found common genetic liabilities for early onset of regular cannabis use and insomnia, implying pleiotropic influences of genes on both traits.

Associations Between Marijuana Use Trajectories and Educational and Occupational Success in Young Adulthood

Adolescence and young adulthood is a critical stage when the economic foundations for life-long health are established. To date, there is little consensus as to whether marijuana use is associated with poor educational and occupational success in adulthood. We investigated associations between trajectories of marijuana use from ages 15 to 28 and multiple indicators of economic well-being in young adulthood including achievement levels (i.e., educational attainment and occupational prestige), work characteristics (i.e., full vs part-time employment, hours worked, annual income), financial strain (i.e., debt, trouble paying for necessities, delaying medical attention), and perceived workplace stress. Data were from the Victoria Healthy Youth Survey, a 10-year prospective study of a randomly recruited community sample of 662 youth (48% male; M_age = 15.5), followed biennially for six assessments. Models adjusted for baseline age, sex, SES, high school grades, heavy drinking, smoking, and internalizing and oppositional defiant disorder symptoms. Chronic users (our highest risk class) reported lower levels of educational attainment, lower occupational prestige, lower income, greater debt, and more difficulty paying for medical necessities in young adulthood compared to abstainers. Similarly, increasers also reported lower educational attainment, occupational prestige, and income. Decreasers, who had high early use but quit over time, showed resilience in economic well-being, performing similar to abstainers. Groups did not differ on employment status or perceived workplace stress. The findings indicate that early onset and persistent high or increasingly frequent use of marijuana in the transition from adolescent to young adulthood is associated with risks for achieving educational and occupational success, and subsequently health, in young adulthood.