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Jones AA, Duncan MS, Perez-Brumer A, Connell CM, Burrows WB, Oser CB. Impacts of intergenerational substance use and trauma among black women involved in the criminal justice system: A longitudinal analysis. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2023; 153:208952. [PMID: 37654010 PMCID: PMC10474323 DOI: 10.1016/j.josat.2023.208952] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 12/01/2022] [Accepted: 01/04/2023] [Indexed: 09/02/2023]
Abstract
INTRODUCTION Intergenerational substance use and trauma disproportionately impact racialized women. Yet, how these factors impact outcomes in women involved in the criminal justice system is understudied. METHODS Using data from 443 participants in the Black Women in a Study of Epidemics, we assessed the impact of intergenerational substance use and trauma on participant drug use and open Child Protective Services (CPS) cases over 18 months. In repeated-measures logistic regression, intergenerational substance and trauma were independent variables, while participants' drug use at each follow-up and any open CPS case (s) served as separate dependent variables. Models were adjusted for criminal justice involvement, age, marital status, education, childhood guardian, number of children, and prior year homelessness. RESULTS On average, participants were aged 35 years, 64 % had never married, and 44 % were raised by both parents. Two-thirds of women (67 %) reported intergenerational substance use (≥1 parent and/or grandparent with alcohol/drug problems), while only 13 % reported intergenerational trauma. Each increase in the number of parents/grandparents with drug/alcohol problems was associated with 30 % increased odds of participants' drug use (aOR 1.30, 95 % CI: 1.07,1.57) and 40 % increased odds of having an open CPS case (aOR 1.40, 95 % CI: 1.11, 1.78). The association of intergenerational trauma and CPS cases was attenuated with sociodemographic/contextualizing factors. CONCLUSIONS Intergenerational substance use and trauma are associated with negative outcomes. Our findings highlight the need for substance use treatment to address the pervasive generational effects of substance use and trauma faced by racialized women in the criminal justice system.
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Affiliation(s)
- Abenaa A Jones
- Department of Human Development and Family Studies, Pennsylvania State University, United States of America; Consortium for Substance Use and Addiction, The Pennsylvania State University, United States of America.
| | - Meredith S Duncan
- Department of Biostatistics, University of Kentucky, United States of America.
| | | | - Christian M Connell
- Department of Human Development and Family Studies, Pennsylvania State University, United States of America.
| | - William B Burrows
- Department of Biostatistics, University of Kentucky, United States of America.
| | - Carrie B Oser
- Department of Sociology, University of Kentucky, United States of America; Center on Drug & Alcohol Research, Center for Health Equity Transformation.
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Cui Y, LoParco CR, Bar-Zeev Y, Duan Z, Levine H, Abroms LC, Wang Y, Khayat A, Berg CJ. Theory-based correlates of cannabis use and intentions among US and Israeli adults: a mixed methods study. Subst Abuse Treat Prev Policy 2023; 18:54. [PMID: 37674246 PMCID: PMC10483868 DOI: 10.1186/s13011-023-00562-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 08/28/2023] [Indexed: 09/08/2023] Open
Abstract
BACKGROUND In the US and Israel, non-medical ('recreational') cannabis use is illegal at the national level; however, use rates are high and decriminalization and legalization is spreading. Thus, theory-based intervention efforts, especially for youth prevention, are crucial. METHODS This mixed-methods study of adults in the US (n = 1,128) and Israel (n = 1,094) analyzed: 1) cross-sectional survey data (Fall 2021) to identify theory-based correlates (risk perceptions, social norms) of past-month cannabis use, next-year use intentions, and intentions to use in the home or among children if non-medical cannabis was legal, using multivariable regression; and 2) qualitative interviews regarding perceptions of cannabis policies and use (US n = 40, Israel n = 44). RESULTS 16.7% reported past-month use; 70.5%, 56.3%, and 82.6% indicated "not at all likely" regarding next-year use and use in the home and among children if legal. Lower perceived risk and greater social norms were associated with past-month use, greater use intentions, and greater intentions to use in the home or among children. Past-month use was more prevalent among US (vs. Israeli) participants (22.0% vs. 11.2%); however, in multivariable regression controlling for past-month use, being from Israel was associated with greater use intentions (next-year; in the home/among children). Qualitative themes indicated: concerns about use (e.g., increasing use, health risks, driving-related risks) and legalization (e.g., impact on society/economy, marketing), and perceived benefits of use (e.g., medical) and legalization (e.g., access/safety, economic, individual rights). CONCLUSIONS Despite differences in cannabis perceptions and use across countries, perceived risk and social norms are relevant intervention targets regardless of sociopolitical context.
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Affiliation(s)
- Yuxian Cui
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Cassidy R LoParco
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Yael Bar-Zeev
- Braun School of Public Health and Community Medicine, Faculty of Medicine, The Hebrew University of Jerusalem and Hadassah Medical Center, Jerusalem, Israel
| | - Zongshuan Duan
- Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, GA, USA
| | - Hagai Levine
- Braun School of Public Health and Community Medicine, Faculty of Medicine, The Hebrew University of Jerusalem and Hadassah Medical Center, Jerusalem, Israel
| | - Lorien C Abroms
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Yan Wang
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Amal Khayat
- Braun School of Public Health and Community Medicine, Faculty of Medicine, The Hebrew University of Jerusalem and Hadassah Medical Center, Jerusalem, Israel
| | - Carla J Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA.
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Trajectories of NEET (Not in Education, Employment, and Training) in emerging adulthood, and later drug use disorder - a national cohort study. Drug Alcohol Depend 2022; 233:109350. [PMID: 35180450 DOI: 10.1016/j.drugalcdep.2022.109350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 01/27/2022] [Accepted: 02/07/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND Being not in education, employment, or training (NEET) has been associated with poor health outcomes. This study aimed to investigate the association between NEET during emerging adulthood and later drug use disorder (DUD) among males and females. METHOD A national cohort comprising 383,116 Swedish males and 362,002 females born between 1984 and 1990. NEET exposure was assessed annually between the ages 17 and 24 years, and follow-up for DUD between ages 25-33. Trajectories of NEET were estimated using group-based trajectory analysis. Cox regression analysis was used to estimate hazard ratios (HR) of DUD. Sibling-comparison model was performed to account for potential shared genetic and environmental factors. RESULTS Four trajectories of NEET were identified: "constant low", "transient peak", "late increase", and "constant high". Compared with the "constant low", all other trajectories were associated with increased HRs of DUD. HR was highest among males and females in the "late increase trajectory"; HR = 4.10 (3.79-4.44, 95% CI) and HR = 3.73 (3.29-4.24, 95% CI), after adjusting for domicile, origin, birth year, psychiatric diagnoses, and parental psychiatric diagnoses. This association was reduced to about a twofold increased risk in the sibling comparison analysis. CONCLUSION Being NEET during emerging adulthood was associated with later DUD for both males and females. Neither origin, psychiatric diagnoses, parental psychiatric diagnoses, nor shared familial factors did fully explain the association. Males and females belonging to the late increase NEET trajectory had about a twofold increased risk of DUD.
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Lee H, Henry KL. Adolescent Substance Use Prevention: Long-Term Benefits of School Engagement. THE JOURNAL OF SCHOOL HEALTH 2022; 92:337-344. [PMID: 35067924 PMCID: PMC8967764 DOI: 10.1111/josh.13133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 07/26/2021] [Accepted: 08/22/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND To determine if school engagement is a viable target for early prevention of adolescent substance use, this study investigated whether school engagement in early adolescence (ages 12-14) is a cause of alcohol and cannabis use during middle to late adolescence (ages 15-19). METHODS To facilitate causal inference, inverse probability of treatment weights (IPTWs), which are based on estimated probabilities of treatment selection (ie, school engagement), were created based on a robust set of potential confounders. Using the IPTWs, a cumulative link mixed model was fit to examine the impact of school engagement on alcohol and cannabis use among an ethnically diverse sample of adolescents (N = 360). RESULTS School engagement was associated with a lower level of alcohol and cannabis use from age 15 to 18. School engagement was not associated with change in alcohol and cannabis use over time, suggesting that school engagement emits its effect early in the developmental course of substance use and offers protection throughout adolescence. CONCLUSIONS This study supports a compensatory role of early school engagement in substance use across middle and late adolescence. School engagement is a malleable factor and thus offers an avenue for prevention efforts.
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Affiliation(s)
- Hyanghee Lee
- Postdoctoral Research Scholar, , Edna Bennett Pierce Prevention Research Center, Pennsylvania State University, 307 Biobehavioral Health Building, University Park, PA 16801
| | - Kimberly L Henry
- Professor, , Department of Psychology, Colorado State University, 220 Behavioral Sciences Building, 410 W Pitkin St, Fort Collins, CO 80523
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Wilson S, Rhee SH. Causal effects of cannabis legalization on parents, parenting, and children: A systematic review. Prev Med 2022; 156:106956. [PMID: 35074421 PMCID: PMC9021885 DOI: 10.1016/j.ypmed.2022.106956] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 12/26/2021] [Accepted: 01/15/2022] [Indexed: 11/29/2022]
Abstract
Medical and recreational cannabis legalization lead to increased cannabis use among adults. There is concern that legalization has negative implications for minors via effects on parents. We conducted a systematic review of studies examining legalization in the United States. Web of Science, PsycInfo, and PubMed were searched through May 2021, studies examining effects of legalization on maternal cannabis and other substance use during pregnancy and postpartum, perinatal outcomes, parental cannabis and other substance use and attitudes, parenting, and child outcomes were identified, and two independent reviewers extracted information on study designs, samples, and outcomes, and assessed classification of evidence and risk of bias. Forty-one studies met inclusion criteria; only 6 (15%) used the most causally informative study design (difference in differences). It is likely legalization increases maternal cannabis use during pregnancy and postpartum, parental cannabis use, and approval of adult cannabis use. Legalization may increase some adverse perinatal outcomes, though findings were inconsistent. It is likely legalization increases unintentional pediatric cannabis exposure. There is insufficient evidence for effects of legalization on child abuse and neglect, and there have been no studies examining effects of legalization on other aspects of parenting or on child adjustment. There is a critical lack of causally informative epidemiological studies examining effects of legalization on parenting and young children. Additional causally informative research is needed. Studies of parental cannabis use in a legal context are particularly needed. Commonsense guidelines must recognize the shifting national landscape around legalization while seeking to minimize potential harm to minors.
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Affiliation(s)
- Sylia Wilson
- Institute of Child Development, University of Minnesota, USA.
| | - Soo Hyun Rhee
- Department of Psychology and Neuroscience, University of Colorado Boulder, USA.
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De Genna NM, Goldschmidt L, Richardson GA, Day NL. Maternal trajectories of cannabis use and young adult cannabis and nicotine dependence. Addict Behav 2022; 126:107212. [PMID: 34929486 PMCID: PMC8802558 DOI: 10.1016/j.addbeh.2021.107212] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 12/09/2021] [Accepted: 12/10/2021] [Indexed: 11/16/2022]
Abstract
INTRODUCTION The goals of this study were to model maternal patterns of cannabis use from one year pre-pregnancy to 16 years postpartum and to determine if different patterns of maternal cannabis use predicted offspring substance use at age 22. METHODS Women were recruited from a prenatal clinic between 1982 and 1984. Maternal cannabis use was assessed by trained interviewers twice during pregnancy, at delivery, 8 and 18 months, 3, 6, 10, 14, and 16 years postpartum. At age 22, substance use and dependence were measured in offspring. Growth mixture models of maternal cannabis use were calculated and adult offspring substance use outcomes were regressed onto maternal cannabis trajectory classes (n = 551). RESULTS There were five distinct patterns of maternal cannabis use. Offspring of mothers who were chronic cannabis users were more likely to use cannabis (p < 0.001) and develop CUD (p < 0.05) than offspring whose mothers did not use cannabis. Offspring of chronic cannabis users were also more likely to be nicotine dependent by age 22 than offspring whose mothers did not use cannabis (p < 0.01) and than offspring whose mothers were decreasingly likely to use over time (p < 0.01). CONCLUSIONS Integrated variable- and person-centered analyses revealed long-term and meaningful patterns of cannabis use and desistance. Chronic maternal cannabis use is a risk factor for regular and dependent cannabis use and for dependent tobacco use among young adult offspring. These findings have implications for maternal-child health given the increasing prevalence of cannabis use among women.
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Affiliation(s)
- Natacha M. De Genna
- Department of Psychiatry, University of Pittsburgh School of Medicine and Department of Epidemiology, Graduate School of Public Health, Pittsburgh, PA. 3801 O’Hara Street, Pittsburgh, PA 15213
| | | | - Gale A. Richardson
- Department of Psychiatry, University of Pittsburgh School of Medicine and Department of Epidemiology, Graduate School of Public Health, Pittsburgh, PA
| | - Nancy L. Day
- Department of Psychiatry, University of Pittsburgh School of Medicine and Department of Epidemiology, Graduate School of Public Health, Pittsburgh, PA
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Berg CJ, Windle M, Dodge T, Cavazos-Rehg P, Yang YT, Ma Y, Haardörfer R. Marijuana Use and Increases in Use over Time among Young Adult College Students in the State of Georgia: Analyses of Sociocontexual Predictors. Subst Use Misuse 2022; 57:350-359. [PMID: 34913832 DOI: 10.1080/10826084.2021.2012691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND While research has assessed correlates of marijuana use, there has been less focus on predictors of differing levels of changes in use during young adulthood, a critical period for use/escalation. OBJECTIVES We examined changes in marijuana use and related sociocontextual predictors (e.g., earlier-onset substance use, parental use, college type). METHODS Using data from Georgia college students (ages 18-25 years) in a 2-year, 6-wave longitudinal study (64.6% female, 63.4% White), 2-part random-effects modeling examined use at any assessment and number of days used. RESULTS Predictors of use status at any assessment included being male (OR = 1.87, 95%CI = [1.28-2.73]), Black (OR = 1.91, 95%CI = [1.15-3.19]), earlier-onset marijuana (OR = 2.63, 95%CI = [1.70-4.06]), cigarette (OR = 2.04, 95%CI = [1.19-3.48]), and alcohol users (OR = 1.49, 95%CI = 1.00-2.22]), parental tobacco (OR = 2.14, 95%CI = [1.18-3.86]) and/or alcohol use (OR = 1.55, 95%CI = [1.09-2.20]), and attending private (vs. public) institutions (OR = 1.68, 95%CI = [1.10-2.59]). Predictors of lower likelihood of use over time included being male (OR = 0.87, 95%CI = [0.77-0.98]), earlier-onset cigarette use (OR = 0.82, 95%CI = [0.68-0.98]), parental alcohol use (OR = 0.86, 95%CI = [0.77-0.97]), and private institution students (OR = 1.17, 95%CI = [1.02-1.34]). Predictors of more days used at baseline included being male (OR = 1.77, 95%CI = [1.40-2.23]), Black (OR = 1.42, 95%CI = [1.04-1.93]), earlier-onset marijuana (OR = 2.32, 95%CI = [1.78-3.01]) and alcohol users (OR = 1.29, 95%CI = [1.01-1.66]), and parental tobacco use (OR = 1.90, 95%CI = [1.32-2.73]). Predictors of fewer days used over time included being older (OR = 0.98, 95%CI = [0.97-1.00]), parental tobacco use (OR = 0.86, 95%CI = [0.78-0.95]), and attending private institutions (OR = 0.89, 95%CI = [0.83-0.93]). CONCLUSIONS Intervention efforts can be informed by current findings that correlates of baseline use (e.g., being male, attending private institutions) also predicted less use over time, and one's earlier use and parents' use of various substances impacted young adult use.
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Affiliation(s)
- Carla J Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington Cancer Center, George Washington University, Washington, DC, USA
| | - Michael Windle
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Tonya Dodge
- Department of Psychological and Brain Sciences, George Washington University, Washington, DC, USA
| | - Patricia Cavazos-Rehg
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - Y Tony Yang
- Center for Health Policy and Media Engagement, School of Nursing, George Washington Cancer Center, George Washington University, Washington, DC, USA
| | - Yan Ma
- Department of Biostatistics and Bioinformatics, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Regine Haardörfer
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
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Henry KL, Agbeke DV, Tiberio SS, Kerr DCR, Capaldi DM, Bailey JA, Epstein M. Does Parents' Age at First Birth Moderate Intergenerational Continuity in Early-Onset Cannabis Use? J Stud Alcohol Drugs 2021; 82:470-475. [PMID: 34343078 PMCID: PMC8356793 DOI: 10.15288/jsad.2021.82.470] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 01/28/2021] [Indexed: 06/22/2024] Open
Abstract
OBJECTIVE The aims of this brief report were to examine the extent to which early onset of cannabis use by parents and their children, and intergenerational continuity in early-onset cannabis use by parents and children, differ as a function of parent age at birth of first child. METHOD A total of 795 parent-child dyads (57% male parents and 49% male children) were compiled from three intergenerational studies: Oregon Youth Study-Three Generational Study (OYS-3GS), Rochester Youth Development Study and Rochester Intergenerational Study (RYDS-RIGS), and Seattle Social Development Project-The Intergenerational Project (SSDP-TIP). Parents and children identified as non-Hispanic White (29% and 22%, respectively), Black (55% and 47%), and Hispanic (8% and 11%). Early-onset cannabis use was defined as initiation at or before age 15. Time-varying effect models were fit to examine the research questions. RESULTS Among parents, earlier initiation of cannabis use was associated with an earlier entry into parenthood. Moreover, parents' later age at first birth was predictive of a lower prevalence of early-onset cannabis use among their children. Last, regarding intergenerational continuity, parental early onset of cannabis use increased the likelihood of child early-onset use, but only among older parents (i.e., later age at first birth). CONCLUSIONS We provide a nuanced examination of the associations between parental and child early-onset cannabis use as a function of parents' age at first birth and describe a novel approach to incorporating parent's age at first birth into models of intergenerational continuity.
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Affiliation(s)
- Kimberly L. Henry
- Department of Psychology, Colorado State University, Fort Collins, Colorado
| | - Della V. Agbeke
- Department of Psychology, Colorado State University, Fort Collins, Colorado
| | | | | | | | - Jennifer A. Bailey
- Social Development Research Group, University of Washington–Seattle, Seattle, Washington
| | - Marina Epstein
- Social Development Research Group, University of Washington–Seattle, Seattle, Washington
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Kerr DCR, Capaldi DM. Introduction to the special section on the intergenerational transmission of risk for substance use. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2021; 34:811-817. [PMID: 33271034 DOI: 10.1037/adb0000652] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Six original research papers were submitted to this Special Section to address questions regarding the intergenerational transmission of risk for cannabis and other substance use. Study teams recruited youth in Iowa, Washington, Oregon, New York, and Arizona in the 1980s-1990s, assessed them into adulthood, and recruited their partners and offspring for another study. All of the studies assessed substance use in 2 or more generations. Other strengths in this section include the strong representation of fathers, the demographic diversity of the samples as a whole, and the demonstrations of varied statistical and replication approaches. The findings highlight features of parental histories of cannabis use during adolescence that are associated with their children's risk for cannabis use and factors that explain or weaken intergenerational similarities. Two groups of prevention scholars also offered commentaries on the implications of these studies for prevention and training, and collaboration. It is hoped that the Special Section will stimulate new hypotheses, replications, and communication among etiological and prevention researchers. Furthermore, the papers highlight that the familial transmission of substance use risk should be taken into account more fully in the design of prevention programs to maximize impacts for youth as well as their future offspring. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Romm KF, West CD, Berg CJ. Mode of Marijuana Use among Young Adults: Perceptions, Use Profiles, and Future Use. Subst Use Misuse 2021; 56:1765-1775. [PMID: 34294001 PMCID: PMC8693385 DOI: 10.1080/10826084.2021.1949724] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND Given changes in marijuana regulations, retail, and products and potential impact on use, we examined young-adult perceptions of different modes of use, the proportion using via different modes (e.g. smoking, vaping, ingesting), and associations with the use levels and stability of use over time. METHODS We analyzed baseline and one-year follow-up survey data (Fall 2018-2019) among 3,006 young adults (ages 18-34) across six metropolitan areas (Atlanta, Boston, Minneapolis-St. Paul, Oklahoma City, San Diego, Seattle). Measures included marijuana use frequency and mode, sociodemographics, other substance use, and social influences. RESULTS Participants' rated the following modes of use as: least harmful/addictive: topicals, oral pills, joint/bowl; most socially acceptable: joint/bowl, edibles/beverages, vaporized; and most harmful/addictive and least acceptable: wrapped, vaped, or waterpipe/bong with tobacco. Baseline past-month use prevalence was 39.2% (n = 1,178). Most frequent use mode was smoking (joints/bowls/cigar papers; 54.0%), vaping (21.8%), via pipe/bong (15.1%), and ingesting (9.1%). Multinomial logistic regression indicated that participants in states with legalized marijuana retail were at greater odds for using via modes other than smoking; participants more frequently using were at greater odds for using via pipe/bong (vs. smoking) (ps < .001). Regarding most frequent mode across time, most consistent was pipe/bong (53.3%), followed by smoking (49.3%), vaping (44.5%), and ingesting (32.9%). Past-month abstinence at follow-up was most common among those originally ingesting (34.3% abstinent), followed by smoking (23.6%), vaping (18.8%), and pipe/bong (14.8%). CONCLUSIONS Ongoing surveillance is needed to understand marijuana use patterns over time across different user groups (particularly by mode) and to inform interventions promoting abstinence.
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Affiliation(s)
- Katelyn F Romm
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington Cancer Center, George Washington University, Washington, DC, USA
| | - Carly D West
- Global Health Epidemiology and Disease Control, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Carla J Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington Cancer Center, George Washington University, Washington, DC, USA
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