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Park SY, Joa CY, Yun GW, Constantino N. Marijuana Message Channels, Health Knowledge, Law Knowledge, and Confidence in Knowledge as Risk and Protective Factors of Marijuana Use among College Students. JOURNAL OF DRUG EDUCATION 2024; 53:19-38. [PMID: 38037278 DOI: 10.1177/00472379231217825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
Abstract
Marijuana use among U.S. college students is the highest since the mid-1980s. Because knowledge about marijuana and confidence in the knowledge are related to changing marijuana laws and marijuana-related messages ubiquitous in college students' information environment, we examined their relationships with use. The Structural Equation Modeling method was used to analyze the relationships using survey responses from 249 college students in an adult-use marijuana legal state. Marijuana health knowledge was related to less use, and law knowledge was related to more use. Both relationships were mediated by perceived risk. Confidence in knowledge was related to more use directly as well as indirectly via lower peer disapproval and lower perceived risk. Among various marijuana message channels, peers were the most influential, contributing to lower health knowledge and higher confidence in knowledge.
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Affiliation(s)
- Sung-Yeon Park
- School of Public Health, University of Nevada, Reno, 1664 N. Virginia St. MS #0274, Reno, NV 89557, USA
| | - Claire Youngnyo Joa
- Department of Media, Culture & the Arts, Middle Georgia State University, 100 University Pkwy, Macon, GA 31206, USA
| | - Gi Woong Yun
- Reynolds School of Journalism, University of Nevada, Reno, 1664 N. Virginia St. MS #310, Reno, NV 89557, USA
| | - Nora Constantino
- School of Public Health, University of Nevada, Reno, 1664 N. Virginia St. MS #0274, Reno, NV 89557, USA
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Dopke C, Romm KF, Berg CJ. Parental openness and communication regarding cannabis and alcohol use with their children. Am J Addict 2024; 33:15-25. [PMID: 37644672 PMCID: PMC10843615 DOI: 10.1111/ajad.13466] [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: 03/14/2023] [Revised: 08/07/2023] [Accepted: 08/08/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Given increases in youth cannabis and alcohol use and changes in the cannabis market, we examined parental openness and communication about cannabis and alcohol. METHODS Among 197 participants who had children ≤18 years old and lived in six US metropolitan areas (Atlanta, Boston, Minneapolis, Oklahoma City, San Diego, Seattle), we examined sociodemographic and use correlates of parental openness (i.e., acceptability of child use, rules regarding use in the home or around children, communication) about cannabis and alcohol, as well as being more open about cannabis versus alcohol. RESULTS In this sample (Mage = 32.30, 70.1% female, 30.5% sexual minority, 33.0% racial/ethnic minority, 41.6% in recreational cannabis state), 33.5% reported past-month cannabis use, and 59.9% alcohol (22.8% used both, 29.4% used neither). Multivariable regression indicated that cannabis users (vs. nonusers) and sexual minority (vs. heterosexual) individuals were more open about cannabis use; alcohol users (vs. nonusers) were more open about alcohol use. Additionally, older parental and child age correlated with greater cannabis- and alcohol-related communication, and females (vs. males) reported greater cannabis-related communication. Those married/cohabitating and reporting past-month alcohol use were less likely to allow cannabis versus alcohol in the home or near children. Parents in legalized recreational (vs. nonlegalized) states, females, and heterosexual individuals reported greater cannabis- versus alcohol-related communication. DISCUSSION AND CONCLUSIONS Interventions are needed to support parental communication regarding substance use, particularly cannabis. SCIENTIFIC SIGNIFICANCE This study addressed parenting and youth substance use during evolving cannabis legislation and can inform youth substance use prevention interventions targeting parent-child communication.
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Affiliation(s)
- Campbell Dopke
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University
| | - Katelyn F. Romm
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center
- Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center
| | - Carla J. Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University
- George Washington Cancer Center, George Washington University
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Sevigny EL, Greathouse J, Medhin DN. Health, safety, and socioeconomic impacts of cannabis liberalization laws: An evidence and gap map. CAMPBELL SYSTEMATIC REVIEWS 2023; 19:e1362. [PMID: 37915420 PMCID: PMC10616541 DOI: 10.1002/cl2.1362] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/03/2023]
Abstract
Background Globally, cannabis laws and regulations are rapidly changing. Countries are increasingly permitting access to cannabis under various decriminalization, medicalization, and legalization laws. With strong economic, public health, and social justice incentives driving these domestic cannabis policy reforms, liberalization trends are bound to continue. However, despite a large and growing body of interdisciplinary research addressing the policy-relevant health, safety, and socioeconomic consequences of cannabis liberalization, there is a lack of robust primary and systematic research that comprehensively investigates the consequences of these reforms. Objectives This evidence and gap map (EGM) summarizes the empirical evidence on cannabis liberalization policies. Primary objectives were to develop a conceptual framework linking cannabis liberalization policies to relevant outcomes, descriptively summarize the empirical evidence, and identify areas of evidence concentration and gaps. Search Methods We comprehensively searched for eligible English-language empirical studies published across 23 academic databases and 11 gray literature sources through August 2020. Additions to the pool of potentially eligible studies from supplemental sources were made through November 2020. Selection Criteria The conceptual framework for this EGM draws upon a legal epidemiological perspective highlighting the causal effects of law and policy on population-level outcomes. Eligible interventions include policies that create or expand access to a legal or decriminalized supply of cannabis: comprehensive medical cannabis laws (MCLs), limited medical cannabidiol laws (CBDLs), recreational cannabis laws (RCLs), industrial hemp laws (IHLs), and decriminalization of cultivations laws (DCLs). Eligible outcomes include intermediate responses (i.e., attitudes/behaviors and markets/environments) and longer-term consequences (health, safety, and socioeconomic outcomes) of these laws. Data Collection and Analysis Both dual screening and dual data extraction were performed with third person deconfliction. Primary studies were appraised using the Maryland Scientific Methods Scale and systematic reviews were assessed using AMSTAR 2. Main Results The EGM includes 447 studies, comprising 438 primary studies and nine systematic reviews. Most research derives from the United States, with little research from other countries. By far, most cannabis liberalization research focuses on the effects of MCLs and RCLs. Studies targeting other laws-including CBDLs, IHLs, and DCLs-are relatively rare. Of the 113 distinct outcomes we documented, cannabis use was the single most frequently investigated. More than half these outcomes were addressed by three or fewer studies, highlighting substantial evidence gaps in the literature. The systematic evidence base is relatively small, comprising just seven completed reviews on cannabis use (3), opioid-related harms (3), and alcohol-related outcomes (1). Moreover, we have limited confidence in the reviews, as five were appraised as minimal quality and two as low quality. Authors’ Conclusions More primary and systematic research is needed to better understand the effects of cannabis liberalization laws on longer-term-and arguably more salient-health, safety, and socioeconomic outcomes. Since most research concerns MCLs and RCLs, there is a critical need for research on the societal impacts of industrial hemp production, medical CBD products, and decriminalized cannabis cultivation. Future research should also prioritize understanding the heterogeneous effects of these laws given differences in specific provisions and implementation across jurisdictions.
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Affiliation(s)
- Eric L. Sevigny
- Department of Criminal Justice and CriminologyGeorgia State UniversityAtlantaGeorgiaUSA
| | - Jared Greathouse
- Department of Criminal Justice and CriminologyGeorgia State UniversityAtlantaGeorgiaUSA
| | - Danye N. Medhin
- Department of Criminal Justice and CriminologyGeorgia State UniversityAtlantaGeorgiaUSA
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Duan Z, Wang Y, Weaver SR, Spears CA, Zheng P, Self-Brown SR, Eriksen MP, Huang J. Effect modification of legalizing recreational cannabis use on the association between e-cigarette use and future cannabis use among US adolescents. Drug Alcohol Depend 2022; 233:109260. [PMID: 35152099 PMCID: PMC8957562 DOI: 10.1016/j.drugalcdep.2021.109260] [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: 08/05/2021] [Revised: 12/07/2021] [Accepted: 12/08/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Many states have legalized recreational cannabis use for adults. However, no study has examined how this policy may interact with youth vaping to influence cannabis use among US adolescents. This study investigates whether the association between baseline e-cigarette use and subsequent cannabis use differs by state recreational cannabis legalization status. METHODS This study analyzed data from the first four waves (2013-2018) of the Population Assessment of Tobacco and Health Study, a nationally representative longitudinal survey. The study sample included adolescents (aged 12-17) who reported never used cannabis at baseline. Generalized estimating equations were used to analyze the effect modification of state recreational cannabis law on the association between baseline e-cigarette use and cannabis use at 12-month follow-up, controlling for individual characteristics. RESULTS Among adolescents who have never used cannabis at baseline, baseline past-30-day e-cigarette use was significantly associated with past-30-day cannabis use at 12-month follow-up (aOR=5.92, 95% CI: 3.52-9.95). This association was different by state recreational cannabis legalization status, as indicated by the significant interaction term. Subgroup analysis showed that the aOR was 18.39 (95% CI: 4.25-79.68) for adolescents living in states that legalized adult recreational cannabis use and 5.09 (95% CI: 2.86-9.07) for adolescents living in states without such laws. CONCLUSIONS E-cigarette use is associated with cannabis initiation among youth. This association is stronger among those living in states that legalized adult recreational cannabis use. Further examination of the impact of e-cigarette use on cannabis initiation in relation to state cannabis laws is warranted.
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Affiliation(s)
- Zongshuan Duan
- Milken Institute School of Public Health, George Washington University, Washington, DC 20052, USA
| | - Yu Wang
- School of Public Health, Georgia State University, Atlanta, GA 30302, USA
| | - Scott R. Weaver
- School of Public Health, Georgia State University, Atlanta, GA 30302, USA
| | - Claire A. Spears
- School of Public Health, Georgia State University, Atlanta, GA 30302, USA
| | - Pinpin Zheng
- School of Public Health, Fudan University, Shanghai 200433, China
| | | | - Michael P. Eriksen
- School of Public Health, Georgia State University, Atlanta, GA 30302, USA
| | - Jidong Huang
- School of Public Health, Georgia State University, Atlanta, GA 30302, USA.
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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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6
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Park SY, Ryu SY, Constantino N, Yun GW, Jennings E, Fred D. Marijuana knowledge, confidence in knowledge, and information efficacy as the protective and risk factors of marijuana use among college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022; 70:363-370. [PMID: 32369710 DOI: 10.1080/07448481.2020.1751171] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 02/21/2019] [Accepted: 03/29/2020] [Indexed: 06/11/2023]
Abstract
Objective This study explored the relationships between marijuana knowledge, confidence in knowledge, and information efficacy and marijuana use. Furthermore, the effects of the knowledge-related variables were examined on intention to use, resistance efficacy, and intention to vote for legalization. Participants: Undergraduate students (N = 215) were surveyed in Fall 2018. Methods: Data were collected online and analyzed through a series of regression analyses. Results: Higher knowledge was related to less use via higher perceived risk whereas higher confidence in knowledge was related to more use. Marijuana use was related to higher future intention to use, lower resistance self-efficacy, and intention to vote for legalization. Information efficacy was related to intention to vote for legalization only. Conclusions: Students with more knowledge were less likely to use marijuana, whereas students who considered themselves well-informed were more likely to use it. Future intervention efforts will benefit from counteracting students' misplaced confidence in their knowledge.
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Affiliation(s)
- Sung-Yeon Park
- School of Community Health Sciences, University of Nevada, Reno, Nevada, USA
| | - So Young Ryu
- School of Community Health Sciences, University of Nevada, Reno, Nevada, USA
| | - Nora Constantino
- School of Community Health Sciences, University of Nevada, Reno, Nevada, USA
| | - Gi Woong Yun
- Reynolds School of Journalism, University of Nevada, Reno, Nevada, USA
| | - Enid Jennings
- School of Community Health Sciences, University of Nevada, Reno, Nevada, USA
- Health Promotion Program Coordinator and Health Educator, Student Health Center, University of Nevada, Reno, Nevada, USA
| | - Daniel Fred
- Project Coordinator, Center for the Application of Substance Abuse Technologies, University of Nevada, Reno, Nevada, USA
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7
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Cannabis Policy Changes and Adolescent Cannabis Use: Evidence from Europe. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105174. [PMID: 34068202 PMCID: PMC8152978 DOI: 10.3390/ijerph18105174] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 04/30/2021] [Accepted: 05/07/2021] [Indexed: 11/17/2022]
Abstract
Cannabis accounts for the largest share of the illicit drug market, with a high prevalence of use even among adolescents. To tackle this longstanding problem, many kinds of reforms to national cannabis control policies have been implemented in Europe, but their effectiveness is still unclear. This paper analyses the association between selected categories of cannabis policy reforms and changes in perceived cannabis availability and patterns of use among adolescents. Data from 20 European countries across 15 years were drawn from a novel database of the European school Survey Project on Alcohol and other Drugs (ESPAD). Our analysis is based on a Difference-in-Differences design, which application is allowed by the fact that only thirteen out of the twenty countries included implemented policy changes. The results suggest that selected categories of reforms influence the availability and prevalence of cannabis use. In particular, some forms of restrictive intervention reduce the general prevalence of use and more liberal reforms seem linked to an increase in the share of students initiating use of cannabis. We find no evidence of an effect of policy changes on the share of frequent users, which are presumably those more likely to develop use-related health consequences.
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8
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Ramer NE, Read JP, Colder CR. Parents' Cannabis-Related Attitudes and Emerging Adult Offspring Cannabis Use: Testing the Mediating Effect of Perceived Parental Approval. Subst Use Misuse 2021; 56:308-317. [PMID: 33426986 PMCID: PMC8121005 DOI: 10.1080/10826084.2020.1868004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Background: Contrary to parental alcohol use and expectancies work, little is known about how parent's cannabis use (CU) and expectancies influence offspring CU. This is a notable gap in the literature given increasing acceptability and use of cannabis, especially among emerging adults (EA). Moreover, limited work has tested mechanisms of transmission of risk from these parent factors. This study addresses these gaps by testing prospective associations of parental CU and expectancies with offspring CU and CU problems, and perceived parental approval of offspring CU as a potential mediator. Method: A community sample of 314 EA and caregiver dyads completed three annual assessments (mean age = 19.13). The sample was 54% female and majority White/non-Hispanic (76%). Caregivers reported on their cannabis expectancies and use, and EA reported on their CU, CU-related problems, and perceived parental approval of CU. Results: Longitudinal structural equation modeling supported a mediated pathway such that high parental positive cannabis expectancies were associated with perceived parental approval of CU, which in turn, predicted increases in EA CU and CU problems. Parental negative expectancies had a significant indirect effect but in the opposite direction. Indirect effects were found above and beyond parental CU, which was not associated with offspring CU. Conclusions: This is the first study to test prospective indirect effects of parental cannabis expectancies on offspring CU. Findings suggest parents' attitudes, even in the absence of parental use, confer risk for offspring use by shaping perceived acceptance of CU, suggesting parental expectancies as targets for parent-based CU interventions.
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Affiliation(s)
- Nolan E Ramer
- Department of Psychology, University at Buffalo, The State University of New York, Buffalo, New York, USA
| | - Jennifer P Read
- Department of Psychology, University at Buffalo, The State University of New York, Buffalo, New York, USA
| | - Craig R Colder
- Department of Psychology, University at Buffalo, The State University of New York, Buffalo, New York, USA
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9
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Adolescent Cannabis Use and Perceived Social Norm Trends Pre- and Post-Implementation of Washington State’s Liberalized Recreational Cannabis Policy: Healthy Youth Survey, 2008–2018. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2020; 21:772-783. [DOI: 10.1007/s11121-020-01136-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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10
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Evans W, Andrade E, Pratt M, Mottern A, Chavez S, Calzetta-Raymond A, Gu J. Peer-to-Peer Social Media as an Effective Prevention Strategy: Quasi-Experimental Evaluation. JMIR Mhealth Uhealth 2020; 8:e16207. [PMID: 32374270 PMCID: PMC7240438 DOI: 10.2196/16207] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 02/02/2020] [Accepted: 02/22/2020] [Indexed: 11/17/2022] Open
Abstract
Background Substance use by adolescents remains to be at unacceptably high levels, and there is evidence that teens’ social norms are becoming more favorable toward recreational use and perceived safety of substances such as marijuana and prescription opioids. Social media offer a low-cost, potentially high-impact approach to disseminate prevention messages. Objective Living the Example (LTE) is a program that trains adolescent youth ambassadors to develop and disseminate prevention messages within their own social media networks and through in-school activities. This study aimed to evaluate the effects of exposure to LTE-based social media on students in the youth ambassadors’ networks. Methods The George Washington (GW) University designed and implemented a quasi-experimental evaluation of the LTE program in 3 Maryland high schools. Before program launch, a sample of 826 students (wave 1) at the 3 schools, drawn from a census of freshmen enrolled in a class attended by all students at the grade level, completed a survey. A total of 584 students were surveyed at the wave 2 program midpoint and 542 at the wave 3 endpoint. The survey contained questions on drug use–related attitudes, beliefs, intentions, and behaviors, all based on validated measures. We evaluated the effects of LTE on the intended next 30-day drug use, and controlling for LTE self-reported exposure, age, and gender from waves 2 and 3 was appended into a single dataset. We first conducted ordinal logistic regressions for each drug use intention in wave 3 (ie, sell or distribute illegal drugs, smoke cigarettes, drink beer/wine/hard liquor when parents do not know about it, use marijuana, use lysergic acid diethylamide, cocaine, amphetamines or other illegal drugs, use heroin, use synthetic drugs, and use any prescription pills without a prescription) to examine the association between LTE exposure and drug use intentions. We included an interaction term for the study wave to examine intervention effects. Results We found a significant positive effect of LTE exposure on all 8 measured drug use intentions: sell/distribute illegal drugs; smoke cigarettes; drink beer, wine, or liquor when my parents do not know about it; use marijuana; use cocaine, amphetamines, or other illegal drug; use heroin; use synthetic drugs; use any prescription pills without a prescription (all P<.05; odds ratios ranging from 2.12 to 3.71). We also found that boys were more likely than girls to exhibit reduced drug use intentions. We also found reductions in 30-day intentions between the second and third survey waves for all 8 measured drug use variables. Conclusions Overall, the results are consistent with and indicate a stronger LTE effect in this study compared with a previous pilot study. LTE appears to offer a protective effect, with exposure to program messages leading to reduced/improved drug use intentions.
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Affiliation(s)
- William Evans
- Milken Institute School of Public Health, George Washington University, Washington, DC, United States
| | - Elizabeth Andrade
- Milken Institute School of Public Health, George Washington University, Washington, DC, United States
| | | | | | | | - Anthony Calzetta-Raymond
- Milken Institute School of Public Health, George Washington University, Washington, DC, United States
| | - Jiayan Gu
- Milken Institute School of Public Health, George Washington University, Washington, DC, United States
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11
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Johnson RM, Fleming CB, Cambron C, Dean LT, Brighthaupt SC, Guttmannova K. Race/Ethnicity Differences in Trends of Marijuana, Cigarette, and Alcohol Use Among 8th, 10th, and 12th Graders in Washington State, 2004-2016. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2020; 20:194-204. [PMID: 29633175 DOI: 10.1007/s11121-018-0899-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Accurate estimates of substance use in the teenage years by race/ethnicity may help identify when to intervene to prevent long-term substance use disparities. We examined trends in past 30-day use of marijuana, cigarette, and alcohol among 8th, 10th, and 12th graders in Washington State, which passed a recreational marijuana law in 2012 and initiated retail marijuana sales in 2014. Data are from the 2004-2016 Washington Healthy Youth Surveys (n = 161,992). We used time series regression models to assess linear and quadratic trends in substance use for the full sample and stratified on race/ethnicity and grade level and examined relative differences in prevalence of use by race/ethnicity. In Washington, across all racial/ethnic groups, marijuana use peaked in 2012. Although there was not a significant overall change in marijuana use for the full sample across the study period, there was a statistically significant increase in use among 12th graders and a statistically significant decrease among 8th graders. Relative to Whites, Asians had a lower prevalence of marijuana use, whereas all other race/ethnicity groups had a higher prevalence of use. Prevalence of marijuana use is particularly high among American Indian/Alaska Native and Black youth and has increased most rapidly among 12th grade Hispanic/Latinx youth. There were large and statistically significant decreases in alcohol and cigarette use across the study period for the full sample, as well as for each race/ethnicity group. These findings highlight the need for continued monitoring of trends in use among these groups and potentially warrant consideration of selective interventions that specifically focus on students of color and that include developmentally-appropriate strategies relevant to each grade.
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Affiliation(s)
- Renee M Johnson
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, 8th Floor, Room 898, Baltimore, MD, 21205-1999, USA. .,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Charles B Fleming
- Center for the Study of Health and Risk Behaviors, Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Christopher Cambron
- School of Social Work, University of Washington, Seattle, WA, USA.,Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Lorraine T Dean
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Sherri-Chanelle Brighthaupt
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, 8th Floor, Room 898, Baltimore, MD, 21205-1999, USA
| | - Katarina Guttmannova
- Center for the Study of Health and Risk Behaviors, Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle, WA, USA
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12
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Cerdá M, Mauro C, Hamilton A, Levy NS, Santaella-Tenorio J, Hasin D, Wall MM, Keyes KM, Martins SS. Association Between Recreational Marijuana Legalization in the United States and Changes in Marijuana Use and Cannabis Use Disorder From 2008 to 2016. JAMA Psychiatry 2020; 77:165-171. [PMID: 31722000 PMCID: PMC6865220 DOI: 10.1001/jamapsychiatry.2019.3254] [Citation(s) in RCA: 318] [Impact Index Per Article: 79.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Little is known about changes in marijuana use and cannabis use disorder (CUD) after recreational marijuana legalization (RML). OBJECTIVES To examine the associations between RML enactment and changes in marijuana use, frequent use, and CUD in the United States from 2008 to 2016. DESIGN, SETTING, AND PARTICIPANTS This survey study used repeated cross-sectional survey data from the National Survey on Drug Use and Health (2008-2016) conducted in the United States among participants in the age groups of 12 to 17, 18 to 25, and 26 years or older. INTERVENTIONS Multilevel logistic regression models were fit to obtain estimates of before-vs-after changes in marijuana use among respondents in states enacting RML compared to changes in other states. MAIN OUTCOMES AND MEASURES Self-reported past-month marijuana use, past-month frequent marijuana use, past-month frequent use among past-month users, past-year CUD, and past-year CUD among past-year users. RESULTS The study included 505 796 respondents consisting of 51.51% females and 77.24% participants 26 years or older. Among the total, 65.43% were white, 11.90% black, 15.36% Hispanic, and 7.31% of other race/ethnicity. Among respondents aged 12 to 17 years, past-year CUD increased from 2.18% to 2.72% after RML enactment, a 25% higher increase than that for the same age group in states that did not enact RML (odds ratio [OR], 1.25; 95% CI, 1.01-1.55). Among past-year marijuana users in this age group, CUD increased from 22.80% to 27.20% (OR, 1.27; 95% CI, 1.01-1.59). Unmeasured confounders would need to be more prevalent in RML states and increase the risk of cannabis use by 1.08 to 1.11 times to explain observed results, indicating results that are sensitive to omitted variables. No associations were found among the respondents aged 18 to 25 years. Among respondents 26 years or older, past-month marijuana use after RML enactment increased from 5.65% to 7.10% (OR, 1.28; 95% CI, 1.16-1.40), past-month frequent use from 2.13% to 2.62% (OR, 1.24; 95% CI, 1.08-1.41), and past-year CUD from 0.90% to 1.23% (OR, 1.36; 95% CI, 1.08-1.71); these results were more robust to unmeasured confounding. Among marijuana users in this age group, past-month frequent marijuana use and past-year CUD did not increase after RML enactment. CONCLUSIONS AND RELEVANCE This study's findings suggest that although marijuana legalization advanced social justice goals, the small post-RML increase in risk for CUD among respondents aged 12 to 17 years and increased frequent use and CUD among adults 26 years or older in this study are a potential public health concern. To undertake prevention efforts, further studies are warranted to assess how these increases occur and to identify subpopulations that may be especially vulnerable.
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Affiliation(s)
- Magdalena Cerdá
- Division of Epidemiology, Department of Population Health, New York University School of Medicine, New York,Violence Prevention Research Program, Department of Emergency Medicine, University of California, Davis, Sacramento
| | - Christine Mauro
- Department of Biostatistics, Columbia University Mailman School of Public Health, New York, New York
| | - Ava Hamilton
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York
| | - Natalie S. Levy
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York
| | - Julián Santaella-Tenorio
- Division of Epidemiology, Department of Population Health, New York University School of Medicine, New York,Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York
| | - Deborah Hasin
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York,Division of Translational Epidemiology, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York,Division of Translational Epidemiology, New York State Psychiatric Institute, New York
| | - Melanie M. Wall
- Department of Biostatistics, Columbia University Mailman School of Public Health, New York, New York
| | - Katherine M. Keyes
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York
| | - Silvia S. Martins
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York
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Jones TM, Eisenberg N, Kosterman R, Lee JO, Bailey JA, Haggerty KP. Parents' Perceptions of Adolescent Exposure to Marijuana Following Legalization in Washington State. JOURNAL OF THE SOCIETY FOR SOCIAL WORK AND RESEARCH 2020; 11:21-38. [PMID: 33841719 PMCID: PMC8034260 DOI: 10.1086/707642] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
OBJECTIVE Parents in Washington State face new challenges related to the non-medical marijuana legislation that was passed in 2012. We asked parent focus group participants about changes they have observed in their environment, how their children are exposed to marijuana, and how this exposure might affect youth marijuana use. METHOD We conducted 6 focus groups with parents of youth ages 8 to 15 (N = 54). Parents were recruited from the Seattle Social Development Project, a multi-ethnic, longitudinal panel study that originated in Seattle in 1985. Thematic content analysis was used to analyze qualitative data. RESULTS Parents agreed that they did not want their children using marijuana, and were concerned that their children were exposed to marijuana more often and in many different contexts. Parents said they now need to monitor their children's environment more carefully, especially the other adults that spend time around their children. Edible marijuana products were particularly concerning for parents, as they offer a new set of challenges for parents in monitoring their children's exposure to and use of marijuana. Parents were concerned that marijuana exposure would increase risk of marijuana use in adolescents. CONCLUSIONS Parents' experiences in Washington State provide valuable lessons for social work practitioners, policymakers and those developing preventive interventions. Prevention efforts and public health messaging should begin before legalization takes effect to support parents in preparing for changes in their social and physical environments, and should seek to incorporate parenting strategies to monitor and intervene when children are exposed to marijuana.
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Perceived Access and Parental Monitoring as Moderators of Impulsivity and Marijuana Use Among Adolescents. J Prim Prev 2019; 39:155-169. [PMID: 29476375 DOI: 10.1007/s10935-018-0503-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
The social and political climate regarding marijuana use has been changing in the US over the past decade. Research suggests that many adolescents report relatively easy access to marijuana and perceptions that recreational use involves minimal harm despite a growing body of research implicating the deleterious effects of use on cognitive and psychological development. Not surprisingly, prevalence rates have been rising in recent years, making it important to identify risk and protective factors associated with adolescent marijuana use. We tested a 3-way interaction model designed to (a) examine the relationship between behavioral impulsivity and marijuana use in adolescents, and (b) evaluate the roles of perceived access and parental monitoring as moderators of this relationship. High school students (N = 498, M age = 15.7, 53% female, 77% White) completed an anonymous self-report assessment examining substance use, perceived access, and psychosocial factors related to substance use (i.e., behavioral impulsivity and parental monitoring). Results indicated that higher levels of impulsivity, greater access, and reduced parental monitoring were related to marijuana use. Significant moderating effects were found for perceived access and parental monitoring, such that use was greater for adolescents who perceived that marijuana was easier to acquire and for those with lower levels of parental monitoring. Among individuals with greater levels of impulsivity, parental monitoring reduced the impact of perceived access. Overall, results highlight risk and protective factors related to adolescent marijuana use and indicate that parental monitoring can be an effective means for reducing consumption.
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Triangulating web & general population surveys: Do results match legal cannabis market sales? THE INTERNATIONAL JOURNAL OF DRUG POLICY 2019; 73:293-300. [DOI: 10.1016/j.drugpo.2019.06.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2018] [Revised: 03/27/2019] [Accepted: 06/06/2019] [Indexed: 11/18/2022]
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Grigorian A, Lester E, Lekawa M, Figueroa C, Kuza CM, Dolich M, Schubl SD, Barrios C, Nahmias J. Marijuana use and outcomes in adult and pediatric trauma patients after legalization in California. Am J Surg 2019; 218:1189-1194. [PMID: 31521241 DOI: 10.1016/j.amjsurg.2019.08.020] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Revised: 08/20/2019] [Accepted: 08/27/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND Marijuana has become legal in eight states since 2012. We hypothesized the incidence of marijuana-positive trauma patients and rate of mortality has increased post-legalization. METHODS A single level-I trauma center was used to identify patients screening positive for marijuana on urine-toxicology. Patients in the pre-legalization and post-legalization periods were compared. RESULTS In the pre-legalization cohort 9.4% were marijuana-positive versus 11.0% in the post-legalization cohort (p = 0.001). Marijuana-positive patients post-legalization had higher rates of critical trauma activation (20.0% vs. 15.0%, p = 0.01) and mortality (2.6% vs. 1.2%, p = 0.03). In the pediatric (age 12-17) subgroup, the incidence of marijuana-positive patients did not change after legalization (pre: 39.3%, post: 46.4%, p = 0.24). CONCLUSION The incidence of marijuana-positive trauma patients increased post-legalization. Adult marijuana-positive trauma patients post-legalization were more likely to meet criteria for critical trauma activation and have a higher mortality rate. A subgroup of pediatric patients had an alarmingly high rate of marijuana use. SUMMARY The rate of marijuana use among trauma patients increased post-legalization in California. The rate of critical trauma activation also increased as well as the mortality rate.
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Affiliation(s)
- A Grigorian
- University of California, Irvine, Department of Surgery, Division of Trauma, Burns and Surgical Critical Care, Orange, CA, USA.
| | - E Lester
- University of California, Irvine, Department of Surgery, Division of Trauma, Burns and Surgical Critical Care, Orange, CA, USA
| | - M Lekawa
- University of California, Irvine, Department of Surgery, Division of Trauma, Burns and Surgical Critical Care, Orange, CA, USA
| | - C Figueroa
- University of California, Irvine, Department of Surgery, Division of Trauma, Burns and Surgical Critical Care, Orange, CA, USA
| | - C M Kuza
- University of Southern California, Department of Anesthesia, Los Angeles, CA, USA
| | - M Dolich
- University of California, Irvine, Department of Surgery, Division of Trauma, Burns and Surgical Critical Care, Orange, CA, USA
| | - S D Schubl
- University of California, Irvine, Department of Surgery, Division of Trauma, Burns and Surgical Critical Care, Orange, CA, USA
| | - C Barrios
- University of California, Irvine, Department of Surgery, Division of Trauma, Burns and Surgical Critical Care, Orange, CA, USA
| | - J Nahmias
- University of California, Irvine, Department of Surgery, Division of Trauma, Burns and Surgical Critical Care, Orange, CA, USA
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Eisenberg N, Jones TM, Kosterman R, Bailey JA, Lee JO, Haggerty KP. Parenting Practices in the Context of Legal Marijuana: Voices from Seattle Parents. JOURNAL OF CHILD AND FAMILY STUDIES 2019; 28:587-598. [PMID: 31396007 PMCID: PMC6686896 DOI: 10.1007/s10826-018-1288-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
OBJECTIVES This study examined marijuana-related parenting attitudes, behaviors, and challenges in the context of nonmedical marijuana legalization in Washington State. METHOD Qualitative data were collected via 6 focus groups with a total of 54 parents of preteen and teenage children, following the opening of the first marijuana retail store in Seattle in 2014. A structured interview protocol was used to ask parents about their marijuana-related parenting behaviors and about information, skills, or strategies that parents might find helpful while raising children in a state where nonmedical marijuana use is legal for adults. Transcripts were analyzed using thematic content analysis with NVivo software. RESULTS Findings indicate that most parents talked to their children about marijuana, communicating rules and information about the effects of the drug. Although most parents felt that marijuana use by underage youth was not acceptable, many recognized that it was something teens would likely experiment with. Most parents set guidelines about marijuana in their households, but several faced challenges monitoring their children's behavior (e.g., use of edibles), imposing consequences when children used marijuana, reconciling societal and personal norms, and deciding whether or not to disclose their own use. Parents expressed that they would benefit from learning strategies to deal with these challenges, including factual information and parenting skills, through programs offered in schools or community settings. CONCLUSIONS Results have implications for future research that seeks to inform prevention program development and shape policies attuned to the needs of parents.
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Affiliation(s)
- Nicole Eisenberg
- Social Development Research Group, School of Social Work, University of Washington, Seattle, WA
| | - Tiffany M. Jones
- Social Development Research Group, School of Social Work, University of Washington, Seattle, WA
| | - Rick Kosterman
- Social Development Research Group, School of Social Work, University of Washington, Seattle, WA
| | - Jennifer A. Bailey
- Social Development Research Group, School of Social Work, University of Washington, Seattle, WA
| | - Jungeun Olivia Lee
- School of Social Work, University of Southern California, Los Angeles, CA
| | - Kevin P. Haggerty
- Social Development Research Group, School of Social Work, University of Washington, Seattle, WA
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Associations between state-level policy liberalism, cannabis use, and cannabis use disorder from 2004 to 2012: Looking beyond medical cannabis law status. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2019; 65:97-103. [PMID: 30685092 DOI: 10.1016/j.drugpo.2018.10.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 09/16/2018] [Accepted: 10/31/2018] [Indexed: 01/24/2023]
Abstract
BACKGROUND Medical cannabis laws (MCL) have received increased attention as potential drivers of cannabis use (CU), but little work has explored how the broader policy climate, independent of MCL, may impact CU outcomes. We explored the association between state-level policy liberalism and past-year cannabis use (CU) and cannabis use disorder (CUD). METHODS We obtained state-level prevalence of past-year CU and CUD among past year cannabis users for ages 12-17, 18-25, and 26+ from the 2004-2006 and 2010-2012 National Surveys on Drug Use and Health. States were categorized as liberal, moderate, or conservative based on state-level policy liberalism rankings in 2005 and 2011. Linear models with random state effects examined the association between policy liberalism and past-year CU and CUD, adjusting for state-level social and economic covariates and medical cannabis laws. RESULTS In adjusted models, liberal states had higher average past-year CU than conservative states for ages 12-17 (+1.58 percentage points; p = 0.03) and 18-25 (+2.96 percentage points; p = 0.01) but not for 26+ (p = 0.19). CUD prevalence among past year users was significantly lower in liberal compared to conservative states for ages 12-17 (-2.87 percentage points; p = 0.045) and marginally lower for ages 26+ (-2.45 percentage points; p = 0.05). CONCLUSION Liberal states had higher past-year CU, but lower CUD prevalence among users, compared to conservative states. Researchers and policy makers should consider how the broader policy environment, independent of MCL, may contribute to CU outcomes.
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Mauro PM, Santaella-Tenorio J, Perlmutter AS, Hasin DS, Mauro CM, Martins SS. Correct knowledge of medical cannabis legal status in one's own state: Differences between adolescents and adults in the United States, 2004-2013. Addict Behav 2019; 88:23-28. [PMID: 30103098 DOI: 10.1016/j.addbeh.2018.07.021] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 07/26/2018] [Accepted: 07/29/2018] [Indexed: 02/01/2023]
Abstract
BACKGROUND Studies have found age-specific effects of medical cannabis laws (MCLs), particularly affecting adult cannabis use but not adolescent use. We examined whether age differences in MCL knowledge are in accordance with age differences in MCL effects on cannabis use. METHODS Data from the 2004-2013 repeated cross-sectional National Surveys on Drug Use and Health included people ages 12 and older in the United States. State-aggregated MCL knowledge was the proportion of people that correctly identified living in a state that did not allow medical cannabis prior to MCL enactment, or that allowed medical cannabis after MCL enactment. We regressed state-aggregated MCL knowledge on time-varying MCL enactment (i.e., no MCL by 2015, before MCL, after MCL), testing associations by age strata (12-17, 18-25, 26+), open dispensary status, and adjusting for time and state-level demographics. RESULTS Model-based MCL knowledge was significantly lower among adolescents than adults; after enactment, 36.8% of ages 12-17, 48.8% of ages 18-25, and 45.4% of ages 26+ were aware of their state's MCL status. Correct MCL status knowledge decreased across all age groups after MCL enactment (i.e., low knowledge of MCL changes at the time they occurred). Open cannabis dispensaries significantly increased correct MCL knowledge, with a 7.7-point increase for adolescents and a 17.5-point increase for adults 26 + . CONCLUSIONS Lower MCL knowledge among adolescents than adults was in accordance with MCL effects on cannabis use previously observed among adults only. Studies should assess whether MCL knowledge is a consequence or predictor of individual-level cannabis use across age groups.
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Oesterle S, Epstein M, Haggerty KP, Moreno MA. Using Facebook to Recruit Parents to Participate in a Family Program to Prevent Teen Drug Use. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2018; 19:559-569. [PMID: 29116552 PMCID: PMC5899621 DOI: 10.1007/s11121-017-0844-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Despite strong evidence that family programs are effective in preventing adolescent substance use, recruiting parents to participate in such programs remains a persistent challenge. This study explored the feasibility of using Facebook to recruit parents of middle school students to a self-directed family program to prevent adolescent drug use. The study used paid Facebook ads aiming to recruit 100 parents in Washington and Colorado using marijuana- or parenting-focused messages. All ad-recruited parents were also invited to refer others in order to compare Facebook recruitment to web-based respondent-driven sampling. Despite offering a $15 incentive for each successfully referred participant, the majority of the screened (70.4%) and eligible (65.1%) parents were recruited through Facebook ads. Yet, eligibility and consent rates were significantly higher among referred (76.6 and 57.3%, respectively) than Facebook-recruited parents (60.0 and 36.6%, respectively). Click-through rates on Facebook were higher for marijuana-focused than parenting-focused ads (0.72 and 0.65%, respectively). The final sample (54% Facebook-recruited) consisted of 103 demographically homogeneous parents (female, educated, non-Hispanic White, and mostly from Washington). Although Facebook was an effective and efficient method to recruit parents to a study with equal to better cost-effectiveness than traditional recruitment strategies, the promise of social media to reach a diverse population was not realized. Additional approaches to Facebook recruitment are needed to reach diverse samples in real-world settings and increase public health impact of family programs.
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Affiliation(s)
- Sabrina Oesterle
- Social Development Research Group, School of Social Work, University of Washington, 9725 3rd Ave NE, Seattle, WA, 98115, USA.
| | - Marina Epstein
- Social Development Research Group, School of Social Work, University of Washington, 9725 3rd Ave NE, Seattle, WA, 98115, USA
| | - Kevin P Haggerty
- Social Development Research Group, School of Social Work, University of Washington, 9725 3rd Ave NE, Seattle, WA, 98115, USA
| | - Megan A Moreno
- Seattle Children's Research Institute, Center for Child Health Behavior and Development, Seattle, WA, USA
- Department of Pediatrics, University of Washington, Seattle, WA, USA
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Caulkins JP, Bao Y, Davenport S, Fahli I, Guo Y, Kinnard K, Najewicz M, Renaud L, Kilmer B. Big data on a big new market: Insights from Washington State's legal cannabis market. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2018; 57:86-94. [PMID: 29709847 DOI: 10.1016/j.drugpo.2018.03.031] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 02/14/2018] [Accepted: 03/31/2018] [Indexed: 01/30/2023]
Abstract
INTRODUCTION Voters in eight U.S. states have passed initiatives to legalize large-scale commercial production of cannabis for non-medical use. All plan or require some form of "seed-to-sale" tracking systems, which provide a view of cannabis market activity at a heretofore unimagined level of detail. Legal markets also create a range of new matters for policy makers to address. DATA Publicly available data were obtained on approximately 45 million individually priced items purchased in the 35 million retail transactions that took place during the first two and a half years of Washington State's legal cannabis market. Records include product type (flower, extract, lotion, liquid edible, etc.), product name, price, and potency with respect to multiple cannabinoids, notably THC and CBD. Items sold can be traced back up the supply chain through the store to the processor and producer, to the level of identifying the specific production batch and mother plant, the firm that tested the product, and test results. METHOD Data visualization methods are employed to describe spatial-temporal patterns of multiple correlated attributes (e.g., price and potency) broken down by product. Text-analytic methods are used to subdivide the broad category of "extracts for inhalation" into more homogeneous sub-categories. To understand the competitiveness of the legal cannabis market in Washington we calculate the Herfindahl-Hirschman index (HHI) for processors and retailers. RESULTS Cannabis prices fell steadily and proportionally at the processor and retailer levels. Retail and wholesale price maintained a roughly 3:1 ratio for multiple product types after some initial fluctuations. Although a wide range of edibles are sold, they account for a modest share of consumer spending; extracts for inhalation are a larger and heterogeneous market segment. The HHI indicates the cannabis market is highly competitive at the processor level, but less so for retail markets at the county level. CONCLUSIONS Washington's state-legal cannabis market is diverse and rapidly evolving in terms of pricing, products, and organization. Post-legalization, researchers and policy makers may need to think in terms of a family of cannabis products, akin to how we think of new psychoactive substances and amphetamine-type stimulants, not a single drug "cannabis."
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Affiliation(s)
- Jonathan P Caulkins
- Carnegie Mellon University Heinz College, 5000 Forbes Ave., Pittsburgh PA 15213, USA.
| | - Yilun Bao
- Carnegie Mellon University Heinz College, 5000 Forbes Ave., Pittsburgh PA 15213, USA
| | - Steve Davenport
- RAND Drug Policy Research Center, 1776 Main St., Santa Monica, CA 90401, USA
| | - Imane Fahli
- Carnegie Mellon University Heinz College, 5000 Forbes Ave., Pittsburgh PA 15213, USA
| | - Yutian Guo
- Carnegie Mellon University Heinz College, 5000 Forbes Ave., Pittsburgh PA 15213, USA
| | - Krista Kinnard
- Carnegie Mellon University Heinz College, 5000 Forbes Ave., Pittsburgh PA 15213, USA
| | - Mary Najewicz
- Carnegie Mellon University Heinz College, 5000 Forbes Ave., Pittsburgh PA 15213, USA
| | - Lauren Renaud
- Carnegie Mellon University Heinz College, 5000 Forbes Ave., Pittsburgh PA 15213, USA
| | - Beau Kilmer
- RAND Drug Policy Research Center, 1776 Main St., Santa Monica, CA 90401, USA
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Hanson K, Haggerty KP, Fleming CB, Skinner ML, Casey-Goldstein M, Mason WA, Thompson RW, Redmond C. Washington State Retail Marijuana Legalization: Parent and Adolescent Preferences for Marijuana Messages in a Sample of Low-Income Families. J Stud Alcohol Drugs 2018; 79:309-317. [PMID: 29553361 DOI: 10.15288/jsad.2018.79.309] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE As legalization of nonmedical retail marijuana increases, states are implementing public health campaigns designed to prevent increases in youth marijuana use. This study investigated which types of marijuana-related messages were rated most highly by parents and their teens and whether these preferences differed by age and marijuana use. METHOD Nine marijuana-focused messages were developed as potential radio, newspaper, or television announcements. The messages fell into four categories: information about the law, general advice/conversation starters, consequences of marijuana use/positive alternatives, and information on potential harmful effects of teen marijuana use. The messages were presented through an online survey to 282 parent (84% female) and 283 teen (54% female) participants in an ongoing study in Washington State. RESULTS Both parents and youth rated messages containing information about the law higher than other types of messages. Messages about potential harms of marijuana use were rated lower than other messages by both generations. Parents who had used marijuana within the past year (n = 80) rated consequence/positive alternative messages lower than parent nonusers (n = 199). Youth marijuana users (n = 77) and nonusers (n = 202) both rated messages containing information about the law higher than other types of messages. Youth users and nonusers were less likely than parents to believe messages on the harmful effects of marijuana. CONCLUSIONS The high ratings for messages based on information about the marijuana law highlight the need for informational health campaigns to be established as a first step in the marijuana legalization process.
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Affiliation(s)
- Koren Hanson
- Social Development Research Group, University of Washington School of Social Work, Seattle, Washington
| | - Kevin P Haggerty
- Social Development Research Group, University of Washington School of Social Work, Seattle, Washington
| | - Charles B Fleming
- Center for the Study of Health and Risk Behaviors, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington
| | - Martie L Skinner
- Social Development Research Group, University of Washington School of Social Work, Seattle, Washington
| | - Mary Casey-Goldstein
- Social Development Research Group, University of Washington School of Social Work, Seattle, Washington
| | - W Alex Mason
- National Research Institute for Child and Family Studies, Boys Town, Nebraska
| | - Ronald W Thompson
- National Research Institute for Child and Family Studies, Boys Town, Nebraska
| | - Cleve Redmond
- Partnerships in Prevention Science Institute, Iowa State University, Ames, Iowa
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Rychert M, Wilkins C, Parker K, Witten K. Are government-approved products containing new psychoactive substances perceived to be safer and more socially acceptable than alcohol, tobacco and illegal drugs? Findings from a survey of police arrestees in New Zealand. Drug Alcohol Rev 2017; 37:406-413. [DOI: 10.1111/dar.12655] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Revised: 11/28/2017] [Accepted: 12/02/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Marta Rychert
- SHORE & Whariki Research Centre; Massey University; Auckland New Zealand
| | - Chris Wilkins
- SHORE & Whariki Research Centre; Massey University; Auckland New Zealand
| | - Karl Parker
- SHORE & Whariki Research Centre; Massey University; Auckland New Zealand
| | - Karen Witten
- SHORE & Whariki Research Centre; Massey University; Auckland New Zealand
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Napper LE, Froidevaux NM, LaBrie JW. Being Blunt About Marijuana: Parent Communication About Marijuana with Their Emerging Adult Children. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2017; 17:882-91. [PMID: 27438296 DOI: 10.1007/s11121-016-0681-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
While research suggests that parents continue to influence students' marijuana use after matriculation to college, there is limited data examining how parents communicate about marijuana use and what impact parent marijuana communication has on college student outcomes. The aim of the current study is to investigate the types of parent marijuana messages that college students receive and the relationship between parent communication and students' marijuana attitudes and behaviors. Students (N = 506) completed a survey assessing marijuana approval, use, negative consequences, and parent communication. A factor analysis of parent communication items yielded three factors: risk communication, permissive communication, and marijuana use communication. Risk communication was the most common form of communication. In multivariate models, risk communication was associated with increased odds of a student remaining abstinent but not with frequency of marijuana use or negative consequences. Greater permissive communication was associated with more approving student attitudes, greater odds of non-abstinence, more frequent use in the past year, and more negative consequences. These findings highlight the need to consider the different types of messages parents deliver when designing interventions aimed at engaging parents in marijuana prevention efforts.
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Affiliation(s)
- Lucy E Napper
- Department of Psychology, and Health, Medicine, and Society Program, Lehigh University, 17 Memorial Drive East, Chandler-Ullmann Hall, Bethlehem, PA, 18015, USA.
| | - Nicole M Froidevaux
- Department of Psychology, Loyola Marymount University, 1 LMU Drive, Suite 4700, Los Angeles, CA, 90045, USA
| | - Joseph W LaBrie
- Department of Psychology, Loyola Marymount University, 1 LMU Drive, Suite 4700, Los Angeles, CA, 90045, USA
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Rusby JC, Westling E, Crowley R, Light JM. Legalization of recreational marijuana and community sales policy in Oregon: Impact on adolescent willingness and intent to use, parent use, and adolescent use. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2017; 32:84-92. [PMID: 29144146 DOI: 10.1037/adb0000327] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Studies investigating the impact of medical marijuana legalization have found no significant changes in adolescent use. In one of the few studies focused on recreational marijuana, we investigated how recreational marijuana legalization and community sales policy influenced factors that likely impact youth use (youth willingness and intent to use, parent use) as well as youth use. Legalization of recreational marijuana in Oregon coincided with our study on adolescent substance use. Cohort 1 transitioned from 8th to 9th grade prior to legalization and Cohort 2 made this transition during legalization (N = 444; 53% female). Communities were allowed to opt out of sales. Multivariate linear regression models estimated the impact of legalization and community sales policy on changes in attitudes and parent use (2 time points 1 year apart). Zero-inflated Poisson growth curve models estimated the effects on initial levels and rate of change from 8th through 9th grade (4 time points). In communities opting out of sales, the prior-to-legalization cohort was less likely to increase their willingness and intent to use marijuana, and the legalization cohort was more likely to increase intent to use. For youth who used marijuana, legalization was associated with increased use, and those in communities opting out of sales had greater growth in marijuana use. Community policy appears to impact youth attitudes toward, and use of, marijuana. Results suggest that legalization of recreational marijuana did not increase marijuana use for youth who did not use marijuana but did increase use in youth who were already using. (PsycINFO Database Record
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Simonen J, Törrönen J, Tigerstedt C, Scheffels J, Moan IS, Karlsson N. Do teenagers’ and parents’ alcohol-related views meet? – Analysing focus group data from Finland and Norway. DRUGS-EDUCATION PREVENTION AND POLICY 2017. [DOI: 10.1080/09687637.2017.1337725] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Jenni Simonen
- Alcohol and Drugs Unit, National Institute for Health and Welfare, Helsinki, Finland,
| | - Jukka Törrönen
- Centre for Social Research on Alcohol and Drugs (SoRAD), Stockholm University, Sweden,
| | | | - Janne Scheffels
- Department of Drug Policy, Norwegian Institute of Public Health, Oslo, Norway, and
| | - Inger Synnøve Moan
- Department of Drug Policy, Norwegian Institute of Public Health, Oslo, Norway, and
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Skinner ML, Haggerty KP, Casey-Goldstein M, Thompson RW, Buddenberg L, Mason WA. Focus Groups of Parents and Teens Help Develop Messages to Prevent Early Marijuana Use in the Context of Legal Retail Sales. Subst Use Misuse 2017; 52:351-358. [PMID: 27768528 PMCID: PMC5241239 DOI: 10.1080/10826084.2016.1227847] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES The changes in Washington State and Colorado marijuana laws call for the development of new brief family-focused adolescent marijuana use preventive interventions that are relevant for and tailored to the context of legalization for retail sale. To that end, focus groups with parents and teens were conducted to find out about their concerns and needs in the context of legalization. METHODS Six semi-structured focus groups (3 with parents, 3 with teens) were conducted in Washington State in 2013 related to consequences of teen marijuana use and messages that would be effective in helping to prevent teens from using marijuana in the context of legal adult use. A total of 33 teens and 35 parents participated. RESULTS Three primary themes were common to these parents and teens: the negative consequences of marijuana use during adolescence on mental, physical, and social health; the need for more or better information; and the need for information/messages to come from trusted sources. The themes related to potential prevention messages include the use of fear; stories about real people; focusing on short-term consequences; and teens needing alternative activities (something better to do). CONCLUSIONS The results suggest that parents and teens need information about the new retail marijuana legalization law. Teens are open to both information and guidance from parents as long as it is calm and respectful. Firsthand accounts of consequences of marijuana use from peers and adults, rather than threats from authority figures, could hold some promise for persuading teens to avoid marijuana use.
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Affiliation(s)
- Martie L Skinner
- a Social Development Research Group, University of Washington , Seattle, Washington , USA
| | - Kevin P Haggerty
- a Social Development Research Group, University of Washington , Seattle, Washington , USA
| | - Mary Casey-Goldstein
- a Social Development Research Group, University of Washington , Seattle, Washington , USA
| | - Ronald W Thompson
- b Boys Town National Research Institute for Child and Family Studies , Boys Town, Nebraska , USA
| | - Laura Buddenberg
- b Boys Town National Research Institute for Child and Family Studies , Boys Town, Nebraska , USA
| | - W Alex Mason
- b Boys Town National Research Institute for Child and Family Studies , Boys Town, Nebraska , USA
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Cerdá M, Wall M, Feng T, Keyes KM, Sarvet A, Schulenberg J, O’Malley PM, Pacula RL, Galea S, Hasin DS. Association of State Recreational Marijuana Laws With Adolescent Marijuana Use. JAMA Pediatr 2017; 171:142-149. [PMID: 28027345 PMCID: PMC5365078 DOI: 10.1001/jamapediatrics.2016.3624] [Citation(s) in RCA: 259] [Impact Index Per Article: 37.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
IMPORTANCE Historical shifts are occurring in marijuana policy. The effect of legalizing marijuana for recreational use on rates of adolescent marijuana use is a topic of considerable debate. OBJECTIVE To examine the association between the legalization of recreational marijuana use in Washington and Colorado in 2012 and the subsequent perceived harmfulness and use of marijuana by adolescents. DESIGN, SETTING, AND PARTICIPANTS We used data of 253 902 students in eighth, 10th, and 12th grades from 2010 to 2015 from Monitoring the Future, a national, annual, cross-sectional survey of students in secondary schools in the contiguous United States. Difference-in-difference estimates compared changes in perceived harmfulness of marijuana use and in past-month marijuana use in Washington and Colorado prior to recreational marijuana legalization (2010-2012) with postlegalization (2013-2015) vs the contemporaneous trends in other states that did not legalize recreational marijuana use in this period. MAIN OUTCOMES AND MEASURES Perceived harmfulness of marijuana use (great or moderate risk to health from smoking marijuana occasionally) and marijuana use (past 30 days). RESULTS Of the 253 902 participants, 120 590 of 245 065(49.2%) were male, and the mean (SD) age was 15.6 (1.7) years. In Washington, perceived harmfulness declined 14.2% and 16.1% among eighth and 10th graders, respectively, while marijuana use increased 2.0% and 4.1% from 2010-2012 to 2013-2015. In contrast, among states that did not legalize recreational marijuana use, perceived harmfulness decreased by 4.9% and 7.2% among eighth and 10th graders, respectively, and marijuana use decreased by 1.3% and 0.9% over the same period. Difference-in-difference estimates comparing Washington vs states that did not legalize recreational drug use indicated that these differences were significant for perceived harmfulness (eighth graders: % [SD], -9.3 [3.5]; P = .01; 10th graders: % [SD], -9.0 [3.8]; P = .02) and marijuana use (eighth graders: % [SD], 5.0 [1.9]; P = .03; 10th graders: % [SD], 3.2 [1.5]; P = .007). No significant differences were found in perceived harmfulness or marijuana use among 12th graders in Washington or for any of the 3 grades in Colorado. CONCLUSIONS AND RELEVANCE Among eighth and 10th graders in Washington, perceived harmfulness of marijuana use decreased and marijuana use increased following legalization of recreational marijuana use. In contrast, Colorado did not exhibit any differential change in perceived harmfulness or past-month adolescent marijuana use following legalization. A cautious interpretation of the findings suggests investment in evidence-based adolescent substance use prevention programs in any additional states that may legalize recreational marijuana use.
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Affiliation(s)
- Magdalena Cerdá
- Department of Emergency Medicine, University of California Davis School of Medicine, Sacramento
| | - Melanie Wall
- Department of Psychiatry, Columbia University Medical Center, New York, New York3New York State Psychiatric Institute, New York4Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, New York
| | - Tianshu Feng
- Department of Psychiatry, Columbia University Medical Center, New York, New York5Research Foundation of Mental Hygiene, New York, New York
| | - Katherine M. Keyes
- Department of Psychiatry, Columbia University Medical Center, New York, New York6Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Aaron Sarvet
- Department of Psychiatry, Columbia University Medical Center, New York, New York3New York State Psychiatric Institute, New York6Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - John Schulenberg
- Department of Psychology, University of Michigan, Ann Arbor8Institute for Social Research, University of Michigan, Ann Arbor
| | | | | | - Sandro Galea
- Boston School of Public Health, Boston University, Boston, Massachusetts
| | - Deborah S. Hasin
- Department of Psychiatry, Columbia University Medical Center, New York, New York3New York State Psychiatric Institute, New York6Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
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Schinke S, Schwinn T, Hopkins J, Gorroochurn P, Wahlstrom L. Is the Legalization of Marijuana Associated With Its Use by Adolescents? Subst Use Misuse 2017; 52:256-258. [PMID: 27754733 PMCID: PMC5159284 DOI: 10.1080/10826084.2016.1223139] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Growing moves in the U.S. toward relaxed laws surrounding adult use of marijuana raise concerns about concurrent increases in adolescent use of marijuana. OBJECTIVES This study collected and analyzed primary data on the relationship between marijuana legalization status in U.S. states and adolescents' marijuana use. METHODS Recruited through social networking sites and youth-services community agencies, a sample of 1,310 adolescents from 48 U.S. states and the District of Columbia reported their use of marijuana. Youths' use rates were compared with the marijuana legalization status of youths' states of residence. RESULTS Study findings failed to show a relationship between adolescents' use of marijuana and state laws regarding marijuana use. Relationships were found for increased marijuana use by older youths, females, and non-Hispanic youths. Youths whose parents completed 2 or more years of college were less likely to report marijuana use than those whose parents completed fewer than 2 years of college. CONCLUSIONS Albeit study findings do not support predictions of growing marijuana use by adolescents in states with liberalized adult use laws, further monitoring of adolescents' use with larger and more representative samples is needed.
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Affiliation(s)
- Steven Schinke
- a School of Social Work, Columbia University , New York , New York , USA
| | - Traci Schwinn
- a School of Social Work, Columbia University , New York , New York , USA
| | - Jessica Hopkins
- a School of Social Work, Columbia University , New York , New York , USA
| | - Prakash Gorroochurn
- b Mailman School of Public Health, Columbia University , New York , New York , USA
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Estoup AC, Moise-Campbell C, Varma M, Stewart DG. The Impact of Marijuana Legalization on Adolescent Use, Consequences, and Perceived Risk. Subst Use Misuse 2016; 51:1881-7. [PMID: 27612596 DOI: 10.1080/10826084.2016.1200623] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Currently, only four states have legalized recreational marijuana use for adults over 21 years of age. Therefore, little is known about the influence that legalization will have on adolescent marijuana use. OBJECTIVES This study examines how marijuana legalization has impacted the frequency and consequences of adolescent use in a sample of participants in a school-based, substance use intervention. We hypothesized that adolescents enrolled in the intervention in years after marijuana legalization would present with more problematic use compared to those enrolled prior, and that changes in the perceived risk of marijuana would be a mechanism of problematic use. METHODS Participants were 262 students enrolled in a school-based substance use intervention in 2010 to 2015. The Customary Drinking and Drug Use Record, Alcohol and Drug Use Consequences Questionnaire, and a decisional balance matrix were used to assess marijuana frequency, negative consequences, and perceived risk of use. A mediation model was used to test the degree to which marijuana legalization may lead to increased frequency and consequences of use through perceived risk. RESULTS Findings indicated a significantly positive correlation between marijuana-related consequences and perceived risk post legalization. Despite relatively equal use between both groups, adolescents in the legalization group experienced higher levels of perceived risk and increased negative consequences. CONCLUSIONS/IMPORTANCE Due to the rising legalization status of marijuana in the United States, it is imperative that psychoeducation is provided to adults and adolescents about the consequences of underage marijuana use.
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Affiliation(s)
- Ashley C Estoup
- a Clinical Psychology, Seattle Pacific University , Seattle , Washington , USA
| | | | - Malini Varma
- a Clinical Psychology, Seattle Pacific University , Seattle , Washington , USA
| | - David G Stewart
- a Clinical Psychology, Seattle Pacific University , Seattle , Washington , USA
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Malouff JM, Johnson CE, Rooke SE. Cannabis Users' Recommended Warnings for Packages of Legally Sold Cannabis: An Australia-Centered Study. Cannabis Cannabinoid Res 2016; 1:239-243. [PMID: 28861495 PMCID: PMC5531364 DOI: 10.1089/can.2016.0029] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Introduction: Although cannabis use creates health risks, governments have recently been legalizing either medical use or leisure use. These governments can mandate health warnings on cannabis packages. Prior research examined recommended warnings of cannabis experts. The aim of this study was to obtain suggested cannabis health and safety warnings from cannabis users. Methods: We used a media release, Facebook postings, and announcements in university classes to seek individuals who had used cannabis at least once according to their own report. Using online data collection software that keeps participants anonymous, we asked the individuals to suggest a warning that governments could mandate on cannabis packages. Results: In total, 288 users suggested warnings. Categorizing the warnings into content categories led to six warning topics: (1) risk of harm to mental health and psychological functioning; (2) risk of operating machinery while under the influence; (3) short-term physical side effects; (4) responsible use; (5) long-term negative physical effects; and (6) dependence, addiction, or abuse. The user-suggested warnings overlapped with six expert-recommended warnings identified in prior survey research and included two content areas that did not feature in expert-recommended warnings: short-term physical side effects and the importance of responsible use. Conclusions: The results are consistent with prior findings that some youths perceive cannabis use as potentially harmful. The current findings provide possible new content for warnings on cannabis packages.
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Affiliation(s)
- John M Malouff
- Department of Psychology, University of New England, Armidale, Australia
| | - Caitlin E Johnson
- Department of Psychology, University of New England, Armidale, Australia
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VanderVeen JD, Hershberger AR, Cyders MA. UPPS-P model impulsivity and marijuana use behaviors in adolescents: A meta-analysis. Drug Alcohol Depend 2016; 168:181-190. [PMID: 27682358 DOI: 10.1016/j.drugalcdep.2016.09.016] [Citation(s) in RCA: 84] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Revised: 09/13/2016] [Accepted: 09/13/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Impulsivity is often included as a risk factor in models of adolescent marijuana use behaviors; however, the magnitude of the association between impulsivity and marijuana use behaviors is variable across studies. The present study reviewed existent literature to 1) quantify the relationship between separable impulsivity-related traits and both marijuana use and negative marijuana consequences and 2) quantify the size of the effect of gender on these relationships. METHOD Thirty-eight studies (41 independent samples) were meta-analyzed using a random effects model to examine the relationship between impulsivity traits and marijuana use behaviors. RESULTS Marijuana use was significantly related to all impulsivity-related traits except lack of perseverance (r's ranging from 0.13-0.23, p's<0.01). Negative marijuana consequences were only significantly related to sensation seeking, lack of planning, and positive urgency (r's ranging from 0.37-0.39, p's<0.01). Effects were small for marijuana use, but medium for negative marijuana consequences. Gender was not a significant moderator of any relationships. CONCLUSIONS Impulsivity-related traits had more robust relationships with negative marijuana consequences than marijuana use, suggesting impulsivity-related traits are important in differentiating adolescents most likely to experience negative consequences from marijuana use. Few relationships examined gender and many of the impulsivity-related traits, other than sensation seeking. Data and trends suggest a more multi-dimensional approach to marijuana use and consequences is warranted.
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Affiliation(s)
- J Davis VanderVeen
- Indiana University-Purdue University Indianapolis, Department of Psychology, 402 N Blackford St., Indianapolis, IN 46202, USA.
| | - Alexandra R Hershberger
- Indiana University-Purdue University Indianapolis, Department of Psychology, 402 N Blackford St., Indianapolis, IN 46202, USA
| | - Melissa A Cyders
- Indiana University-Purdue University Indianapolis, Department of Psychology, 402 N Blackford St., Indianapolis, IN 46202, USA
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Kosterman R, Bailey JA, Guttmannova K, Jones TM, Eisenberg N, Hill KG, Hawkins JD. Marijuana Legalization and Parents' Attitudes, Use, and Parenting in Washington State. J Adolesc Health 2016; 59:450-6. [PMID: 27523977 PMCID: PMC5035605 DOI: 10.1016/j.jadohealth.2016.07.004] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Revised: 07/02/2016] [Accepted: 07/02/2016] [Indexed: 01/09/2023]
Abstract
PURPOSE The recent legalization of nonmedical marijuana use in several U.S. states has unknown implications for those who are actively parenting. This study examined parents' reactions to marijuana legalization and changes in attitudes and behaviors over time. METHODS Data were from a gender-balanced, ethnically diverse sample of 395 parents in Washington State who were participating in the longitudinal Seattle Social Development Project. Participants were interviewed 15 times between 1985 (age 10) and 2014 (age 39). Adult nonmedical marijuana use was legalized in Washington in 2012 and retail outlets opened in 2014. RESULTS Results showed (1) one third of parents incorrectly believed the legal age of nonmedical marijuana use to be 18; (2) significant increase in approval of adult marijuana use and decrease in perceived harm of regular use; (3) wide opposition to teen use and use around one's children; and (4) substantial increases in frequency of use and marijuana use disorder among parents who used. CONCLUSIONS Despite increased acceptance and frequency of adult use, parents remain widely opposed to teen use but need facts and strategies for talking with their children about marijuana.
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Bailey JA, Hill KG, Guttmannova K, Epstein M, Abbott RD, Steeger CM, Skinner ML. Associations Between Parental and Grandparental Marijuana Use and Child Substance Use Norms in a Prospective, Three-Generation Study. J Adolesc Health 2016; 59:262-268. [PMID: 27265424 PMCID: PMC5002069 DOI: 10.1016/j.jadohealth.2016.04.010] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Revised: 04/05/2016] [Accepted: 04/06/2016] [Indexed: 10/21/2022]
Abstract
PURPOSE Using prospective longitudinal data from three generations, this study seeks to test whether and how parent and grandparent marijuana use (current and prior) predicts an increased likelihood of child cigarette, alcohol, and marijuana use. METHODS Using multilevel modeling of prospective data spanning three generations (n = 306 families, children ages 6-22), this study tested associations between grandparent (G1) and parent (G2) marijuana use and child (G3) past-year cigarette, alcohol, and marijuana use. Analyses tested whether G3 substance-related norms mediated these associations. Current G1 and G2 marijuana use was examined, as was G2 high school and early adult use and G1 marijuana use when G2 parents were in early adolescence. Controls included G2 age at G3 birth, G2 education and depression, and G3 gender. RESULTS G2 current marijuana use predicted a higher likelihood of G3 alcohol and marijuana use but was not related to the probability of G3 cigarette use. G3's perceptions of their parents' norms and G2 current marijuana use both contributed independently to the likelihood of G3 alcohol and marijuana use when included in the same model. G3 children's own norms and their perceptions of friends' norms mediated the link between G2 current marijuana use and G3 alcohol and marijuana use. CONCLUSIONS Results are discussed in light of the growing trend toward marijuana legalization. To the extent that parent marijuana use increases under legalization, we can expect more youth to use alcohol and marijuana and to have norms that favor substance use.
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Affiliation(s)
- Jennifer A. Bailey
- Social Development Research Group, School of Social Work, University of Washington, 9725 3rd Ave NE, Suite 401, Seattle, WA 98115, USA
| | - Karl G. Hill
- Social Development Research Group, School of Social Work, University of Washington, 9725 3rd Ave NE, Suite 401, Seattle, WA 98115, USA
| | - Katarina Guttmannova
- Social Development Research Group, School of Social Work, University of Washington, 9725 3rd Ave NE, Suite 401, Seattle, WA 98115, USA
| | - Marina Epstein
- Social Development Research Group, School of Social Work, University of Washington, 9725 3rd Ave NE, Suite 401, Seattle, WA 98115, USA
| | - Robert D. Abbott
- College of Education, University of Washington, Box 353600, Seattle, WA 98195-3600, USA
| | - Christine M. Steeger
- Social Development Research Group, School of Social Work, University of Washington, 9725 3rd Ave NE, Suite 401, Seattle, WA 98115, USA
| | - Martie L. Skinner
- Social Development Research Group, School of Social Work, University of Washington, 9725 3rd Ave NE, Suite 401, Seattle, WA 98115, USA
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Guttmannova K, Lee CM, Kilmer JR, Fleming CB, Rhew IC, Kosterman R, Larimer ME. Impacts of Changing Marijuana Policies on Alcohol Use in the United States. Alcohol Clin Exp Res 2016; 40:33-46. [PMID: 26727520 PMCID: PMC4700545 DOI: 10.1111/acer.12942] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Accepted: 10/22/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND Marijuana policies are rapidly evolving. In the United States, recreational use of marijuana is now legal in 4 states and medical marijuana is legal in 23 states. Research evaluating such policies has focused primarily on how policies affect issues of price, access to, use, and consequences of marijuana. Due to potential spillover effects, researchers also need to examine how marijuana policies may impact use and consequences of alcohol. METHODS The current paper is a critical review of articles evaluating alcohol outcomes associated with marijuana decriminalization, medical marijuana legalization, and nonmedical or recreational marijuana legalization. We identified articles and reports through (1) online searches of EBSCO host database including Academic Search Premier, Econlit, Legal Collection, Medline, PsycARTICLES, and PsycINFO, as well as PubMed and Google Scholar databases; (2) review of additional articles cited in papers identified through electronic searches; and (3) targeted searches of state and local government records regarding marijuana law implementation. We reviewed studies with respect to their data sources and sample characteristics, methodology, and the margin of alcohol and marijuana use, timing of policy change, and the aspects of laws examined. RESULTS The extant literature provides some evidence for both substitution (i.e., more liberal marijuana policies related to less alcohol use as marijuana becomes a substitute) and complementary (i.e., more liberal marijuana policies related to increases in both marijuana and alcohol use) relationships in the context of liberalization of marijuana policies in the United States. CONCLUSIONS Impact of more liberal marijuana policies on alcohol use is complex, and likely depends on specific aspects of policy implementation, including how long the policy has been in place. Furthermore, evaluation of marijuana policy effects on alcohol use may be sensitive to the age group studied and the margin of alcohol use examined. Design of policy evaluation research requires careful consideration of these issues.
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Affiliation(s)
- Katarina Guttmannova
- Katarina Guttmannova, Charles B. Fleming, Isaac C. Rhew, Rick Kosterman, Social Development Research Group, School of Social Work, University of Washington, 9725 3 Ave NE, Suite 401, Seattle, WA 98115
| | - Christine M. Lee
- Christine M. Lee, Jason R. Kilmer, Isaac C. Rhew, and Mary E. Larimer, Department of Psychiatry and Behavioral Sciences, University of Washington, 1100 NE 45 St., Suite 300, Seattle, WA 98105
| | - Jason R. Kilmer
- Christine M. Lee, Jason R. Kilmer, Isaac C. Rhew, and Mary E. Larimer, Department of Psychiatry and Behavioral Sciences, University of Washington, 1100 NE 45 St., Suite 300, Seattle, WA 98105
| | - Charles B. Fleming
- Katarina Guttmannova, Charles B. Fleming, Isaac C. Rhew, Rick Kosterman, Social Development Research Group, School of Social Work, University of Washington, 9725 3 Ave NE, Suite 401, Seattle, WA 98115
| | - Isaac C. Rhew
- Katarina Guttmannova, Charles B. Fleming, Isaac C. Rhew, Rick Kosterman, Social Development Research Group, School of Social Work, University of Washington, 9725 3 Ave NE, Suite 401, Seattle, WA 98115
- Christine M. Lee, Jason R. Kilmer, Isaac C. Rhew, and Mary E. Larimer, Department of Psychiatry and Behavioral Sciences, University of Washington, 1100 NE 45 St., Suite 300, Seattle, WA 98105
| | | | - Mary E. Larimer
- Christine M. Lee, Jason R. Kilmer, Isaac C. Rhew, and Mary E. Larimer, Department of Psychiatry and Behavioral Sciences, University of Washington, 1100 NE 45 St., Suite 300, Seattle, WA 98105
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Hasin DS, Saha TD, Kerridge BT, Goldstein RB, Chou SP, Zhang H, Jung J, Pickering RP, Ruan WJ, Smith SM, Huang B, Grant BF. Prevalence of Marijuana Use Disorders in the United States Between 2001-2002 and 2012-2013. JAMA Psychiatry 2015; 72:1235-42. [PMID: 26502112 PMCID: PMC5037576 DOI: 10.1001/jamapsychiatry.2015.1858] [Citation(s) in RCA: 716] [Impact Index Per Article: 79.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
IMPORTANCE Laws and attitudes toward marijuana in the United States are becoming more permissive but little is known about whether the prevalence rates of marijuana use and marijuana use disorders have changed in the 21st century. OBJECTIVE To present nationally representative information on the past-year prevalence rates of marijuana use, marijuana use disorder, and marijuana use disorder among marijuana users in the US adult general population and whether this has changed between 2001-2002 and 2012-2013. DESIGN, SETTING, AND PARTICIPANTS Face-to-face interviews conducted in surveys of 2 nationally representative samples of US adults: the National Epidemiologic Survey on Alcohol and Related Conditions (data collected April 2001-April 2002; N = 43,093) and the National Epidemiologic Survey on Alcohol and Related Conditions-III (data collected April 2012-June 2013; N = 36,309). Data were analyzed March through May 2015. MAIN OUTCOMES AND MEASURES Past-year marijuana use and DSM-IV marijuana use disorder (abuse or dependence). RESULTS The past-year prevalence of marijuana use was 4.1% (SE, 0.15) in 2001-2002 and 9.5% (SE, 0.27) in 2012-2013, a significant increase (P < .05). Significant increases were also found across demographic subgroups (sex, age, race/ethnicity, education, marital status, income, urban/rural, and region). The past-year prevalence of DSM-IV marijuana use disorder was 1.5% (0.08) in 2001-2002 and 2.9% (SE, 0.13) in 2012-2013 (P < .05). With few exceptions, increases in the prevalence of marijuana use disorder between 2001-2002 and 2012-2013 were also statistically significant (P < .05) across demographic subgroups. However, the prevalence of marijuana use disorder among marijuana users decreased significantly from 2001-2002 (35.6%; SE, 1.37) to 2012-2013 (30.6%; SE, 1.04). CONCLUSIONS AND RELEVANCE The prevalence of marijuana use more than doubled between 2001-2002 and 2012-2013, and there was a large increase in marijuana use disorders during that time. While not all marijuana users experience problems, nearly 3 of 10 marijuana users manifested a marijuana use disorder in 2012-2013. Because the risk for marijuana use disorder did not increase among users, the increase in prevalence of marijuana use disorder is owing to an increase in prevalence of users in the US adult population. Given changing laws and attitudes toward marijuana, a balanced presentation of the likelihood of adverse consequences of marijuana use to policy makers, professionals, and the public is needed.
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Affiliation(s)
- Deborah S Hasin
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York2Mailman School of Public Health, Columbia University, New York, New York3New York State Psychiatric Institute, New York
| | - Tulshi D Saha
- Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, Maryland
| | - Bradley T Kerridge
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Risë B Goldstein
- Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, Maryland
| | - S Patricia Chou
- Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, Maryland
| | - Haitao Zhang
- Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, Maryland
| | - Jeesun Jung
- Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, Maryland
| | - Roger P Pickering
- Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, Maryland
| | - W June Ruan
- Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, Maryland
| | - Sharon M Smith
- Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, Maryland
| | - Boji Huang
- Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, Maryland
| | - Bridget F Grant
- Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, Maryland
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