A comparison of cannabis protective behavioral strategies use across cultures and sex

Abstract

Background: Cannabis protective behavioral strategies (PBS) are behaviors used before, during, after, and/or instead of cannabis use to reduce consumption, intoxication, and related harms. To leverage PBS to address the global health burden of cannabis use, especially in light of the changes in cannabis-related policies around the world, a better understanding of PBS across cultures is needed. In the present study, we conduct a cross-cultural examination of cannabis PBS use among college students. Method: Participants were 1175 college students (U.S. [n = 697], Argentina [n = 153], Uruguay [n = 46], Spain [n = 169], and the Netherlands [n = 66]) who reported past-month cannabis use (63.3% female; Mage = 20.96, SD = 3.95). Results: We found differences in the frequency of cannabis PBS use across countries such that the U.S. and Spain samples reported the most frequent cannabis PBS use and the Netherlands sample reported the least frequent cannabis PBS use. Although not statistically significant, we found that cannabis PBS use was positively correlated with cannabis-related outcomes (i.e., frequency, quantity, and negative consequences of cannabis use) among the Argentina and the Netherlands samples. Finally, across all countries but the Netherlands, females reported more frequent cannabis PBS use than males, but the associations of PBS with cannabis-related outcomes were larger for males than females. Conclusions: Given preliminary evidence for cultural differences in cannabis PBS use, future research is needed to better understand the cultural factors underlying these differences to inform the delivery of interventions aimed at reducing the harms of cannabis among college students.