Attitudes about cannabis mediate the relationship between cannabis knowledge and use in active adult athletes

Joanna S Zeiger,Robert S Zeiger,William S Silvers,Edward M Fleegler

doi:10.1186/s42238-020-00023-3

Joanna S Zeiger, Robert S Zeiger + Show 2 more

Open Access

https://doi.org/10.1186/s42238-020-00023-3

Copy DOI

Abstract

BackgroundLittle is known about how cannabis knowledge and attitudes impact cannabis use behavior.ObjectiveTo test the knowledge-attitudes-behavior paradigm in active adult athletes.DesignThe Athlete Pain, Exercise, and Cannabis Experience (PEACE) Survey, a cross-sectional survey study, used social media and email blasts to recruit participants and SurveyGizmo to collect data.ParticipantsSelf-defined active adult athletes (n = 1161).Main measuresKnowledge about cannabis was evaluated with four questions. Attitudes toward cannabis was evaluated with 11 questions. The attitudes questions were used in a TwoStep Cluster analysis in SPSS to assign group membership by attitudes. Chi-square was used to determine if there were differences in cluster membership by demographic factors and if knowledge about cannabis differed by cluster membership. Regression analysis was performed to determine if cannabis attitudes mediated the relationship between cannabis knowledge and cannabis use.Key resultsA three-cluster solution was the best fit to the data. The clusters were named Conservative (n = 374, 32.2%), Unsure (n = 533, 45.9%), and Liberal (n = 254, 21.9). There was a significant difference among the clusters for all 11 attitudes items (all p < 0.001). Attitude cluster membership was significantly different by age (p < 0.001), primary sport (p < 0.05), and knowledge about cannabis (p < 0.001). Athletes in the liberal cluster answered the knowledge questions correctly most often. Attitudes mediated the relationship between cannabis knowledge and cannabis use [Never (32.4%), Past (41.6%), Current (26.0%)] with athletes in the liberal cluster showing more knowledge and greater likelihood to be a current cannabis user (p < 0.001). Among current cannabis users there were differential patterns of cannabis use depending on their attitudes and knowledge; liberal athletes tended to co-use THC and CBD and used cannabis longer. (p < 0.001).ConclusionsCannabis education needs to consider attitudes about cannabis, especially among those who might benefit from medical cannabis.

Highlights

Little is known about how cannabis knowledge and attitudes impact cannabis use behavior
Cannabis education needs to consider attitudes about cannabis, especially among those who might benefit from medical cannabis
The triad of knowledge-attitudes-behavior has not been well studied in terms of cannabis use, but previous studies have taken a harms-avoidance approach examining drug use in adolescents

Summary

Introduction

Little is known about how cannabis knowledge and attitudes impact cannabis use behavior. Theories of the connection between attitudes and behavior were considered “guiding” or “influential” (Fazio et al 1983) and that this process was oneto-one, ignoring the presence of other potential variables that might impact this relationship (Fazio 1986). It is widely believed that other factors may change the attitude-behavior relationship with knowledge being one such intervening variable (Fazio 1986; Macaulay et al 2005; Borden et al 2008). The triad of knowledge-attitudes-behavior has not been well studied in terms of cannabis use, but previous studies have taken a harms-avoidance approach examining drug use in adolescents. A study of parenting practices and adolescent drug use tested adolescent drug knowledge, pro-drug attitudes, and adolescent drug use (Macaulay et al 2005). Another study in adolescents showed that education regarding substance use impacted substance use attitudes which decreased cigarette smoking and cannabis use (Botvin et al 1990)

Methods

Results

Conclusion