Attitudes, Subjective Norms, and Perceived Behavioral Control Associated with Age of First Use of Cannabis among Adolescents.

Abstract

Prevention of early age initiation of cannabis use is a national priority, highlighting the importance of identifying cannabis-specific attitudes, norms, and perceived behavioral control in relation to initiation age. Data were from the NEXT Generation Health Study, a national longitudinal sample of US adolescents followed from 10th grade (N=1850). Cannabis-specific attitudes, norms, and perceived behavioral control were assessed at 10th grade. Age of first use was reported retrospectively 2-3 years after high-school and participants were categorized as early initiators (<14 years; 3.8%), high-school (HS) initiators (14-18 years; 35.6%), post-HS initiators (>18 years; 8.3%), or never users (52.3%). Relative to never users, early initiators were more likely to endorse pro-use attitudes (AOR [adjusted odds ratio]=2.39, 95% confidence interval [CI]=1.27-4.50), less disapproving parental attitudes toward use (AOR=2.50, 95% CI=1.45-4.28), higher cannabis use among friends (AOR=3.81, 95% CI=2.21-6.60), and higher ease of access (AOR=2.10, 95% CI=1.14-3.87); HS initiators were similarly more likely to report less disapproving attitudes toward use (AOR=1.55, 95% CI=1.25-1.91), higher cannabis use among friends (AOR=2.81, 95% CI=2.18-3.65), and higher ease of access (AOR=1.66, 95% CI=1.21-2.28). Earlier cannabis initiation was associated with more favorable cannabis attitudes, subjective norms, and perceived behavioral control, highlight these variables as potential intervention targets.