Ecological Momentary Assessment of Cannabis Use Contexts

Abstract

BACKGROUND: As recreational cannabis use increases, it is important to document the context in which use occurs. Cannabis use contexts may relate to safety and daily functioning (e.g., if cannabis is used while driving or at work/school) as well as motives for use (e.g., if cannabis is used in social environments). The present study used ecological momentary assessment (EMA) to examine the context surrounding cannabis use in adults’ natural environments. METHODS: Participants were recruited for a longitudinal study of dual use of cigarette and e-cigarettes. Data were collected in Illinois prior to legalization of recreational cannabis use. Participants completed baseline questionnaires and two seven-day waves of EMA; the current study included those who reported cannabis use on EMA interviews. Participants completed EMA when randomly prompted (5-6 times/day) and when using tobacco products. EMA reports measured past-hour substance use and current location, behavior, and social environment. Descriptive analyses evaluated relative frequencies of EMA events when cannabis use was reported (cannabis use events) and not reported (non-use events). Cannabis use and non-use event frequencies were examined by social environment (alone; with a partner/spouse, family, friends, children, coworkers, other), location (home, school/work, coffee shop/restaurant, sport/entertainment venue, car, other transit, bar/club), and behavior (hanging out, socializing, transit/driving, relaxing, texting/talking on phone, using a computer/app, nothing, other). Participants chose one location and could select all items that applied for social environment and behavior. Event frequencies were also examined by day of the week and time of day (4:00-8:59 AM, 9:00 AM-1:59 PM, 2:00-5:59 PM, 6:00-9:59 PM, and 10:00 PM-3:50 AM). RESULTS: Data come from 200 participants (35.5% female; mean age = 30; 11.5% Hispanic/Latino; 44.5% Non-Hispanic White; 29.5% Non-Hispanic Black; 10.0% Asian/Pacific Islander; 4.5% other race/ethnicity). Past 6-month cannabis use frequency was reported at baseline: 12.5% no use, 10.5% monthly or less, 14% 2-4 times/month, 15% 2-3 times/week, 48% 4+ times/week. The average baseline score on the Cannabis Use Disorders Identification Test-Revised was 9.90 (SD = 6.57). Overall, 14,160 EMA events were captured with 2,672 cannabis use events and 11,488 non-use events. Most cannabis use (77.2%) occurred at home. 9.1% of cannabis use occurred when driving/in transit. At cannabis use times, participants reported hanging out (41.5%), relaxing (35.0%), watching TV/movies (29.2%), and socializing (24.4%). Participants were alone in 41.0% of cannabis use events; when not alone during cannabis use, participants were most often with friends (48.0% of social cannabis use events), a partner/spouse (43.1%), or a family member (24.1%). Cannabis use was relatively consistent across days of the week, with slight increases on Thursday (15.9%) and Friday (16.4%). Most cannabis use (34.5%) occurred between 6:00-9:59 PM. CONCLUSIONS: These findings characterize the naturalistic context of cannabis use among a community sample of adults. Most cannabis use occurred at home and when engaging in leisure activities (e.g., relaxing, hanging out). Cannabis use did not appear to be very common in hazardous situations (e.g., while driving). As cannabis use continues to increase, the naturalistic context of cannabis use has implications for safety, motives, and cannabis use disorder.