Past 30-day Marijuana Research Articles

Tribal Identity, Pain Interference, and Substance Use Among American Indian and Alaska Native Adolescents

Substance use is high among American Indian/Alaska Native adolescents. Pain interference is a risk factor for substance use, and identifying potential protective factors, such as Tribal identity, is important to help inform culturally grounded substance use prevention strategies. To examine the protective potential of Tribal identity as a moderator in the association between pain interference and substance use in American Indian/Alaska Native adolescents. This cross-sectional study of 10th-grade students self-identifying as American Indian/Alaska Native was conducted among students enrolled at 20 high schools on or near the Cherokee Nation Reservation. Data for this study were collected from the baseline assessments of a cluster randomized trial to prevent substance use among adolescents living on or near the Cherokee Nation Reservation. Inclusion criteria for high schools' participation included being located within counties that partially or fully fall within the Cherokee Nation reservation, a town population of 3000 individuals or fewer, and class sizes between 30 and 100 students. Exclusion criteria included high schools within metropolitan and micropolitan cores (per the US Census Bureau's Rural-Urban Commuting Area codes) and the existence of an established community drug prevention coalition. Student surveys were conducted from September 2021 to May 2024. Pain interference in the 7 days prior to baseline assessment. The primary outcomes were past 30-day alcohol use, marijuana use, and prescription opioid misuse. Generalized estimating equations Poisson models were used, with an exchangeable correlation structure clustered on the school level using baseline data from a cluster randomized trial to prevent alcohol and substance use among adolescents. For each substance, a separate multivariable model was fit, which included pain interference, Tribal identity, an interaction term between pain interference and Tribal identity, age, gender, food insecurity, anxiety symptoms, and depressive symptoms. Among 514 self-identified American Indian/Alaska Native students at 20 high schools on or near the Cherokee Nation Reservation, mean (SD) participant age was 15.59 (0.62) years, and 252 participants (49.0%) self-identified as female. Pain interference was associated with alcohol use and prescription opioid misuse in American Indian/Alaska Native adolescents, controlling for age, gender, food insecurity, anxiety symptoms, and depressive symptoms. Tribal identity significantly moderated the association between pain interference and alcohol use (coefficient, -0.13; 95% CI, -0.23 to -0.02). When Tribal identity was high, the adverse association of pain interference with alcohol use was significantly attenuated. This demonstrates a protective role of Tribal identity on alcohol use, which can inform future substance use prevention efforts among American Indian/Alaska Native adolescents. ClinicalTrials.gov Identifier: NCT04839978.

Changes in substance use among adolescents before and during the COVID-19 pandemic in Guatemala.

Due to the COVID-19 pandemic, on March 16th, schools had to be closed in Guatemala and went to online teaching. We sought to analyze the change in substance use among high school students in Guatemala associated with the lockdown. Data from two surveys (2019, n=2096, and 2020, n=1606) of a student cohort in private high schools in Guatemala City was used. Logistic models for past 30-day cigarette, e-cigarette, marijuana, and alcohol (including binge drinking) were used, regressing these on survey wave, while adjusting for sex, scholastic performance, high school year of student, parental education, substance use, and household member tobacco use. Prevalence declined for smoking (10% to 3%, p<0.001), e-cigarette (31% to 14%, p<0.001), marijuana (4.3% to 1.9%, p<0.001), and alcohol use (47% to 38.5%, p<0.001), and binge drinking (24% to 13%, p<0.001). Adjusted models showed wave 2 associated with lower odds of using cigarettes (AOR=0.44, 95%CI=0.32-0.62), e-cigarettes (AOR=0.41, 95% CI=0.35-0.49, p<0.001), and binge drinking (AOR=0.73, 95%CI=0.59-0.89; p=0.002). Among Guatemalan adolescents, COVID-19 restrictions were associated with a significant decrease in smoking, e-cigarette use, and binge drinking.

Associations between Adolescent Marijuana Use, Driving after Marijuana Use and Recreational Retail Sale in Colorado, USA

Objective We investigated associations between the retail distribution of recreational marijuana in Colorado and (i) past 30-day marijuana use and (ii) driving after marijuana use (DAMU) among a representative sample of public high school students using four waves of data from a state surveillance system. Methods Past 30-day marijuana use was assessed among all sampled students (n = 85,336). DAMU was assessed among students 15 years or older who indicated driving (n = 47,518). Modified Poisson regression with robust variance estimates was used to estimate prevalence ratios (PR) comparing the pre-distribution (2013) and post-distribution (2015, 2017, 2019) periods for marijuana-related behaviors. Frequency of behavioral engagement was assessed using a multinomial approach. Results An estimated 20.3% of students engaged in past 30-day marijuana use and 10.5% of student drivers engaged in DAMU. Retail distribution of recreational marijuana was not significantly associated with the prevalence of any marijuana use or DAMU. However, it was associated with 1.16 (95% CI: 1.04–1.29) times the prevalence of using marijuana one or two times in the last 30 days, 1.27 (1.03, 1.55) times the prevalence of DAMU one time, and 0.82 (0.69, 0.98) times the prevalence of DAMU six or more times. No significant associations were observed for the remaining frequency categories. Conclusions Approximately 1 in 10 students who drive reported DAMU. Varying prevalence in the frequency of past 30-day marijuana use and DAMU was observed following the retail distribution of recreational marijuana in Colorado. Care should be taken to properly educate adolescent drivers regarding the dangers of DAMU.

Premium and Non-Premium Cigar Use Among a Nationally Representative Sample of Reproductive Age Women: Findings from the 2010-2019 National Survey on Drug Use and Health.

Little is known about cigar use among women of reproductive age, especially potential differences relating to the use of premium versus non-premium cigars. Using 2010-2019 data from the National Survey on Drug Use and Health, rates and trends in premium and non-premium cigar use were determined among women of reproductive age (18-49; n = 5651). Weighted sociodemographic characteristics, substance co-use, patterns of use, and health indicators were compared between women using premium versus non-premium cigars. Among reproductive-aged women who smoked cigars in the past 30 days, 4.9% reported use of premium cigar brands. The most commonly used premium brands were Romeo y Julieta, Cohiba, and Macanudos. Women who used premium versus non-premium cigars were less likely to identify as non-Hispanic black (16.5% vs. 35.5%), more likely to have household income >$50 000 (54.2% vs. 26.6%), and less likely to report past 30-day marijuana (28.7% vs. 55.7%) or blunt use (26.0% vs. 53.9%; ps < .001). Women who used premium cigars also reported later age of onset of cigar use (24.1 vs. 20.3 years; p < .001) and smoked fewer cigars in the last 30 days (9.8 vs. 2.3 days; p < .001). Trend analysis revealed that although rates of past 30-day premium cigar use remained consistent from 2010 (4.7%) to 2019 (4.9%), prevalence decreased from 6.6% in 2017 to 2.8% in 2018 before increasing to 4.9% in 2019. Understanding premium and non-premium cigar use among reproductive-age women, an understudied vulnerable population, will provide critical data to the Food and Drug Administration to inform policy and regulatory decisions. The current study revealed prevalence of ~5% premium cigar use among women of reproductive age who smoke cigars, and evidence for consistency in women's rates of premium cigar use across time. Women who used premium versus non-premium cigars were more likely to identify as non-Hispanic white, older, and of higher socioeconomic status were in better health and less likely to co-use cigarettes and marijuana, but more likely to co-use alcohol. Consideration of reproductive age and pregnant women as uniquely vulnerable populations is warranted in the development of regulations regarding premium and non-premium cigars. Comprehensive regulation of cigars (both premium and non-premium) may offer the potential to positively impact women's health.

The Theory of Planned Behavior and Adolescent Marijuana Use: Examining the Moderating Effects of Cigarette and E-cigarette Co-use

Background: This study examines the moderating effects of cigarette and e-cigarette co-use on the relationship between adolescent intention to use and marijuana use using the Theory of Planned Behavior (TPB). Method: A total of 217,276 adolescents in grades 6, 8, 10, and 12 were assessed using data from a large statewide surveillance dataset of youth self-report of substance use and related risk and protective factors. Structural Equation Models consisting of latent variables representing behavioral, normative, and control beliefs were regressed on intention to use and past 30-day marijuana use. Tests of moderation of the pathways between intention and marijuana use were used to test hypotheses, and grade level, gender, and race were included as covariates. Results: The overall model fit of the TPB predicting adolescent marijuana use provided good fit to the data (χ2(127) = 58042, p < 0.01, CFI = 0.95, TLI = 0.94, RMSEA = 0.04, SRMR = 0.03). After controlling for features of the model that may serve as common liability to substance use, past 30-day cigarette use moderated the relationship between intention and marijuana use (β = 0.46, p <.001). A stronger moderating effect was observed with past 30-day e-cigarette use (β = 0.63, p <.001). Past 12-month nicotine vaping (β = 0.44, p <.001) and flavor-only vaping (β = 0.30, p <.001) strengthened the relationship between intention and marijuana use. Conclusion: Adolescent marijuana use prevention may be enhanced by targeting general inhalation behaviors and restricting access to cigarettes, e-cigarettes, and flavor-only vaping products.

Symptoms of Depression and Anxiety and Subsequent Use of Nicotine and THC in Electronic Cigarettes

Background: This study examines whether symptoms of depression, anxiety, or comorbid depression and anxiety are associated with future use of nicotine or THC in e-cigarettes. Methods: Data were from an online survey of youth and young adults in urban areas of Texas with complete data (n = 2,307) in spring 2019 (baseline) and spring 2020 (12-month follow-up). Multivariable logistic regression models examined associations between self-reported symptoms of depression, anxiety, or comorbid depression and anxiety at baseline and past 30-day e-cigarette use with nicotine or THC at 12-month follow-up. Analyses adjusted for baseline demographics and baseline past 30-day e-cigarette, combustible tobacco, marijuana, and alcohol use and stratified by race/ethnicity, gender, grade level, and SES. Results: Participants were 16–23 years old, 58.1% female and 37.9% Hispanic. At baseline, 14.7% reported symptoms of comorbid depression and anxiety, 7.9% depression, and 4.7% anxiety. Prevalence of past 30-day e-cigarette use at 12-month follow-up was 10.4% with nicotine and 10.3% with THC. Symptoms of depression and comorbid depression and anxiety at baseline were significantly associated with both nicotine and THC use in e-cigarettes 12 months later. Symptoms of anxiety were associated with nicotine use in e-cigarettes 12 months later. Conclusions: Symptoms of anxiety and depression may be important indicators of future nicotine and THC vaping among young people. Clinicians should be aware of groups most at risk who may benefit from substance use counseling and intervention.

Latent Classes of Perceived Addictiveness Predict Marijuana, Alcohol, and Tobacco Use in Youth and Young Adults

Background: Mass media substance use prevention efforts target addiction perceptions in young people. This study examined youth and young adults’ (YAs) perceived addictiveness across several substances and the associations between addiction perceptions and substance use. Methods: Data were collected in 2019 in an online cohort study of Vermonters aged 12–25. Latent class analyses grouped participants by perceived addictiveness of nicotine, caffeine, alcohol, marijuana, cigarettes, electronic vapor products (EVPs), and opioids. Bivariate multinomial logistic and modified Poisson regression estimated associations between sociodemographics, substance use correlates, and subsequent use across latent classes. Results: Four latent classes captured addiction perceptions: high perceived addictiveness of EVPs, cigarettes, marijuana, and alcohol (Class 1: n = 317; 31.3%), low perceived addictiveness of marijuana, alcohol, and caffeine (Class 2: n = 151; 14.3%), low perceived addictiveness of marijuana (Class 3: n = 581; 46.5%), and low perceived addictiveness of nicotine, cigarettes, and EVPs (Class 4: n = 83; 7.9%). For each year increase in age, there was a 36% increased likelihood of being in Class 2 (vs. Class 1) and a 148% increased likelihood of belonging to Class 3 (vs. Class 1). Low perceived addictiveness classes were associated with ever and past 30-day marijuana and alcohol use and predicted past 30-day alcohol use at three-month follow-up. Membership in Classes 2 and 3 also predicted past 30-day marijuana use at Wave 3. Discussion: The strong association between age and latent classes defined by low perceived addictiveness suggests age group differences in addiction perceptions. Findings suggest that YAs may benefit from prevention messaging on addictiveness.

Patterns in Mental Health Symptomatology and Cigarette, E-cigarette, and Marijuana Use Among Texas Youth and Young Adults Amid the Coronavirus Disease 2019 Pandemic.

This study examined patterns in mental health symptomatology and smoking and vaping behaviors among youth and young adults over a 1-year period from before to during the first year of the Coronavirus Disease 2019 (COVID-19) pandemic. Participants (n = 2148) were 16-24-year-olds who completed three waves of the Texas Adolescent Tobacco and Marketing Surveillance Study (TATAMS). Descriptive statistics and mixed effects logistic regression models were used to examine changes in anxiety symptoms, depressive symptoms, perceived stress, and cigarette, e-cigarette, and marijuana use from before COVID-19 (fall 2019) to 6-month follow-up (spring 2020) and 12-month follow-up (fall 2020) periods during COVID-19. Longitudinal associations between mental health symptomatology and smoking and vaping were examined. Modest increases in symptoms of anxiety and depression were observed from before to during COVID-19. Perceived stress remained high and unchanged. Ever marijuana use increased at 6- and 12-month follow-up, while ever cigarette and e-cigarette use increased significantly only at 12-month follow-up. Marijuana use frequency increased significantly at 6- and 12-month follow-ups. Adjusting for sociodemographic factors, increased symptoms of anxiety and depression predicted increases in ever cigarette, e-cigarette, and marijuana use, and past 30-day cigarette and e-cigarette use, but not past 30-day marijuana use. Higher perceived stress predicted increases in ever use of cigarettes and e-cigarettes and past 30-day cigarette use. Changes in mental health symptomatology and smoking and vaping behaviors among young people in Texas varied during this period of the COVID era. Increases in mental health symptomatology predicted increases in cigarette, e-cigarette, and marijuana use behaviors. This study adds to the limited research on the longitudinal impact of anxiety symptoms, depressive symptoms, and perceived stress on cigarette, e-cigarette, and marijuana use from before to during the first year of the COVID-19 pandemic. Findings warrant health messaging and interventions that address the significant impact of worse mental health on increased smoking and vaping behavior, especially during crises like COVID-19 that may exacerbate mental health and substance use behaviors.

Substance Use Behaviors Among LGBTQ+ Youth of Color: Identification of the Populations Bearing the Greatest Burden in Three Large Samples

PurposeResearch has identified persistent disparities in alcohol, e-cigarette, and marijuana use, by sexual orientation, gender identity, and race/ethnicity. Using an intersectionality framework, the present study analyzes three large datasets to identify intersecting social positions bearing the highest burden of substance use. MethodsData from adolescents in grades 9–12 in three samples (2019 Minnesota Student Survey, 2017–2019 California Healthy Kids Survey, and 2017 National Teen Survey) were harmonized for an analysis (N = 602,470). A Chi-squared Automatic Interaction Detection analysis compared the prevalence of four types of substance use across all combinations of four social positions (six racial/ethnic identities, five sexual orientations, three gender identities, and two sexes assigned at birth). For each substance, 10 intersectional groups with the highest prevalence of use were examined. ResultsIn the full sample, 12%–14% of participants reported past 30-day alcohol, e-cigarette, or marijuana use and 7% reported past 30-day binge drinking. Several intersecting marginalized social positions were consistently found to bear a high burden of substance use. For example, transgender and gender diverse (TGD) Latina/x/o young people, particularly those assigned male at birth, were in the high prevalence groups for alcohol use, binge drinking, and marijuana use. Black TGD or gender-questioning youth were commonly in the high prevalence groups. DiscussionFindings suggest that support, resources, and structural changes specifically tailored to youth with multiple marginalized identities (especially TGD) may be needed. The results argue for intersectional efforts that explicitly address racial/ethnic and cultural differences, while also integrating awareness and understanding of sexual and gender diversity.

Discrimination, Substance Use, and Mental Health among Sexual and Gender Minority Adults Accessing Day Shelter Services

Background Sexual and gender minority (SGM) adults are overrepresented in the population of individuals experiencing homelessness, and high rates of substance use are common in this group. Plausibly, poor mental health and discrimination may contribute to substance use among SGM adults experiencing homelessness. This study described participant characteristics, and the interrelations among sociodemographic variables, substance use, mental health, and discrimination experiences among 87 SGM adults seeking services at a day shelter in Oklahoma City, OK. Discrimination experiences were characterized by race (White vs. non-White), sex (female vs. male), sexual identity (heterosexual vs. sexual minority), and gender identity (gender conforming vs. gender minority). Methods Participants reported their past 30-day tobacco (cigarette/cigarillos, alternative tobacco products [ATP]), alcohol, and marijuana use, as well as everyday and lifetime major discrimination experiences, substance use problems, depression, anxiety, and post-traumatic stress disorder (PTSD). Independent samples t-tests examined differences in discrimination based on substance use and mental health. Results Participants had high rates of tobacco and marijuana use, substance use problems, depression, anxiety, and PTSD. Over 80% reported experiencing everyday or lifetime major discrimination. Depression and PTSD were associated with ATP use, and anxiety was associated with alcohol use. All mental health variables were associated with substance use problems and everyday discrimination. Depression was associated with lifetime major discrimination. Conclusions SGM adults accessing shelter services frequently experienced discrimination and poor mental health, and substance use was common. Future research should examine the causal impact of discrimination on mental health and substance use among SGM adults experiencing homelessness.

Testing Narrative Persuasion of a Culturally Grounded, School-Based “Dale Se REAL” Entertainment-Education Intervention and Peer Communication on Nicaraguan Adolescent Substance Use

Guided by narrative engagement theory and social cognitive theory, the present study investigates effects of narrative persuasion and peer communication on Nicaraguan adolescent substance use. Eighth-grade students in Nicaragua were recruited to participate in the culturally grounded, school-based prevention intervention Dale se REAL and to watch five entertainment-education intervention videos that teach drug refusal communication strategies. Using the cross-sectional survey (N = 224), a path analysis was run to examine the mediated moderation effects of narrative engagement (e.g., interest, realism, and identification with main characters) and peer communication about the intervention videos (e.g., frequency and valence of communication) on adolescent refusal self-efficacy and substance use behaviors. Results revealed that realism was significantly related to adolescent refusal self-efficacy and frequent peer communication moderated the association between refusal self-efficacy and the past 30-day marijuana use. Findings suggest that health communication scholars should take into consideration social factors and cultural contexts for adolescent substance use prevention research.

Age groups differences in the prevalence and popularity of individual tobacco product use in young adult and adult marijuana and tobacco co-users and tobacco-only users: Findings from Wave 4 of the population assessment of tobacco and health study

BackgroundTobacco use is high among marijuana and tobacco users, compared to tobacco-only users. This study examined the relative ranking (based on prevalence) of past 30-day tobacco product use separately across young adult and older adult past 30-day marijuana and tobacco co-users and tobacco-only users. MethodPrevalence and relative ranking of past 30-day use of eight different tobacco products and blunts were examined in young adult (ages 18–24) and adults (ages 25 +) tobacco users who did and did not report past 30-day marijuana use (unweighted n = 33,644) from Wave 4 of the Population Assessment of Tobacco and Health study. Multiple logistic regressions examined increased odds of using each product in the past 30-days by marijuana and tobacco co-use. ResultsNearly half (47.9%) of past 30-day young adult tobacco users reported past 30-day marijuana use (e.g., co-use); 27.7% of adult tobacco users reported past 30-day co-use. Cigarettes were the most popular product used in the past 30-days across tobacco-only and co-users of both age groups. Rankings of all other tobacco products differed between the age groups. Among young adult co-users, blunts were ranked the second most popular product used in the past 30-days, followed by e-cigarettes, and then cigarillos/filtered cigars. Among adult co-users, blunts were ranked the fourth most popular product used in the past 30-days. Adult co-users reported significantly higher prevalence of past 30-day use of all combustible products compared to tobacco only users. ConclusionsCo-users may be at increased risk of health consequences given high rates of combustible tobacco use.

Stigma, Social Support, and Substance Use in Diverse Men Who Have Sex With Men and Transgender Women Living with HIV in the US Southeast.

Human immunodeficiency virus (HIV) rates in the southeast United States are high and substance use is common among people living with HIV (PLWH). This study used baseline data from the weCare intervention study to examine factors associated with the use of alcohol, tobacco, and marijuana among racially and ethnically diverse young gay, bisexual, and other men who have sex with men (GBMSM) and transgender women in the southeast who were newly diagnosed as having HIV, not linked to care, out of care, and/or not virally suppressed. Self-reported data were collected from 196 GBMSM and transgender women living with HIV via Audio Computer-Assisted Self-Interview at enrollment. Measures assessed demographics; stigma; social support; basic and clinical service needs; HIV disclosure; social media use; and recent use of alcohol, tobacco, and marijuana. Logistic regression identified correlates of past 30-day substance use. In multivariable analysis, increased age and needing basic support services were associated with past 30-day tobacco, cigarette, electronic cigarette, and/or hookah use. Increased HIV-related stigma and needing basic support services were associated with past 30-day marijuana use. Being White and needing clinical support services were associated with infrequent or no past 30-day marijuana use. HIV-related stigma and needing basic support services were associated with substance use among GBMSM and transgender women living with HIV in the southeastern United States. Routine screening for basic needs could identify GBMSM and transgender women living with HIV at risk for substance use and offer insight into intervention leverage points.

Protective Factors for Nicotine and Marijuana Vaping Among U.S. Adolescents

Nicotine and marijuana vaping among U.S. adolescents are public health priorities. Research has assessed the demographic and risk factors related to vaping, but there is a dearth of research on protective factors for vaping. On the basis of the healthy youth development perspective, the developmental assets framework is used to assess cumulative protective factors and vaping in a national sample of adolescents. Data came from the nationally representative Monitoring the Future study, consisting of 12th graders (n=6,982) from the 48 contiguous U.S. states (2017-2019). Past 30-day nicotine and marijuana vaping and developmental assets (low, medium, or high) were examined. Covariates included demographics and other substance use. Weighted descriptive statistics, logistic regression, postestimation analyses, and multiple imputation were used. Students with higher assets were less likely to vape nicotine and marijuana, even after adjusting for covariates. The odds of nicotine vaping were lower for students with medium assets (AOR=0.65, 95% CI=0.54, 0.78) and high assets (AOR=0.22, 95% CI=0.16, 0.29) than for students with low assets. Similarly, the odds of marijuana vaping were lower for youth with medium assets (AOR=0.54, 95% CI=0.42, 0.69) and high assets (AOR=0.09, 95% CI=0.05, 0.18) than for those with low assets. Social competence and positive peer norms were strongly protective against both forms of vaping. The healthy youth development perspective applies to the critical issues of nicotine and marijuana vaping among adolescents. Promoting cumulative assets may help to prevent vaping among U.S. adolescents, and increasing the specific assets of social competence and positive peer norms could be particularly fruitful.

Mental health and substance use by sexual minority status in high school students who experienced sexual violence

To examine the association between sexual minority status and the prevalence of emotional distress and substance use among a nationally-representative sample of youth who reported sexual violence victimization. Data were from the 2017 National Youth Risk Behavior Survey, a biennial school-based survey. We restricted the sample to youth who reported any past-year sexual violence victimization. We estimated prevalence ratios using modified Poisson regression with robust error variance to examine associations of sexual minority status with depressive symptomology, suicidality, and substance use. Among the 1364 (9.7%) students who experienced sexual violence, 78% were girls. Relative to heterosexual youth, sexual minority youth had higher prevalence estimates for the emotional distress outcomes and marijuana use. Sexual minority status was associated with depressive symptomology (adjusted prevalence ratio [aPR] 1.33, 95% confidence interval 1.22-1.44), suicidal ideation (aPR: 1.91, 1.66-2.20), medically treated suicide attempt (aPR: 2.74, 1.53-4.93), and past 30-day marijuana use (aPR: 1.29, 1.06-1.57). Among youth who experience sexual violence, sexual minorities may experience more emotional distress and substance use outcomes than heterosexuals. Rape crisis programs and other tertiary interventions should attend to the unique needs of sexual minorities who have been sexually victimized.

Recreational Marijuana Legalization and Co-use With Alcohol Among Adolescents

Little is known about the possible impacts of recreational marijuana legalization on alcohol and marijuana co-use among underage youth. This study examines the association between recreational marijuana legalization in California in 2016 and alcohol and marijuana co-use among adolescents. Additional analyses investigate the associations between recreational marijuana legalization and co-use among past 30-day drinkers and marijuana users and the frequency of alcohol and marijuana use among co-users. This study used annual cross-sectional data from 7th, 9th, and 11th graders (N=3,319,329) who participated in the California Healthy Kids Survey from 2010-2011 to 2018-2019. Measures included past 30-day alcohol and marijuana use and student demographic characteristics, survey year, pre-post recreational marijuana legalization, and urbanicity. Multilevel regression analyses were conducted in 2021. Recreational marijuana legalization was associated with greater odds of past 30-day alcohol and marijuana co-use in the total sample (OR=1.06, 95% CI=1.05, 1.07). Recreational marijuana legalization was more strongly associated with co-use among adolescents who reported past 30-day alcohol use (OR=1.58, 95% CI=1.52, 1.62) and heavy drinking (OR=1.25, 95% CI=1.21, 1.29) but was inversely related to co-use among past 30-day marijuana users (OR=0.76, 95% CI=0.74, 0.78). Among past 30-day co-users, there was a positive association with the frequency of marijuana use (β=0.36, SE=0.07). Recreational marijuana legalization may increase the risk of alcohol and marijuana co-use among adolescents. Greater restrictions on the numbers of alcohol and marijuana retail outlets and hours of operation and advertising and higher taxes on alcohol and marijuana products may help reduce the availability of these substances to adolescents.

Peer selection and influence for marijuana use in a complete network of first-year college students

BackgroundMarijuana is the most frequently used illicit drug among college students, and there is a need to understand the social processes that contribute to young adults’ marijuana use. Substance use behaviors tend to be more similar (homophilous) among individuals with social ties to one another. However, little is known about whether marijuana use homophily within young adult relationships is due to social selection (seeking out ties with similar marijuana use to one’s own) or social influence (adopting similar marijuana use behaviors as one’s ties), or both. Methods: Students (N = 1,489; 54.6% female; Mage = 18.6 years) at one University completed online surveys in their first three semesters of college. Surveys assessed participant characteristics, marijuana use, and ties to up to 10 other students in the whole (sociocentric) network of first-year college students. Stochastic-actor oriented models (SAOMs) were used to analyze the co-evolution of marijuana use and social ties over time. Results: Participants were more likely to select peers with similar past 30-day marijuana use as themselves. Concurrently, students’ past 30-day marijuana use became more similar to their peers’ use over time. Discussion: Evidence for selection and influence effects were highly significant after controlling for network structure and other covariates indicating these processes may work in tandem to increase marijuana use homophily over the first year of college. This highlights the importance of relationships made early in the first-year of college, as these initial peer ties are likely to reinforce marijuana use behaviors that occur within these relationships.

Substance Use and Mental Health Outcomes from a Text Messaging-Based Intervention for Smoking Cessation Among Young People Experiencing Homelessness.

Cigarette smoking and associated high-risk behaviors are prevalent among youth experiencing homelessness (YEH), making appropriately tailored interventions targeting smoking behavior important for this group. We pilot tested a brief text-messaging intervention (TMI) as an adjunct to standard care for YEH who smoke and found promising preliminary effects of the intervention on smoking cessation. The purpose of the present study was to test the TMI's effect on the secondary outcomes of other substance use (including use of other tobacco/nicotine devices) and mental health symptoms. A total of 77 participants completed the pilot randomized controlled trial, with 40 receiving the TMI (174 automated text messages plus a group smoking counseling session and provision of nicotine patches). They completed an assessment at baseline and another three months later that evaluated use of other tobacco/nicotine devices, alcohol, marijuana, and anxiety and depression symptoms. We found that the TMI helped to reduce secondary substance use behaviors and mental health symptoms among the participants; mainly there were medium effects of the intervention on changes in other tobacco/nicotine use, drinking, and anxiety and depression symptoms. The intervention did not have an effect on number of marijuana use days in the past month; however, past 30-day marijuana users who received the intervention benefited by reducing the number of times they used marijuana per day. In addition to helping reduce cigarette smoking, we found that a TMI for YEH was helpful in improving secondary outcomes, suggesting the promise of the TMI on benefiting YEH even beyond targeted smoking behavior. This pilot study demonstrates that by targeting cigarette smoking using a text message-based intervention among youth experiencing homelessness, effects may be seen in other areas of functioning such as other substance use and mental health. ClinicalTrials.gov Identifier NCT03874585. Registered March 14, 2019, https://clinicaltrials.gov/ct2/show/record/NCT03874585.

The impact of childhood trauma on substance use trajectories from adolescence to adulthood: Findings from a longitudinal Hispanic cohort study

BackgroundAdverse Childhood Experiences (ACE) are associated with substance use in adolescence and adulthood. However, there is a lack of longitudinal research examining the effect of ACE on substance use trajectories from adolescence through emerging adulthood. ObjectiveThis study examined the role of ACE in substance use trajectories among Hispanic emerging adults. ParticipantsWe surveyed a cohort of Hispanic adolescents (n = 1399) in Southern California across eight survey waves (beginning in 9th grade and continuing through emerging adulthood). MethodsGrowth curve models were used to examine the effect of ACE on past 30-day cigarette, marijuana, and alcohol use over seven time points, and an interaction term of ACE ∗ time was included to investigate the cross-level effect of ACE. ResultsACE was a significant predictor at 9th grade across all substances. Every additional ACE was associated with significantly higher past 30-day cigarette use (β = 0.05, 95%CI = 0.01, 0.10), marijuana use, (β = 0.15, 95%CI = 0.06, 0.25) and alcohol use (β = 0.14, 95%CI = 0.06, 0.21). Across all models, cross level interactions between ACE and time indicated that young adults exposed to more ACE experience significantly steeper inclining trajectories of 30-day cigarette use (β = 0.05, 95%CI = 0.02, 0.68), marijuana use (β = 0.07, 95%CI = 0.03, 0.11), and alcohol use (β = 0.02, 95%CI = 0.02, 0.68) than young adults with fewer ACE. ConclusionACE continue to have an impact on substance use trends through emerging adulthood. Results highlight the graded effect of ACE on substance use during and beyond adolescence and illustrate that ACE exposure is linked to an escalation of substance use frequency.

Proactive and reactive aggression and substance use among detained youth

ABSTRACT Background: Proactive and reactive functions of aggression have been found to be differentially associated with substance use; however, the pattern of associations differs across substance and outcome assessed. Methods: The current study extends extant literature by examining associations between proactive and reactive functions of aggression and frequency of substance use (tobacco, alcohol, marijuana, e-cigarettes, and prescription drugs) 30 days prior to detainment among a sample of justice-involved youth. Further, the moderating effect of behavioral dysregulation on these associations was evaluated. Results: While proactive aggression was positively correlated with past 30-day marijuana and prescription drug use for non-medical purposes, reactive aggression was positively correlated with tobacco, alcohol, marijuana, and prescription drug use. However, only reactive aggression was uniquely associated with past 30-day use, specifically marijuana and prescription drug use. Further behavioral dysregulation moderated associations, such that reactive aggression was positively associated with frequency of tobacco use and marijuana use, but only at low levels of behavioral dysregulation. Conclusions: Reactive aggression appears to be associated with more frequent substance use than proactive aggression during adolescence. Implications for findings are discussed.