Youth Marijuana Use Research Articles

Trends in use of marijuana and attitudes toward marijuana among youth before and after decriminalization: The case of California 2007–2013

BackgroundThis analysis examines decriminalization as a risk factor for future increases in youth marijuana acceptance and use. Specifically, we examine marijuana-related behaviors and attitudes of 8th, 10th, and 12th graders in California as compared to other U.S. states during the years before and after California passed legislation in 2010 to decriminalize marijuana. MethodsData come from Monitoring the Future, an annual, nationally representative survey of 8th, 10th, and 12th grade students. ResultsIn 2012 and afterwards California 12th graders as compared to their peers in other states became (a) 25% more likely to have used marijuana in the past 30 days, (b) 20% less likely to perceive regular marijuana use as a great health risk, (c) 20% less likely to strongly disapprove of regular marijuana use, and (d) about 60% more likely to expect to be using marijuana five years in the future. Analysis of 10th graders raises the possibility that the findings among 12th graders may reflect a cohort effect that was set into place two years earlier. ConclusionThese results provide empirical evidence to support concerns that decriminalization may be a risk factor for future increases in youth marijuana use and acceptance.

The Parent-Child Acculturation Gap, Parental Monitoring, and Substance Use in Mexican Heritage Adolescents in Mexican Neighborhoods of the Southwest U.S.

A sample of 206 Mexican-heritage 7th-grade adolescents attending predominantly Mexican-heritage schools in Arizona was assessed on their linguistic acculturation, perceived parental monitoring, and substance use. One of their parents also reported on their own parental level of acculturation. While greater parental acculturation predicted greater marijuana use, the acculturation gap (child's level of acculturation over and above that of the parent) was not predictive of substance use. There was a significant acculturation gap by parental monitoring interaction for marijuana use, where the negative correlation between parental monitoring and marijuana use was attenuated for parent-youth dyads that exhibited the largest acculturation gap. This suggests that a greater parent-youth cultural distance (the acculturation gap) attenuates that protective effect of parental monitoring on youth marijuana use. Results are discussed in terms of how the acculturation gap increases the risk for problem behaviors in Mexican American adolescents through its effect on family processes.

Parental influences on African American adolescent marijuana use

The purpose of this study was to examine the impact of parental factors on annual (past year) marijuana use in African American youth within the Greater Cincinnati area. The following research questions were examined for this study: (1) Do family structure, parental education and parental job status impact African American adolescent marijuana use? (2) Does impact of these variables differ based on sex and grade? Participants were African American students in 7th through 12th grade (n = 7488) in schools within the Greater Cincinnati area. Logistic regression analyses revealed that annual marijuana use differed based on family structure, parental education, and parental job status. More specifically, annual marijuana use was lowest among students who lived with both of their biological parents, had parents who had some college experience and had parents who were employed. Findings should be considered by health educators and prevention specialists when developing programs and efforts to prevent youth marijuana use.

Examining the influence of community belonging on marijuana use among youth living in British Columbia, Canada

Background: Using cross-sectional data from the Canadian Community Health Survey (2007–2008), this study aimed to examine the impact of community belonging on marijuana use among British Columbian youth aged 12–24.Methods: Bivariable and multivariable multinomial logistic regression was used to examine the association between self-perceived community belonging and youth marijuana use (i.e. never, tried once and more than once lifetime use), and stratified by high and low adult marijuana use regions to determine if the relationships varied by the extent of adult marijuana use in each region.Results: Of 2095 youth respondents, 21.8% had used marijuana at least once in the past year, with the majority (70.9%) reporting a strong sense of community belonging. Weak community belonging increased youth’s odds of initiation [Adjusted odds ratio (AOR) = 1.74; 95% Confidence Interval (CI) 1.18–2.56] and odds of more-than-once lifetime use (AOR = 1.40; 95% CI 1.10–1.79), and these associations were increased in regions where adult marijuana use was high.Conclusion: These findings suggest an association between weak sense of community belonging and youth marijuana use, and that use in the general population may increase this relationship. There is a need to better understand how youth interpret “community belonging”, and further explore the relationship between marijuana availability and youth use.

Parent–Child Drug Communication: Pathway From Parents' Ad Exposure to Youth's Marijuana Use Intention

The authors combined the 2-step flow of communication model and the theory of planned behavior to create a framework to evaluate the effectiveness of a set of advertisements from the National Youth Anti-Drug Media Campaign promoting parent–child drug communication. The sample consisted of 1,349 pairs of parents and children who responded to the first and second annual rounds of the National Survey of Parents and Youth, and 1,276 pairs from Rounds 3 and 4. Parents' exposure to the campaign reported at Round 1 was indirectly associated with youth's lowered intentions to use marijuana at Round 2. Ad exposure was associated with positive changes in parental attitudes toward drug communication and perceived social approval of antidrug communications. These two beliefs, along with perceived behavioral control, predicted parents' intentions to discuss drugs with their children. Parental intentions to discuss drugs reported at Round 1 were associated with youth's report of actual drug communication with their parents at Round 2. Frequency and breadth of the topics in parent–child drug communication were associated with less positive attitudes toward marijuana use among youth who spoke with their parents. Together, the child's attitudes toward marijuana use and perceived ability to refuse marijuana use predicted youth's intentions to use marijuana. The proposed model fit well with the data and was replicated in a parallel analysis of the data from Rounds 3 and 4. Implications for future antidrug media campaign efforts are discussed.

Real-time, contextual intervention using mobile technology to reduce marijuana use among youth: A pilot study

We evaluated the feasibility, acceptability, and potential efficacy of MOMENT, an intervention to reduce youth marijuana use that combines brief motivational enhancement therapy with mobile self-monitoring and responsive messaging. At baseline, primary care patients ages 15–24 who used marijuana frequently (at least 3 times per week) completed a recall assessment, then 1week of mobile momentary and daily reports on use-related factors. For the intervention, youth participated in two motivational enhancement therapy sessions, during which they identified their top-3 social and emotional triggers for use and discussed healthy ways to manage them. They then completed two weeks of mobile reports. Upon reporting a top-3 trigger for use, desire to use, or recent use, they received a message supporting self-efficacy and prompting consideration of coping strategies. Generalized estimating equations examined changes in momentary-, daily-, and individual-level measures on 3-month recall and mobile assessments. Twenty-seven youth (M=19.2years, 70% female) enrolled; there were 377–677 momentary and 50–106 daily reports per study phase. Participants reported reading the messages and finding them motivating, being comfortable with participation, and not experiencing the study as burdensome. Although proportion of momentary reports of being in a top-3 trigger context did not change (36%–43%), marijuana desire in a top-3 trigger context and marijuana use after top-3 trigger exposure decreased over the study (p<.0001 and p=.03, respectively). Daily- and individual-level measures showed similar, non-significant, improvements. The MOMENT intervention appears feasible, well-accepted, and potentially efficacious for youth who use marijuana frequently.

Peer Influence on Marijuana Use in Different Types of Friendships

Although several social network studies have demonstrated peer influence effects on adolescent substance use, findings for marijuana use have been equivocal. This study examines whether structural features of friendships moderate friends' influence on adolescent marijuana use over time. Using 1-year longitudinal data from the National Longitudinal Study of Adolescent Health, this article examines whether three structural features of friendships moderate friends' influence on adolescent marijuana use: whether the friendship is reciprocated, the popularity of the nominated friend, and the popularity/status difference between the nominated friend and the adolescent. The sample consists of students in grade 10/11 at wave I, who were in grade 11/12 at wave II, from two large schools with complete grade-based friendship network data (N = 1,612). In one school, friends' influence on marijuana use was more likely to occur within mutual, reciprocated friendships compared with nonreciprocated relationships. In the other school, friends' influence was stronger when the friends were relatively popular within the school setting or much more popular than the adolescents themselves. Friends' influence on youth marijuana use may play out in different ways, depending on the school context. In one school, influence occurred predominantly within reciprocated relationships that are likely characterized by closeness and trust, whereas in the other school adopting friends' drug use behaviors appeared to be a strategy to attain social status. Further research is needed to better understand the conditions under which structural features of friendships moderate friends' influence on adolescent marijuana use.

“Counselor in Your Pocket”: Youth and Provider Perspectives on a Mobile Motivational Intervention for Marijuana Use

Previous interventions for marijuana use have been administered out of the real-life contexts in which use occurs. In 2010, we interviewed youth aged 15–24 years who use marijuana frequently (n = 8) and providers who treat them (n = 6) on the acceptability and utility of a mobile intervention involving momentary self-monitoring of use-related contexts and responsive motivational messaging following clinic-based brief motivational enhancement therapy. Thematic analysis was used to examine youth and provider perspectives on the mobile intervention. Results suggest that mobile technology is a promising tool for brief interventions to reduce youth marijuana use and warrants further development.

Momentary affective states predicting substance use events in depressed youth

The relationship between mood and substance use in depressed adolescents has been well established, but the precise mechanisms need elucidation. We sought to characterize 24-h momentary affective antecedents of alcohol and marijuana use in depressed youth. Thirty-eight participants (84% females, 15–22 years old), all clinically depressed and substance users, completed four to six daily momentary reports for two weeks using a hand-held device. The reports included participants' momentary positive and negative affect (PA and NA) and their recent consumption of alcohol and/or marijuana. Statistical models compared affect characteristics during 24-h periods preceding substance use with affect at other times. Because most participants were females, we also examined data for girls alone. Participants reported 394 total substance use events. Prior to use, participants displayed narrower ranges of PA and NA compared with times distant from use, especially for marijuana use. Girls had lower maximum PA prior to mar...

Legalization of medical marijuana and marijuana use among youths

Aim: This study examined the relationship of youth marijuana use and perceived ease of access with the number of medical marijuana cards at the county-level, and marijuana norms as indicated by per cent of voters approving legalization of medical marijuana in 2004.Methods: Survey data from 17,482 youths (aged 13–19) in Montana and county-level archival data, including votes for the legalization of medical marijuana and the number of medical marijuana cards were analysed using hierarchical linear modelling.Findings: Living in a county with more medical marijuana cards was not related to lifetime or 30-day marijuana use. However, voter approval of medical marijuana was positively related to lifetime and 30-day use. Perceived ease of access to marijuana was positively related to medical marijuana cards, but this relation became non-significant when voter approval was controlled. Among marijuana users, marijuana cards and voter approval were positively related to perceived ease of access.Conclusions: The relation between medical marijuana cards and youth use may be related to an overall normative environment that is more tolerant of marijuana use. Interventions to prevent youth marijuana use should focus on adult norms regarding use by and provision of marijuana to youths.

Predicting nonresponse to juvenile drug court interventions

Using data from a recent randomized clinical trial involving juvenile drug court (JDC), youth marijuana use trajectories and the predictors of treatment nonresponse were examined. Participants were 118 juvenile offenders meeting diagnostic criteria for substance use disorders assigned to JDC and their families. Urine drug screen results were gathered from weekly court visits for 6 months, and youth reported their marijuana use over 12 months. Semiparametric mixture modeling jointly estimated and classified trajectories of both marijuana use indices. Youth were classified into responder versus nonresponder trajectory groups based on both outcomes. Regression analyses examined pretreatment individual, family, and extrafamilial predictors of nonresponse. Results indicated that youth whose caregivers reported illegal drug use pretreatment were almost 10 times as likely to be classified into the nonresponder trajectory group. No other variable significantly distinguished drug use trajectory groups. Findings have implications for the design of interventions to improve JDC outcomes.

Evidence for Connections Between Prosecutor-Reported Marijuana Case Dispositions and Community Youth Marijuana-Related Attitudes and Behaviors

This article examines relationships between local drug policy (as represented by prosecutor-reported case outcomes for first-offender juvenile marijuana possession cases) and youth self-reported marijuana use, perceived risk, and disapproval. Interviews with prosecutors and surveys of 8th-, 10th-, and 12th-grade students in the United States were conducted in 2000. Analyses include data from 97 prosecutors and students from 127 schools in 40 states. Results indicate significant relationships between local drug policy and youth marijuana use and attitudes. In general, more-severe dispositions are associated with less marijuana use, higher disapproval rates, and increased perceptions of great risk. Associations primarily appear to be specific to marijuana-related outcomes. Results are discussed within the framework of both deterrence and broader social norms regarding substance use.

Drug Use Patterns and Trends in Rural Communities

This study examines the prevalence of tobacco, alcohol, and illicit drug use among adolescents and adults in 3 types of counties: "rural" (nonmetropolitan counties with urban population less than 20,000), "urbanized nonmetropolitan" (nonmetropolitan counties with urban population 20,000 or higher), and "metropolitan" (counties in metropolitan areas). Data from the 2002-2004 National Surveys on Drug Use and Health are used to compare residents of the 3 county types. Descriptive findings and a multivariate model of marijuana use among adolescents are presented by county type. Past year illicit drug use is generally similar among adolescents in rural, urbanized nonmetropolitan, and metropolitan counties, except that Ecstasy use is higher among youth in metropolitan and urbanized nonmetropolitan counties than rural counties, while rural youth have a higher prevalence of stimulant and methamphetamine use than metropolitan youth. Gender, race/ethnicity, and family income functioned differentially across the 3 county types as predictors of youth marijuana use during the past year. Rural adults had generally lower rates of illicit drug use than metropolitan adults, but adults in rural and urbanized nonmetropolitan areas had higher rates of methamphetamine use than those in metropolitan areas. Rural youth had a higher prevalence of past month use of tobacco and alcohol. Rural adults had higher rates of tobacco use but lower rates of alcohol use. This study dispels the notion that substance abuse is only an urban problem and provides information useful in developing and implementing interventions that consider the unique characteristics of rural residents.

Understanding the Relative Influence of Neighborhood, Family, and Youth on Adolescent Drug Use

In the United States, a variety of programs have been developed to prevent substance use among youth. These programs often target youth directly, and may also have components that address the relational influence of families, schools, and communities. We discuss clustering of youth marijuana use within and between households and neighborhoods. As often discussed in the literature, we consider analyzing “components of variance” in a hierarchical sample design with two or more levels. With a continuous outcome variable, the estimated relative size of variance components at each level can be interpreted as its relative “importance.” We estimate variance components when the outcome is dichotomous, and find that for the use of marijuana in the past year, the role of the individual (individual adolescent vs. role of household vs. role of neighborhood) is quite prominent (79% of variation). A similar result is observed for the continuous scale variable of individual positive attitudes toward drug use (83%). For continuous constructs related to either household (parental monitoring) or neighborhood (neighborhood disorganization) the majority of variation still occurs at the individual level (67% and 51%, respectively), although they reveal significant percent variation (about 30%) at the corresponding family or neighborhood levels as well. We discuss the use of variance component methodology and the relevance for prevention programs.

Storytelling for Empowerment: Decreasing At-Risk Youth's Alcohol and Marijuana Use

The Storytelling for Empowerment Program decreased marijuana and alcohol use in high risk middle school youth, aged 11–15, across two years of implementation (Cohort 98 and Cohort 99). The program was a unique combination of cultural empowerment, cognitive skills, storytelling and the arts for emotional expression. A quasi-experimental research design compared participants' pre and posttest responses on drug use and also compared participants' responses to those from students who attended comparison schools who did not receive the program. High contact participants were defined as being those above the median of contact hours for that year. For Cohort 98 this was 28 hours and for Cohort 99 this was 19.75 hours. High contact participants had the most marked changes with a decrease in their alcohol and marijuana use. In addition, all participants in the last year of the program regardless of contact hours decreased their alcohol use and increased in their resistancy to drug use.

Exposure opportunity as a mechanism linking youth marijuana use to hallucinogen use

The aim of this study is to shed light upon an observed association between the use of marijuana and hallucinogens (e.g. LSD), with a specific focus on the idea that two separate mechanisms might link marijuana use to hallucinogen use: (1) greater hallucinogen exposure opportunity for marijuana users versus nonusers; (2) increased probability of hallucinogen use for marijuana users versus nonusers, once the opportunity to use hallucinogens has occurred. This work is based on a novel analysis of retrospective, self-report data from more than 40 000 young participants in the 1991–1994 National Household Surveys on Drug Abuse (NHSDA), with discrete time survival analysis models. Youths who had used marijuana were substantially more likely than nonusers to have the opportunity to use hallucinogens (estimated unadjusted relative risk, uRR=16.3; 95%. Confidence interval (CI)=14.3–18.6). Once an opportunity to use hallucinogens occurred, marijuana users were more likely than nonusers to initiate hallucinogen use (uRR=12.6; 95% CI=9.0–17.6). This evidence provides a more complete view of interconnections between marijuana use and hallucinogen use, and helps to clarify the pivotal role for drug exposure opportunities. Important next steps will be to understand what accounts for variation in the exposure opportunities experienced by marijuana users, and to understand why some marijuana users do not progress even when they have a chance to do so.