Objective:Environmental perturbations such as prenatal cannabis exposure (PCE) during critical periods may lead to disruptions in biological systems that have downstream consequences on behavior and development. Developmental milestones have served as a measure of normative development that allows providers and parents to identify areas for intervention. However, little is known about the direct impacts of PCE on development milestone attainment and whether failures to attain development milestones mediate later disruptions in executive functioning and behavioral disinhibition. Method:Data from the Adolescent Brain Cognitive Development (ABCD) study were used to examine prenatal cannabis effects on development while using a propensity score approach to control for familial and environmental characteristics. Results:PCE was not significantly associated with any delays in gross motor or language attainment; however, after accounting for confounders via propensity score for PCE (pPCE), PCE was significantly associated with delays in 'saying his/her first word' (Odds Ratio = 1.51, 95% Confidence Interval: [1.08, 2.10]). Upon examining the mediating effects, there were no significant total direct or total indirect effects on executive functioning. However, pPCE was associated with behavioral disinhibition and a significant mediation of PCE on behavioral disinhibition via delays in saying his/her first word were observed. Conclusions:This study suggests that delays in saying his/her first word serves as a risk factor for later behavioral disinhibition/externalizing problems. Importantly, the current study didn't examine language development, rather delays in saying his/her first word can provide insight into the possible impacts prenatal cannabis exposure has on developmental milestone attainment.
Objective:Sleep difficulties are a common motive for cannabis use during pregnancy. However, evidence supporting cannabis use as an effective sleep aid is limited, while substantial research demonstrates the efficacy of cognitive behavioral treatments. This study characterized the sleep complaints of adults using cannabis during pregnancy to inform prevention and intervention efforts. Method:Pregnant adults reporting cannabis use (a) in the month prior to or (b) after becoming pregnant were recruited from across the United States between May and August of 2025. Participants completed a cross-sectional research survey, and those who passed all fraudulent responding criteria were included in data analysis. Descriptive statistics, chi-square, and t-tests compared the demographic and clinical characteristics of pregnant adults who did and did not report using cannabis to help their sleep. Results:Of the 210 valid respondents (100% assigned female at birth, 93% cisgender; age M = 29.3 years; 53% White, 38% Black; 58% in second trimester), 185 persisted in cannabis use during pregnancy and 119 reported using "mostly" or "almost always" to help their sleep. Those using cannabis for sleep reported greater insomnia severity, earlier bedtimes, and more wake after sleep onset than those using cannabis for other reasons, but they were less likely to report taking >30 minutes to fall asleep, consistent with expectancies that cannabis would help their sleep. Three out of four using cannabis for sleep (78%) expressed interest in alternative sleep treatments. Conclusions:Sleep is a common reason for cannabis use during pregnancy that appears to be a promising target for prevention and intervention efforts.
Objective:Cannabis is the most commonly used illicit substance during pregnancy. Negative health and social outcomes associated with cannabis use disproportionately affect birthing people of color, particularly Latinas. Latina birthing people face compounding barriers to prenatal care, including discrimination, immigration-related fears, and distrust of healthcare systems rooted in histories of obstetric racism. This study examines the perspectives and experiences of Latina birthing people in California as they navigate prenatal care while using cannabis. Method:We conducted qualitative, semi-structured interviews with 20 Latina birthing people. Eligible participants reported current or previous pregnancy within the last year concurrent with cannabis use, identified as Latina, lived in California, were 21 years or older, and spoke English and/or Spanish. We used constructivist grounded theory methods to analyze the data. Results:We found that Latina birthing people who use cannabis: 1) Perceived their intersectional identities (race/ethnicity, age, partnership status) as potential vulnerabilities to poor prenatal care, particularly around cannabis use disclosure; 2) Sought more supportive clinicians based on these intersectional identities, though financial and insurance barriers prevented them from accessing preferred clinicians; and 3) Proposed solutions to improve their care, such as identifying clinicians who looked like them or adopting a whole-person approach that contextualized their cannabis use within their lived experiences. Conclusions:Discrimination, stigma, and racial profiling of Latina birthing people who use cannabis contribute to unsafe prenatal care environments. Open communication about the motivations and implications of cannabis use is needed to improve prenatal experiences and outcomes for Latinas, who may be using cannabis as a form of self-medication in the context of inadequate care access. Given that Latina birthing people who use cannabis experience discrimination, stigma, and racial profiling in prenatal care settings, it is critical to build structurally competent clinical environments that foster open, nonjudgmental counseling where discussions around cannabis use can occur safely. Systems-level interventions are needed, including clinician training on cannabis use counseling and bias, expanded and diversified clinical workforces, and community-based care options, such as doula integration.
Objective: Perinatal cannabis use is a significant public health concern linked to adverse maternal and neonatal outcomes. Despite growing evidence of prenatal cannabis use (PCU) risks, many individuals use it to manage symptoms such as nausea, anxiety, or pain. The Theory of Planned Behavior (TPB) identifies intentions as key predictors of substance use. While intentions and use patterns have been well studied in non-pregnant populations, research on prenatal intentions for cannabis use is limited. This pilot ecological momentary assessment (EMA) study examines: (a) cannabis use and non-use days in terms of intentions and use; (b) associations between daily intentions and use across prenatal and postpartum; and (c) motives linked to planned versus unplanned use. Method: Pregnant participants (N = 20; Mage = 30.15) reporting current prenatal CU completed two 14-day EMA bursts (in pregnancy and at 6-weeks postpartum) tracking daily CU, motives, and intentions. Planned use days were coded based on morning endorsement of intention to use, followed by reported use; unplanned use days were coded based on no morning intention, followed by reported use. Results: Planned use was most common both in pregnancy and postpartum, followed by planned nonuse, unplanned use, and foregoing plans to use. Intentions strongly predicted daily cannabis use (OR = 5.78, p < .001), with no significant difference between pregnancy and postpartum. Common motives across both planned and unplanned days included relaxation, pain relief, and sleep improvement. Some motives, including appetite increase and anxiety reduction, were more frequent on planned days, while enhancement motives were more common on unplanned days. Conclusions: Findings support TPB’s relevance to perinatal cannabis use, highlighting distinct motives for planned versus unplanned use. Larger samples are needed to expand these insights.
Objective:Adolescent pregnancy is associated with socioeconomic disadvantages and higher risks of adverse obstetric, fetal, and developmental outcomes. Pregnant adolescents and young adults also use cannabis at a higher rate than older individuals, which may compound these risks. In considering clinical interventions aimed at reducing prenatal cannabis exposure, it is critical to understand the perspectives of young pregnant individuals, including why some individuals in this age group abstain and why others use cannabis but stop for pregnancy. This qualitative study aimed to identify beliefs, attitudes, and perceptions of cannabis use in young pregnant patients. Method:We conducted qualitative semi-structured interviews of young pregnant individuals with and without prenatal cannabis use as part of the YoungMoms study. Interviews were transcribed, coded, and reviewed for patterns and themes. Results:Thirty-eight participants completed the interviews including 12 that continued to use cannabis during pregnancy, 15 that stopped upon pregnancy recognition, and 11 that had never used cannabis. The average age of the participants was 19 years (range: 17-21) and 68% identified as Black/African American. Participants voiced the following themes: 1) using prenatal cannabis to relieve physical symptoms and stress; 2) believing prenatal cannabis to be less harmful than other substances such as prescribed medications, while also voicing concern about potential risks; 3) relying on both non-professional and professional resources to shape their perspectives; and 4) recognizing and asserting autonomy regarding the rationales, decisions, and strategies to continue and/or reduce cannabis use during pregnancy. Conclusions:Young pregnant patients described mixed beliefs about the safety of prenatal cannabis use and felt that cannabis could be helpful to treat symptoms of nausea and stress. Participants highlighted a desire to make their own decisions and sought information from trusted sources. These findings suggest young pregnant patients may be receptive to patient-centered approaches when discussing prenatal cannabis use.
Objective: Cannabis use is increasing in the United States, including among pregnant women. Legalization of cannabis and decreased public perceptions of risk have contributed to increased cannabis use. Relatively few studies have examined the association of cannabis use with maternal mental health in pregnancy, particularly among Black women who have higher rates of adverse pregnancy outcomes. Method: Biosocial Impacts on Black Births (BIBB) is a prospective study conducted from 2017-2022 in three prenatal care sites in Michigan, Ohio and Florida with pregnant Black women (n = 1,066). We examined the associations between self-reported cannabis use in pregnancy and psychological health. Psychological health was assessed using the Center for Epidemiologic Studies Depression Scale (CES-D), the Cohen’s Perceived Stress Scale, and the Psychological General Well-Being (PGWB) Index. Results: Over 20% of women (n = 227) reported cannabis use during pregnancy. The mean age was 27 years, >60% of the participants completed a high school education, and 85% were living with the father of the baby. The most common reasons for use were to reduce stress and nausea. After controlling for confounding by state of residence, maternal age, education level, marital status, current financial status, gestational age at enrollment, and tobacco use, cannabis use in pregnancy was associated with higher levels of depressive symptoms (β = 3.44; 95% CI: 1.8, 5.1), higher perceived stress (β = 2.78; CI: 1.8, 3.7), and lower levels of maternal psychological well-being (β = -4.5; CI: -7.1, -1.9). Conclusions: These findings highlight the importance of health care provider awareness about prenatal cannabis use and psychological health in pregnant women. Prospective studies are needed to examine factors related to cannabis use in pregnancy to potentially reduce adverse outcomes associated with use.
Objective: Prenatal cannabis use is increasing in prevalence and associated with potential harm to maternal-fetal health. Pregnant individuals who use cannabis seek information about prenatal cannabis use informally (e.g., online) and adopt practices perceived to reduce harm. However, no evidence-based harm reduction interventions address prenatal cannabis use. Cannabis protective behavioral strategies (PBS) are associated with less cannabis use and fewer cannabis-related negative consequences among non-pregnant populations. There is a lack of research exploring PBS during pregnancy. Method: This study combined two samples of pregnant individuals who use cannabis (N = 48; Mage = 30.33; 2% American Indian or Alaska Native, 2% Asian, 19% Black, 15% multiracial, 58% White). Participants completed the Protective Behavioral Strategies for Marijuana scale (PBSM; Pedersen et al., 2017), adapted for pregnancy, and an open-ended question about prenatal PBS. We examined relationships between prenatal cannabis use, PBS, consequences, and perceived harm of prenatal cannabis use. Results: Participants reported using PBS (M = 4.07, SD = 0.93) and experiencing consequences in the past 30 days (M = 3.77, SD = 3.30). Higher perceived harm of cannabis to fetal health (B = 0.02, p = .010) and use in later trimesters (second: B = 0.69, p = .011; third: B = 0.82, p = .013) were positively associated with PBS. PBS was associated with lower weekly (IRR = 0.79, 95% CI [0.69, 0.90], p < .001) and daily prenatal cannabis use frequency (IRR = 0.41, 95% CI [0.33, 0.51], p = .001) but was not significantly associated with consequences. Open-ended responses revealed pregnancy-specific practices perceived to reduce harm (e.g., “I had a date set to quit and slowly decreased the amount I was smoking”). Conclusions: Results underscore the need for harm reduction research and validation of PBS and consequence measures for prenatal cannabis use to support informed decision-making among pregnant individuals who use cannabis.
Objective: This paper presents rich and in-depth insights emerging from “Wading through the Weeds” (WttW), a participatory arts-based research study that used the Photovoice method to centre the lived experience of 23 mothers throughout Canada who consumed cannabis during pregnancy, lactation and motherhood. Method: Specifically, this paper examines and elucidates the ways that the mothers in our study used cannabis to address mental health challenges during the perinatal period and beyond. Results: A significant theme emerging from our research findings was the connection between the mothers’ decision to consume cannabis to cope with and/or overcome mental health challenges and a strong belief that cannabis supported them with their perinatal and maternal health and well-being. This included multiple stressors such as financial and interpersonal concerns, experiences of anxiety and depression, histories of addiction, trauma, and abuse, and managing of symptoms associated with Post Traumatic Stress Disorder (PTSD) that impacted their everyday lives. Conclusions: Our inquiry suggests that there is a dire need for public health decision-makers, clinicians, and social workers to understand and respond to the historical context, current realities, and intersecting identities of pregnant, lactating and parenting people who consume cannabis. Responses that run counter to the current context, where stigma and fear prevent parents from accessing cannabis information and support, have the potential to more effectively support the mental health and wellbeing of these parents during the perinatal period.
Objective: Cannabis is one of the most used substances in pregnancy, with an estimated 10% of U.S. pregnancies affected by cannabis use. Although research has linked fetal cannabis exposure to potential risks, many pregnant women continue to use cannabis for diverse medical and nonmedical reasons. Motives for substance use are modifiable targets for intervention that can be leveraged for tailored intervention and prevention strategies, yet little work has been done to integrate women’s motives for cannabis use across the reproductive continuum. Method: To address this gap, this integrative review examines literature on cannabis motives across reproductive time periods using the Whittemore and Knafl approach, to map the range of motives reported across studies, synthesize distinct motives into meaningful categories, and examine how motives are related to cannabis use behavior—including frequency, initiation and persistence. Results: Overall, 33 studies met inclusion criteria with 27 focused on the prenatal period and no studies exclusively on preconception, for a total of 45 period-specific observations. Across the reproductive continuum, medical/therapeutic motives were frequently reported (97%) and were linked to persistent and frequent use. Coping motives were also linked to use behavior and were more prominent during postpartum compared to preconception or prenatal periods (100% vs. 80% vs. 79%, respectively). Recreational and social motives appeared more often preconception. Conclusions: Altogether, motives for cannabis use were varied and dynamic, but medical motives were the most consistent across the reproductive continuum. Motives can provide a framework for non-stigmatizing intervention that distinguishes symptom driven use, bridges provider communication barriers, and acknowledges patient reported benefits.
Objective: Cannabis use during pregnancy is increasing; however, the prevalence and correlates of cannabis use transitions between preconception and early pregnancy (e.g., persistent use, new uptake, discontinuation) are understudied. Method: Data were from a prospective cohort of United States and Canadian residents trying to conceive who completed online questionnaires during preconception (every 2 months for up to 12 months) and early pregnancy (<12 weeks gestation). Among 9,200 participants who conceived between 2013-2025, we examined associations of sociodemographic characteristics, preconception behaviors, and nausea and vomiting during pregnancy (NVP) with: a) any past-month cannabis use in pregnancy; b) persistent cannabis use (vs. discontinuation) among participants using cannabis during preconception; and c) new uptake of cannabis (vs. persistent nonuse) among participants not using cannabis during preconception. Results: In the full sample (n = 9,200), 284 (3.1%) reported persistent cannabis use, 911 (9.9%) discontinued use, 45 (0.5%) reported new uptake, and 7,960 (86.5%) reported persistent nonuse between preconception and early pregnancy. Among individuals using cannabis during preconception (n = 1,194), 23.8% continued use in pregnancy; among preconception daily cannabis users (n = 8,006), 54.8% continued use in pregnancy. Lower education and income, being unmarried, age <25 years, and history of diagnosed depression and/or anxiety were associated with any cannabis use, persistent use, and new uptake during pregnancy. Preconception alcohol and cigarette use were associated with any cannabis use but not persistent use in pregnancy. NVP was inversely associated with any cannabis use, persistent use, and new uptake during pregnancy. Conclusions: Findings highlight a need for cannabis cessation interventions during preconception and early pregnancy, particularly for reproductive-aged individuals with comorbid mental health issues who use cannabis frequently.
Objective:Prenatal cannabis use is associated with adverse pregnancy and neonatal outcomes, but research on its association with child anxiety and depressive disorders is limited. This study aimed to test the hypothesis that prenatal cannabis use is associated with child anxiety or depressive disorder diagnoses. Method:Population-based retrospective birth cohort study of children (N = 115,553) born between 1/1/2011-12/31-2017 to pregnant individuals (N = 97,376) universally screened for prenatal cannabis use. Cox proportional hazards regression models examined associations between cannabis use during early pregnancy (at ∼8-10 weeks gestation based on self-reported use or a positive urine toxicology test for delta-9-tetrahydrocannabinol [THC]) and child anxiety and depressive disorders from ages 6 to 13 years based on diagnosis codes, adjusting for maternal sociodemographic and clinical characteristics. Results:The median age at pregnancy onset was 31 (inter quartile range [IQR] = 6) years. Most pregnancies (61.4%) were to non-White individuals; 4.4% screened positive for any cannabis use; 3.7% had a positive toxicology test and 1.9% self-reported use. Overall, 9,230 children were diagnosed with an anxiety disorder at median age of 8 (IQR = 3) years and 1,224 with depressive disorder at median age of 9 (IQR = 3) years. Prenatal cannabis use was associated with a lower risk of child anxiety disorders (aHR:0.84, 95%CI: 0.75-0.95), which remained significant when defined by a toxicology test but not by self-report. Maternal prenatal cannabis use was not associated with child depressive disorders (aHR:1.15, 95%CI: 0.85-1.54). Conclusions:Prenatal cannabis use during early pregnancy was not associated with an increased risk of offspring early onset anxiety or depressive disorders.
Objective:This cross-sectional study examined associations between modes of cannabis use (smoke, vape, edibles, and/or dabs) during the year before pregnancy and cannabis use disorder (CUD). Method:Patients were universally screened for substance use at entrance to prenatal care in an integrated healthcare delivery system (January 2020-July 2024). CUD diagnoses were ascertained from ICD-10 codes in electronic health records during the year before pregnancy. At entrance to prenatal care, patients self-reported frequency of cannabis used during the year before pregnancy (monthly or less, weekly, daily, none) and modes of use during the year before pregnancy (smoke, vape, edibles, dabs). Mode was categorized as no cannabis use, only smoking, only vaping, only dabbing, only edibles, or multiple modes. Results:Of 159,270 pregnancies among 130,712 women (mean age of 31.8 [SD = 5.2]), 16.6% used cannabis during the year before pregnancy (4.4% only smoked, 1.0% only vaped, 0.1% only dabbed, 3.8% only used edibles, and 7.2% used multiple modes); 908 (0.6%) had a CUD diagnosis in the year before pregnancy. Compared to no cannabis use, use of multiple modes was associated with the greatest CUD prevalence (adjusted prevalence ratio, aPR:11.11, 95% CI: 9.09-13.58), followed by only smoking (aPR:10.10, 95% CI: 8.11-12.58), only dabbing (aPR: 8.99, 95% CI: 3.98-20.30), only vaping (aPR: 5.03, 95% CI:3.04-8.33), and only using edibles (aPR:3.21, 95% CI: 2.15-4.79). Comparing modes, only smoking was associated with greater CUD than only vaping (aPR 2.01, 95% CI: 1.22-3.30) and only using edibles (aPR 3.15, 95% CI: 2.11-4.70); and only dabbing was associated with greater CUD prevalence than only using edibles (aPR 2.80, 95% CI: 1.15-6.82). Conclusions:Use of multiple cannabis modes and use of smoked or dabbed modes, compared with edibles or vaping, were associated with a higher prevalence of preconception CUD.
Objective: To explore practices and perspectives of perinatal providers related to cannabis use during pregnancy and postpartum. Method: A mixed methods approach was employed using data collected from 18 perinatal providers practicing in the United States. Results: Most (72%) providers surveyed conduct universal evidence-based screening for perinatal cannabis use. Providers report these conversations are important and relevant, but only 55% report comfort with the topic. Four higher-order themes and five sub-themes emerged to further describe providers experiences of these conversations, including barriers and beliefs. Conclusions: Providers believe conversations about peripartum cannabis use are important, but describe needing additional support navigating up-to-date information, legal statues, and patient perceptions.
Objective: Scientific and medical sources continue to be outpaced by the burgeoning cannabis marketplace regarding emerging forms of cannabis, leaving consumers with a great deal of uncertainty about safety and efficacy that may be addressed in cannabis dispensary and online settings. The present study examines how cannabis dispensary staff ("budtenders") use and evaluate the trustworthiness of online information about cannabis, especially social media content. Method: Qualitative semi-structured interviews were conducted with San Francisco Bay Area budtenders (n = 18) and analyzed thematically. Results: Social media was not viewed as a reliable information source for dispensary-based social interactions. Budtenders were skeptical of most commercially-oriented social media content and frustrated with inconsistent content moderation practices of social media platforms. Budtenders instead preferred offline information sources and relationships, as well as information derived from first and secondhand experiences with cannabis products. When evaluating information on social media, online settings promoting privacy, community moderation, and accountability were seen as features of trustworthy environments. Budtenders also expressed a range of confidence in medical, natural healing, and personal experience frameworks of health and cannabis knowledge production; concordance of social media content with these frameworks was an additional signal of trustworthy information. Conclusions: This research highlights the role of budtenders in evaluating and triangulating emerging online cannabis information sources for consumers and the varied features and signals that cue budtenders to consider some online information as more trustworthy and credible for cannabis consumers.
Objective: Current methods of assessing cannabis-related attentional bias such as modified Stroop tasks are characterized by several limitations, including low reliability. The goal of the present study was to explore the reliability and utility of a novel methodological tool that is a proxy for eye-tracking- MouseView.js-to examine cannabis-related attentional bias. Method: Canadian postsecondary students (N = 580) freely viewed 30 image pairs of neutral and cannabis stimuli using MouseView.js. Participants also completed self-report measures of cannabis use, including problematic cannabis use. Reliability coefficients (Cronbach's alpha and split-half) were calculated to estimate the internal consistency of cannabis images, neutral images, and dwell difference scores. A hierarchical testing strategy was used to examine whether image (neutral vs. cannabis) and cannabis use status (non-use, recreational use, problematic use), as well as the interaction between image and cannabis use status, explain variation in dwell times. Results: A total of 368 participants (64.4%) did not use cannabis, 138 (23.8%) used cannabis recreationally, and 74 (12.8%) used cannabis at problematic levels. The reliability estimates for cannabis images, neutral images, and attentional bias scores ranged from acceptable to excellent. There was a main effect of image, such that all participants spent more time viewing cannabis relative to neutral images, indicative of an attentional bias. The main effects for cannabis use status and interactions between cannabis use status and image type were not statistically significant. Conclusions: Taken together, the present findings suggest MouseView.js may be a reliable method to assess cannabis-related attentional biases.
Objective: As medical cannabis (MC) legalization expands across the United States, understanding the factors shaping healthcare students' support for its use is essential to informing educational practices and reducing stigma in clinical care. Method: This secondary analysis examined factors associated with students' support for medical cannabis use (SFMCU), including clinical experience, personal cannabis use, demographic characteristics, and variation across patient vignettes. Participants (N = 349) were recruited from sciences and healthcare majors at multiple higher education institutions. SFMCU was measured using four clinical vignettes, and linear mixed-effects modeling was employed to account for both within-and between-subject variability. Results: Students with clinical experience demonstrated significantly lower SFMCU compared to those without such experience (p < .001). Personal cannabis use was also associated with higher SFMCU, with users reporting greater support than non-users (p < .001). Older age and male gender predicted higher SFMCU (p < .05). Support varied by vignette type, with participants reporting greater SFMCU for post-traumatic stress disorder and insomnia compared to depression (p < .001). Conclusions: Findings indicate that clinical experience, personal cannabis use, and demographic factors each influence students' attitudes toward MC. Students with healthcare experience exhibited lower support, possibly reflecting exposure to traditional medical norms or institutional stigma. These results underscore the need to integrate evidence-based MC education into healthcare curricula to enhance student knowledge, address misconceptions, and prepare future professionals to engage in informed, stigma-free patient care.
Objective: Motivational models of cannabis use, amongst other substances, suggest that individuals are driven to use it to achieve variable personally important outcomes. Understanding individuals’ personal motivations for cannabis use is essential to screen for problematic use and intervene where appropriate. Importantly, more research is needed to understand how individuals transition from recreational to problematic use, as well as maintenance factors. As such, the use of psychometrically sound measures of motives for cannabis use is necessary, particularly in populations of individuals with anxiety and related disorders (ARDs), where there is a high rate of cannabis use. Method: We examined the factor structure of the Marijuana Motives Measure (MMM) to confirm its structural validity in a clinical sample. Treatment-seeking adults from an outpatient anxiety clinic in Canada (N = 253) completed the MMM and several symptom questionnaires. Results: Confirmatory factor analysis exhibited strong fit indices and good internal consistency across subscales ranging from .88-.93. Significant positive correlations were observed amongst most subscale pairs, the highest between expansion and coping (cor = 0.78). Scores on a measure of cannabis use disorder symptoms showed the strongest association with the coping subscale (τ = 0.54). Conclusions: The MMM demonstrated structural and convergent validity in this sample, adding evidence supporting its use in an adult, treatment-seeking population with ARDs.
Objective: This study examined cannabis use and motives (i.e., medical, non-medical ['recreational']) for first use and current use among young adult cancer survivors (ages 18-39). Method: We analyzed 2024 baseline survey data from 155 young adult cancer survivors (Mage = 32.89 [SD = 4.89], 87.7% female, 81.9% White, M = 1.34 [SD = 1.04] years post-treatment) regarding cannabis use, use motives (i.e., medical, nonmedical), use characteristics (e.g., frequency/mode), and quality of life (PROMIS). Analyses characterized participants by lifetime use, past-month use, and first use for medical or non-medical purposes; multivariable binary logistic regression assessed correlates of past-month cannabis use among all participants and among those reporting lifetime use, respectively. Results: Of those reporting lifetime use (n = 68, 43.9%), 48 (70.6%) first used for non-medical purposes and 18 (26.5%) for medical. Among those reporting past-month use (n = 41, 26.5%), 4 (9.8%) used for only medical purposes, 12 (29.3%) primarily medical but some non-medical, 6 (14.6%) equally medical/non-medical, 6 (14.6%) primarily non-medical but some medical, and 4 (9.8%) only non-medical. Common reasons for first and current medical use included pain, insomnia, anxiety, and nausea. Past-month use among all participants was associated with less advanced cancer stage, treatment involving chemotherapy, and greater anxiety symptoms. Among those reporting lifetime use, past-month use was also associated with first using for non-medical purposes. Conclusions: A large proportion of young adult survivors first used cannabis for non-medical purposes but also reported medical use. It is crucial to understand use motives and trajectories over time to identify those who may benefit from medical use or face use-related harms.
Objective:Cannabis and alcohol are among the substances most frequently used by adolescents. Adolescents also frequently co-use these substances, with use of alcohol predicting subsequent initiation of cannabis use, and vice-versa. Minimal research has explored adolescents' attitudes towards cannabis use qualitatively, and how these attitudes may directly/indirectly relate to attitudes towards alcohol use and vice versa. Method:Forty U.S. adolescents (MAge = 16.68, SD = 0.86) who had recently completed a study reporting their in-vivo exposure to substance use content in media completed follow-up interviews focused on substance depictions in media and attitudes towards substance use. Interviews were individual, semi-structured, and approximately one hour long. A priori codes were derived from the interview agenda. Interviews were transcribed and qualitatively coded by a team of three graduate students. Percent agreement across coders was 80%, suggesting substantial agreement. Results:Several themes emerged from analysis. Most adolescents reported that their approval/disapproval of cannabis use was contingent on several factors including legality, age, degree of use/problematic use, and purpose (i.e., medicinal/recreational). Participants more commonly endorsed cannabis use as more acceptable than alcohol. Common reasons for this comparative approval included perceived social and health impacts (e.g., alcohol poisoning, liver disease), perceived addictive potential, and different effects of intoxication. Conclusions:Results of the present study provide rich context to recent trends in adolescent cannabis and alcohol use and perceptions, as well as co-use and abstention. Understanding teens' attitudes towards substance use may be beneficial in developing appropriate substance prevention and intervention strategies (e.g., effectively communicating health risks of cannabis use).
