Direct and indirect effects of cannabis risk perceptions on cannabis use frequency

Abstract

Background

Perceived risk of harm associated with cannabis use has decreased in recent decades, particularly among emerging adults who show the highest prevalence of use. Cannabis-related protective behavioral strategies (PBS) are associated with lower cannabis use and fewer consequences; however, individuals who perceive using cannabis as low risk may use cannabis PBS less often. Therefore, using cross-sectional data, we examined the associations between perceived risk of harm associated with cannabis use, cannabis PBS, and cannabis use frequency.

Method

Participants were 146 emerging adults between the ages of 18–25 (56.2% female) who reported consuming cannabis at least 3 times/week and completed measures of past-month cannabis use, past three-month use of cannabis PBS, and perceived risk of harm associated with cannabis use. Path analyses examined direct and indirect effects of perceived risk of cannabis-related harm on cannabis frequency through cannabis PBS.

Results

Most (66.4%) participants reported no perceived risk of harm associated with occasional cannabis use, whereas 30.1% reported no perceived risk of harm associated with regular cannabis use. Findings indicated a significant indirect effect between perceived risk of harm and cannabis use frequency through cannabis PBS, b = −10.23, SE = 3.80, 95% CI [−17.67, −2.80], p = .007.

Conclusions

Among emerging adults who consume cannabis regularly, findings suggest that a greater perceived risk of cannabis-related harm is associated with decreased cannabis use frequency via increased use of cannabis PBS. Although future analyses evaluating causal mechanisms are needed, these findings have clinical implications for harm reduction interventions focused on cannabis use. Trial Registration: The parent study from which these data were drawn was preregistered at Clinical Trials.Gov NCT04187989.

Keywords:

• Cannabis
• emerging adults
• protective behavioral strategies
• risk perception

Ethical approval

The University of Michigan Institutional Review Board approved all study procedures.

Disclosure statement

The authors do not have any personal financial interests related to this manuscript, with the following exceptions: MW is a minor shareholder in Facebook and has a conflict-of-interest plan approved by the University of Michigan. SY is an advisor to Grassp and Radicle Sciences, startup companies conducting research in the cannabis space and has received an unrestricted gift from Facebook, on file with the University of California, Irvine.

Additional information

Funding

This work was funded by the National Institute on Drug Abuse [R34DA045067; PI: Bonar]. ARF’s time was supported by the National Institute on Alcohol Abuse and Alcoholism [T32AA007477; PI: Blow]. These funders had no role in the study design, execution, analysis, reporting of results, or the decision to submit the paper for publication.