Multilevel associations of peer cognitive factors and adolescent cannabis use in a legal recreational cannabis region

Emily A Kenyon; Manshu Yang; Tammy Chung; Anna C Wilson; Sarah W Feldstein Ewing

doi:10.3389/fpsyt.2024.1477000

Multilevel associations of peer cognitive factors and adolescent cannabis use in a legal recreational cannabis region

Front Psychiatry. 2024 Nov 19:15:1477000. doi: 10.3389/fpsyt.2024.1477000. eCollection 2024.

Authors

Emily A Kenyon¹, Manshu Yang¹, Tammy Chung², Anna C Wilson³, Sarah W Feldstein Ewing⁴

Affiliations

¹ Department of Psychology, College of Health Sciences, University of Rhode Island, Kingston, RI, United States.
² Center for Population Behavioral Health, Rutgers the State University of New Jersey, New Brunswick, NJ, United States.
³ Department of Pediatrics, Oregon Health & Science University, Portland, OR, United States.
⁴ Departments of Psychiatry and Child Psychiatry, University of Connecticut School of Medicine, Farmington, CT, United States.

Abstract

Background: Cannabis use can have unintended, harmful consequences for adolescents, a developmental group that struggles with heightened pressure to align with peer attitudes and behaviors. The role of social-cognitive factors in shifting cannabis use dynamics remains under explored, particularly in states where recreational cannabis use is legal.

Objectives: The present study examined multilevel longitudinal associations between resistance to peer influence, peer norms, and adolescent cannabis use over the course of 12 months.

Method: Participants were N=204 adolescents ages 15-19 (M _age = 18.68; 67% female) recruited via community outreach after the legalization of adult (age 21+) recreational cannabis use in the Portland, Oregon metropolitan region. Eligible participants endorsed 1+ heavy episodic drinking (HED) episode in the prior two months. Data were collected across four timepoints over 12 months. Multilevel latent growth curve modeling investigated associations between time-varying cognitive factors (resistance to peer influence, peer norms) and two cannabis outcomes (hazardous use, past-month use).

Results: Findings showed individual increases in hazardous cannabis use over time were significantly associated with adolescents reporting higher peer norms (i.e., higher perceived prevalence and frequency of peer cannabis use) and lower resistance to peer influence. When assessing between-adolescent differences, hazardous cannabis use was only associated with peer norms. Individual variation over time and between-adolescent differences on past-month cannabis use was associated with peer norms, but not resistance to peer influence.

Conclusions: Evolving cognitive factors like resistance to peer influence and peer norms may enhance understanding of longitudinal changes in hazardous cannabis use among adolescents and implicate helpful targets for prevention and intervention. It is a public health priority to identify factors that contribute to adolescent use trajectories in this period of growing cannabis legislation in order to guide the development of impactful prevention and intervention strategies.

Keywords: adolescent; cannabis; longitudinal multilevel analysis; peer influence; peer norms; recreational cannabis legalization; social cognition.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. Funding for the parent study was provided by NIAAA (1R01AA023658-01; PI: SFE). This project was also supported by 1F31AA031163-01 (PI: EK). NIAAA had no role in the study design, collection, analysis, or interpretation of the data, writing the manuscript, or the decision to submit the paper for publication.