STASH, Vol. 21(5) – How do emerging adults perceive risks associated with cannabis use?

Editor’s note: Today’s review is part of our month-long Special Series on Education to Promote Lower-risk Drinking, Gambling, and Substance Use. Throughout May, The BASIS investigates the public’s awareness of, perceptions toward, and adherence to low-risk guidelines for alcohol and substance use and gambling.

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In Canada in 2022, emerging adults consumed more cannabis during the past year than any other age group. Cannabis use during emerging adulthood can hurt a person’s cognitive, physical, and mental health, but it seems that this age group does not fully realize these impacts or strategies to reduce them. The Lower-Risk Cannabis Use Guidelines (LRCUG) were developed to help individuals identify high-risk cannabis use behaviors and reduce their risk of cannabis-related harm. This week, as a part of our Special Series on Education to Promote Lower-risk Drinking, Gambling, and Substance Use, STASH reviews a study by Isobel McMahon and colleagues that explored whether emerging adults perceived cannabis consumption behaviors to be harmful to overall, cognitive, physical, and mental health.

What was the research question?
Do emerging adults perceive cannabis consumption behaviors to be harmful to overall, cognitive, physical, and mental health?

What did the researchers do?
The researchers created 5 sets of fictional stories, each depicting a 21-year-old recreational cannabis user. Each set of stories focused on one aspect of cannabis use: (1) frequency, (2) polysubstance use, (3) method of consumption, (4) family history of mental illness/substance use, or (5) cannabis strength. Within each set of stories, there were three versions that ranged from low to high risk. For instance, the three frequency-of-consumption stories depicted weekly, almost daily, or daily cannabis use. Then the researchers recruited 653 emerging adults (age 18-25) living in Canada through social media, email, and college campus outreach. Participants completed an online survey that included a randomly-assigned version of each story set, for a total of 5 stories. Participants rated the riskiness of the behaviors they read about on a scale from 0 to 4 (on overall and cognitive, physical and mental health). They also answered socio-demographic questions, like their awareness of the LRCUG. The researchers studied the perceived riskiness of each story version using a series of ANOVAs and ANCOVAs. Post hoc analyses were conducted to analyze group comparisons.

What did they find?
Only about 25% of participants were aware of the LRCUG. However, they seemed to have an implicit understanding of harmful cannabis behaviors (see Figure). More specifically, participants perceived (1) frequent consumption as riskier to overall, cognitive, physical, and mental health compared to less frequent consumption, (2) combining cannabis and tobacco as riskier to overall and physical health compared to cannabis alone (but saw no difference between combining cannabis and alcohol compared to cannabis alone), (3) using cannabis while having a family history of mental health/substance use as riskier to overall health compared to no family history, (4) smoking and vaping as riskier to overall and physical health compared to eating edibles, and (5) using cannabis with high THC/low CBD content as riskier to overall, cognitive, physical, and mental health compared to cannabis with low THC/high CBD content (but saw no differences in risk between the two high THC/low CBD strains).

Figure. Level of perceived riskiness of cannabis consumption behaviors on overall health. Click image to enlarge.

Why do these findings matter?
Emerging adults were able to identify some risks associated with cannabis use. Public health professionals can attempt to improve knowledge among emerging adults by developing educational campaigns structured around harm reduction approaches and the effects of cannabis use, such as the impact of higher THC strength and combining cannabis with alcohol.

Every study has limitations. What are the limitations in this study?
The recruitment strategies may have resulted in a sample with more knowledge about high-risk cannabis use compared to the general population. Although participants successfully identified risks of cannabis use, the effect sizes were small. Future research should evaluate at what point this awareness will lead to meaningful behavior change.

For more information:
If you are worried that you or someone you know is experiencing addiction, the SAMHSA National Helpline is a free treatment and information service available 24/7. For more details about addiction, visit our Addiction Resources page.

— Nakita Sconsoni, MSW

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