Young adults’ cannabis environments and their cannabis use and misuse

Objective: Considering the interplay between normative and legal aspects of young adults’ cannabis environments may help improve cannabis use and misuse prevention and harm reduction among young people.

Method: Data came from 3,818 U.S. young adults (average age 23 years, 𝑆𝐷=.49) living in diverse legal cannabis contexts (54.8% illegal, 17.7% medical legal, 27.8% nonmedical legal). Cannabis norms were measured by young adults’ perceptions of cannabis use and approval by parents, peers, spouse/partner, and community members. Logistic regressions estimated the separate, additive, and interactive associations of cannabis norms and legal permissiveness with young adults’ past-year cannabis use and misuse, adjusting for past cannabis use and norms and other covariates.

Results: Legal and normative permissiveness were highly correlated. However, only norms were independently associated with past-year cannabis use (adjusted odds ratio [AOR]=6.50, CI=[1.62,5.05]), frequent past-month cannabis use (AOR=5.58, CI=[3.94,7.92]), and cannabis use disorder (AOR=2.48, CI=[2.10,2.94]) when examined together. The association between cannabis norms and use did not differ by legal permissiveness.

Conclusions: Changing cannabis norms in young adults’ social environments beyond peers could be an impactful prevention and intervention strategy.