Cannabis use characteristics and associations with problematic use outcomes, quitting-related factors, and mental health among US young adults

Carla J. Berg, Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA. carlaberg@gwu.edu.
Cassidy R. LoParco, Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA.
Katelyn F. Romm, TSET Health Promotion Research Center, Stephenson Cancer Center; Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
Yuxian Cui, Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA.
Darcey M. McCready, Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA.
Yan Wang, Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA.
Y Tony Yang, George Washington Cancer Center, George Washington University, Washington, DC, USA.
Hannah S. Szlyk, Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA.
Erin Kasson, Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA.
Rishika Chakraborty, Center for Health Policy and Media Engagement, School of Nursing, George Washington University, Washington, DC, USA.
Patricia A. Cavazos-Rehg, Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA.

Document Type

Journal Article

Publication Date

1-11-2025

Journal

Substance abuse treatment, prevention, and policy

Volume

20

Issue

1

DOI

10.1186/s13011-025-00634-0

Keywords

Cannabis; Epidemiology; Marijuana; Problematic use; Risk factors

Abstract

OBJECTIVE: Given the changes in trends of cannabis use (e.g., product types), this study examined latent classes of young adult use and associations with use-related outcomes. METHODS: We analyzed 2023 survey data among 4,031 US young adults (M=26.29, 59.4% female, 19.0% Hispanic, 13.5% Black, 13.6% Asian). Among those reporting past-month use (48.8%), latent class analysis (LCA) indicators included: days used (1-5; 6-20; 21-30), use/day (1; 2-4; ≥5), and type usually used (herb/flower; edibles; oils/vape; concentrates/other). Multivariable regressions examined class in relation to problematic use, quitting-related factors, and mental health, controlling for sociodemographics and state non-medical cannabis laws. RESULTS: LCA identified 4 classes of cannabis use frequency and types used: 'infrequent-herb/edibles' (41.4%), 'frequent-herb' (16.8%), 'moderate-herb' (28.0%), and 'moderate-oil/other' (13.8%). In multivariable analyses (referent group: 'moderate-herb' class), 'frequent-herb' reported less problematic use (B=-0.18, 95%CI=-0.30, -0.07), while 'moderate-oil/other' reported greater (B = 0.39, 95%CI = 0.27, 0.51). 'Infrequent-herb/edibles' had lower odds of driving post-use of cannabis (aOR = 0.28, 95%CI = 0.22, 0.37) and cannabis/alcohol (aOR = 0.52, 95%CI = 0.35, 0.76), whereas 'frequent-herb' (aOR = 1.52, 95%CI = 1.02, 2.28) and 'moderate-oil/other' (aOR = 3.98, 95%CI = 2.72, 5.82) reported greater odds of driving post-cannabis/alcohol use. 'Moderate-oil/other' reported higher quitting importance (B = 0.59, 95%CI = 0.17, 1.01), while 'frequent-herb' reported lower (B=-0.33, 95%CI=-0.99, -0.18). 'Infrequent-herb/edibles' reported higher quitting confidence (B = 0.56, 95%CI = 0.20, 0.92), whereas 'frequent-herb' (B=-1.01, 95%CI=-1.45, -0.57) and 'moderate-oil/other' (B=-1.27, 95%CI=-1.74, -0.81) reported lower. 'Infrequent-herb/edibles' reported fewer mental health symptoms (B=-0.55, 95%CI=-0.93, -0.17), while 'moderate-oil/other' reported more (B = 1.03, 95%CI = 0.53, 1.52). CONCLUSIONS: Preventing frequent and moderate use of cannabis, particularly of oils/concentrates, is crucial given the potential negative implications for problematic use, quitting, and mental health.

Department

Prevention and Community Health

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