A longitudinal mediated examination of legal, commercial, and individual determinants of cannabis and derived cannabis use behaviors and consequences among US young adults

Authors

Cassidy R. LoParco, Department of Prevention and Community Health, Milken Institute School of Public Health, the George Washington University, Washington, DC, USA. Electronic address: Cassidy.LoParco@gwu.edu.
Matthew E. Rossheim, Department of Health Administration and Health Policy, College of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA.
Yan Wang, Department of Prevention and Community Health, Milken Institute School of Public Health, the George Washington University, Washington, DC, USA; George Washington Cancer Center, the George Washington University, Washington, DC, USA.
Y Tony Yang, George Washington Cancer Center, the George Washington University, Washington, DC, USA; Department of Health Policy and Media Engagement, School of Nursing, the George Washington University, Washington, DC, USA.
Nino Paichadze, Department of Global Health, Milken Institute School of Public Health, the George Washington University, Washington, DC, USA.
Patricia A. Cavazos-Rehg, Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA.
Carla J. Berg, Department of Prevention and Community Health, Milken Institute School of Public Health, the George Washington University, Washington, DC, USA; George Washington Cancer Center, the George Washington University, Washington, DC, USA.

Document Type

Journal Article

Publication Date

10-19-2025

Journal

Addictive behaviors

Volume

172

DOI

10.1016/j.addbeh.2025.108526

Keywords

Cannabis; Consequences; Delta-8; Marketing; Policy; Risk perceptions; Use motives

Abstract

BACKGROUND: Cannabis and derived intoxicating cannabis product (DICP; e.g., delta-8 tetrahydrocannabinol [THC]) use is increasing, particularly among young adults. We examined how state cannabis and DICP laws and cannabis advertisement exposure impact cannabis/DICP risk perceptions and use motives and how those, in turn, impact cannabis and DICP behaviors (use, frequency, intentions) and consequences. METHODS: We analyzed two waves (2023-2024) of longitudinal survey data among 3,437 US young adults ages 18-34 (∼50 % past-month cannabis use by design). Multivariable regressions assessed direct and indirect associations via parallel mediation. RESULTS: Participants in states with legal (vs. illegal) non-medical cannabis had lower DICP use motives, higher odds of cannabis-only use (vs. neither or both), and used cannabis more frequently; associations with use behaviors were mediated by cannabis/DICP motives and risk perceptions. More restrictive delta-8 THC laws were associated with higher odds of cannabis-only use (vs. neither or both). More digital cannabis ad exposure and less exposure to traditional/store-based ads were associated with lower risk perceptions and higher use motives, odds of cannabis/DICP use, use intentions, and consequences; associations were mediated by cannabis/DICP use motives and/or risk perceptions. Lower cannabis/DICP risk perceptions and higher use motives were associated with higher odds of using each respective substance, co-use, and intentions. Using cannabis/DICPs more frequently was associated with experiencing more cannabis consequences; cannabis/DICP frequency mediated associations of cannabis state laws, advertising exposure, and motives with cannabis consequences. CONCLUSIONS: These pathways underscore how laws and marketing shape use, supporting interventions targeting risk perceptions and motives to reduce harm.

APA Citation

LoParco, Cassidy R.; Rossheim, Matthew E.; Wang, Yan; Yang, Y Tony; Paichadze, Nino; Cavazos-Rehg, Patricia A.; and Berg, Carla J., "A longitudinal mediated examination of legal, commercial, and individual determinants of cannabis and derived cannabis use behaviors and consequences among US young adults" (2025). GW Authored Works. Paper 8261.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/8261

Department

Prevention and Community Health