Theoretical understanding of contextual motivations for sustained adolescent marijuana use in South Africa

Background: Although various reasons for adolescent marijuana use have extensively been explored, contextual factors that sustain the practice in settings where the plant is illegally cultivated, especially in South Africa, remain a grey area.Aim: We aimed to explore the contextual factors of sustained adolescent marijuana use in two illicit marijuana-growing settings of the Ingquza Hill Local Municipality of South Africa, based on the differential opportunity theory (DOT) and subcultural theory (SCT).Setting: The study was conducted in two illicit marijuana-growing communities in the Ingquza Hill Local Municipality of the Eastern Cape Province of South Africa.Methods: Exploratory qualitative research, using focus group discussions approach, was conducted amongst 37 participants, four focus groups and in two communities in the Ingquza Hill Municipality of the Eastern Cape Province of South Africa. Purposive and snowball sampling techniques were used to select the communities and participants, respectively. The data were analysed using a thematic content analysis approach and presented under various themes.Results: Nine themes, grouped under two broad factors, DOT influences (availability and affordability of marijuana, idleness and means of dealing with personal problems) and SCT influences (peer conformity, the pleasure derived from marijuana smoking, manipulation of appetite, health reasons, for higher cognitive function and addiction), emerged from the analysis.Conclusion: As marijuana has been identified to be a gateway drug for the use of other illicit drugs, its sustained usage amongst adolescents poses a health challenge to the user, community and the country’s healthcare system at large. Hence, there is the need to intensify adolescent marijuana use prevention campaigns in illicit marijuana-growing contexts of South Africa, focussing on the differential opportunities and subcultural inclinations that promote the behaviour in those contexts.

Changes in Late Adolescent Marijuana Use During the COVID-19 Outbreak Vary as a Function of Typical Use

Adolescent marijuana use is a significant public health concern given that many individuals first begin using during this developmental period and an earlier age of onset is prospectively associated with numerous marijuana misuse outcomes. The outbreak of COVID-19 has resulted in stay-at-home orders and social distancing guidelines across the United States. For many adolescents, these orders resulted in a number of changes that could alter one’s marijuana use including changes to marijuana availability, parental supervision, amount of free time, and stress levels. Despite these possible changes, the impacts of the COVID-19 outbreak on adolescent marijuana use are unknown. The aims of this analysis were to 1) assess changes to marijuana use among late adolescents related to the COVID-19 outbreak, and 2) examine whether these changes vary as a function of one’s pre-COVID-19 levels of use. Data described here come from a screening survey for a larger study which was completed by 156 adolescents (ages 14-18, 78% male) after the stay-at-home order was put in place in Washington state on March 23rd, 2020. All participants completed a self-report questionnaire that included demographic information, marijuana use, and changes to marijuana use following the state’s stay-at-home order. In the sample, 55 participants described themselves as never having tried marijuana, and none of these participants reported having used during the COVID-19 outbreak. Of the 101 participants who reported any prior marijuana use, 44 reported stopping or decreasing their use as a result of COVID-19, 30 reported using similar amounts as before, and 27 reported increased marijuana use as a result of COVID-19. A chi-square test of independence revealed that changes in use significantly varied as a function of pre-COVID-19 levels of use, X2 (2, N = 98) = 29.79, p < .001. The odds of irregular and light marijuana users decreasing their use was 13.73 times higher than moderate and heavy users. Moderate and heavy users had higher odds of maintaining their current use (5.04 times higher) and increasing their use (3.07 times higher) compared to irregular and light users during the COVID-19 outbreak. Primary reasons given for decreasing use included decreased availability and less socialization. Primary reasons for increasing use included more free time, fewer responsibilities, and coping with stress and anxiety. The findings suggest that although marijuana use may appear to decrease on average across a range of late adolescents that vary according to their regular use, these decreases are not likely among moderate and heavy users who may actually be at increased risk of marijuana misuse during the COVID-19 outbreak.

Genotype–environment correlation by intervention effects underlying middle childhood peer rejection and associations with adolescent marijuana use

Aggressive behavior in middle childhood can contribute to peer rejection, subsequently increasing risk for substance use in adolescence. However, the quality of peer relationships a child experiences can be associated with his or her genetic predisposition, a genotype–environment correlation (rGE). In addition, recent evidence indicates that psychosocial preventive interventions can buffer genetic predispositions for negative behavior. The current study examined associations between polygenic risk for aggression, aggressive behavior, and peer rejection from 8.5 to 10.5 years, and the subsequent influence of peer rejection on marijuana use in adolescence (n = 515; 256 control, 259 intervention). Associations were examined separately in control and intervention groups for children of families who participated in a randomized controlled trial of the family-based preventive intervention, the Family Check-Up . Using time-varying effect modeling (TVEM), polygenic risk for aggression was associated with peer rejection from approximately age 8.50 to 9.50 in the control group but no associations were present in the intervention group. Subsequent analyses showed peer rejection mediated the association between polygenic risk for aggression and adolescent marijuana use in the control group. The role of rGEs in middle childhood peer processes and implications for preventive intervention programs for adolescent substance use are discussed.

Adolescent Marijuana Use in the United States and Structural Breaks: An Age-Period-Cohort Analysis, 1991 to 2018

To investigate temporal patterns, socio-demographic gradients, and structural breaks in adolescent marijuana use in the United States from 1991 to 2018, we used hierarchical Age-Period-Cohort logistic models to separate temporal effects of marijuana use among 8th, 10th, and 12th graders from 28 waves of the Monitoring the Future survey. Structural breaks in period effects were further detected via a dynamic-programing-based method. Net of other effects, we found a clear age-related increase in the probability of marijuana use (10.46%, 23.17%, and 31.19% for 8th, 10th and 12th graders, respectively). Period effects showed a substantial increase over time (from 16.23% in 2006 to 26.38% in 2018), while cohort effects remained stable over the period of study. Risk of adolescent marijuana use varied by sex, racial group, family status, and parental education. Significant structural breaks during 1995–1996, 2006–2008, and 2011–2013 were identified in sub-populations. A steady increase in marijuana use among adolescents over the latter years of this time period was identified. Adolescents who were male, non-Black, lived in non-intact families, and who had less educated parents were especially at risk of marijuana usage. Trends of adolescent marijuana use changed significantly during times of economic crisis.