Real-Time Antecedents of Cannabis Use Among Young Adults: An Ecological Momentary Assessment Study

Knowledge regarding in-the-moment antecedents of cannabis use is lacking. We examined internal (e.g., mood, cravings) and external (e.g., locations, people) antecedents of cannabis use among young adults regularly using both cannabis and tobacco. Over 30 days, 36 young adults (M_age = 24.2 years, 33% female, 8% nonbinary, 61% sexual minority, 44% Non-Hispanic White) completed multiple daily Ecological Momentary Assessment surveys, totaling 1,632 prompts. Generalized estimating equations estimated population-averaged relationships between the presence of antecedents and cannabis use outcomes (use vs. nonuse). Overall cannabis use was likelier at neutral ranges of affect (aOR = 0.95; 95% CI [0.91, 1.00]) and affective arousal (aOR = 1.52; 95% CI [0.91, 1.00], see Footnote 1), higher cannabis craving (aOR = 1.52; 95% CI [1.31, 1.76]), and substance intoxication (aOR = 1.25; 95% CI [1.01, 1.55]). Overall use was likelier at home (aOR = 1.97; 95% CI [1.16, 3.37]), and less likely in a place where cannabis smoking was forbidden (aOR = 0.46; 95% CI [0.25, 0.85]) or more people were present (aOR = 0.91; 95% CI [0.87, 0.96]). Other antecedents of use were seeing cannabis product packaging (aOR = 1.91; 95% CI [1.07, 3.39]) and experiencing racial/ethnic-based discrimination (aOR = 2.26; 95% CI [1.39, 3.69]). Future digital interventions for cannabis use will benefit from (a) testing real-time interactions between internal and external antecedents and (b) triggering interventions while users are at home alone, after discrimination experiences, and/or when feeling mild, neutral affect. Note: CIs containing 1.00 interpreted as statistically significant are due to having rounded up to the upper limit.