To use or not to use? An exploration of cannabis use motives and constraints Dr Liz Temple etemple3@une.edu.au

Why this topic? Changes in legal status of cannabis use Decriminalisation/legalisation (medicinal vs. recreational) Increased availability of cannabis and cannabis products Possible impacts of increased access Increased use by current users? Increased number of users? Earlier initiation of use? More problematic use? Depends on why people choose to use or not use

Three studies Study 1: Initiation of cannabis use Study 2: Motives for current cannabis use Study 3: Constraints on cannabis use

Study 1 Initiation of cannabis use Methodology anonymous online questionnaires recruitment through online forums, social media, university student samples Participants 945 adults (63% male) 18-73 years (M=29.6; SD = 11.7) used cannabis at least once in their life Context of first cannabis use mean age at first use: 16 years (SD = 3.09) 85% used with friend/s; sibling (4%), boy/girlfriend (4%) at friend’s home (35%), public space (21%), or in own home (18%)

Access vs. Interest Prior to Initiation of Use All (N = 870) Age at first use Subsequent daily use <16 yrs (N = 415) 16+ yrs (N = 455) Yes (N = 564) No (N = 216) No Access 59 % No interest 26 % 27 % 28 % Concerned 6 % 5 % 7 %  7 % Wanted to 32 % 22 % 29 % 21 % Access 16 % 19 % 4 % 12 % No knowledge 11 % 13 % 9 % Age at 1st use: 2(6, N=870) = 24.4, p <.001 Daily Use: 2(6, N=870) = 17.6, p =.007

Motives/Affect Associated with Initiation of Use All (N = 945) Age at first use Subsequent daily use <16 yrs (N = 415) 16+ yrs (N = 455) Yes (N = 564) No (N = 216) Planned 1st use 58 % 57 % 59 % 61 % 52 %  Motive/Affect   Curious 79 % 80 % 78 % 77 % Excited 49 % 51 % 48 % 53 % 40 % Happy 30 % 32 % 27 % 33 % 21 % Unsure 22 % Worried 13 % 12 % 14 % Pressured 4 % 5 % 3 % 6 % Planned 1st use: 2(1, N=870) = 6.0, p =.015 Excited: 2(1, N=870) = 13.9, p <.001 Happy: 2(1, N=870) = 14.7, p <.001

Study 1 Key Findings Access vs. Interest Prior to Initiation of Use Lack of access (obviously) delays initiation of cannabis use But, lack of interest in using is a stronger preventative Concern about negative effects is not a particularly strong preventative (& may backfire) Motives/Affect associated with Initiation of Use Curiosity is the primary motivation for initial use No differences associated with being younger/older at initiation Planned initiation, being excited and happy about use are associated with subsequent daily use

Study 2 Motives for cannabis use Methodology anonymous online questionnaires recruitment through online forums, social media, university student samples Participants 978 adults (60% male) aged 18-68 (M=28.9; SD = 10.9) had used cannabis within the previous 12 months Cannabis use mean age at first use: 16 years (SD = 3.39) 34 % use daily/most days; 22% weekly; 18% monthly; 26% < monthly 17% dependent (Severity of Dependence Scale)

Main Reason for Use All (N = 904) Daily/near daily use Dependent Yes No (N = 588) (N = 159) (N = 740) To relax 33 % 34 % 29 % 35 % To socialise 14 %  6 % 18 % 15 % 9 %  To have fun 27 % 36 % Relieve pain 9 % 10 % Relieve distress 5 % 3 % 12 % 4 % Help sleep 11 % Daily/near daily use Dependent To relax: ns ns To socialise: 2(1, N=904) = 23.4, p <.001 ns To have fun: 2(1, N=904) = 8.7, p =.003 ns Relieve pain: 2(1, N=904) = 21.9, p <.001 ns Relieve distress: 2(1, N=904) = 13.2, p <.001 2(1, N=904) = 17.6, p <.001 Help sleep: 2(1, N=904) = 14.8, p <.001 2(1, N=904) = 8.5, p =.003

Demographic & patterns of use differences % Male Age (M & SD) Age 1st use % Use alone Usual level intoxication To relax 63 % 31 (11.2) 16.3 39 % 2.2 (1.0) To socialise 56 %  26 (8.8) 16.7 16 % 2.3 (1.0) To have fun 73 % 27 (10.8) 15.8 33 % 2.6 (1.1) Relieve pain 53 % 36 (12.9) 16.2 66 % 2.0 (1.2) Relieve distress 41 % 28 (9.5) 15.4 64 % 2.1 (1.0) Help sleep 40 % 27 (9.0) 15.6 43 % 2.7 (1.2) Daily/near daily 62 % 31 (11.3) 56 % 2.4 (1.2) Dependent 55 % 27 (8.6) 52 % 2.7 (1.1) Reasons for Use Daily/near daily Dependent % Male: p <.001 ns ns Age: p <.001 p <.001 p =.015 Age 1st Use: ns p <.001 p =.019 Use alone: p <.001 p <.001 p <.001 Intoxication: p <.001 ns p <.001

Study 2 Key Findings Reasons for Use Most common reasons given for use are to relax or have fun Daily/near daily users differ from less frequent users on most reasons for use Dependent users more likely to use to relieve psychological distress and help sleep than non-dependent users, but otherwise similar Differences associated with Reasons for Use To relax: older, more male, lower intoxication, sometimes use alone To socialise: youngest, mod intoxication, rarely use alone To have fun: younger, mostly male, higher intoxication, sometimes use alone Relieve pain: oldest, lower intoxication, mostly use alone Relieve distress: more female, lower intoxication, mostly use alone Help sleep: younger, more female, higher intoxication

Study 3 Constraints on cannabis use Methodology anonymous online questionnaires recruitment through online forums, social media, university student samples Participants 451 adults (69% female) aged 18-87 (M=34.3; SD = 12.9) General population (i.e., users & non-users) Cannabis use 38% had never used cannabis, 28% had used, but not in past 12 months, 34% were current users mean age at first use: 17 years (SD = 4.4) 31 % of current users use daily/most days & 19% dependent (Severity of Dependence Scale)

Constraints on cannabis use Based on Richard Hammersley’s Constraint Theory Hammersley, R. (2014). Constraint theory: A cognitive, motivational theory of dependence, Addiction Research & Theory, 22(1) Morals: 8 items; α = .92; “It’s against my family’s religion” Others: 7 items; α = .91; “My family disapproves of cannabis use” Lifestyle: 7 items; α = .92; “My schedule limits when I can use cannabis” Social: 6 items; α = .92; “I do not know many people who use cannabis” Effects: 5 items; α = .90; “I have experienced effects of use that were unpleasant” Stress/Other: 10 items; α = .95; “I have found better ways to relax” Like Effects: 5 items; α = .88; “I appreciate it more if I don’t take it all the time” Health: 5 items; α = .86; “Smoking is bad for my health” Dependence: 6 items; α = .90; “I do not want to become addicted to cannabis” Legal: 5 items; α = .88; “I’m worried about getting in trouble with the law if caught” Availability: 6 items; α = .93; “I have to travel too far to get cannabis” Cost: 7 items; α = .92; “Cannabis is too expensive” Self Beliefs: 6 items; α = .93; “I think it is irresponsible for me to use cannabis”

Never Used (N = 146) Past Use (N = 121) Current Use (N = 148) Significance Morals 1.5 (1.4) 1.5 (1.0) 1.6 (0.6) ns Others 1.3 (1.4) 1.6 (1.2) 2.1 (0.8) <.001 Lifestyle 1.2 (1.2) 2.1 (1.4) 2.5 (0.8) Social 0.9 (0.9) 1.5 (1.2) Effects 0.6 (0.9) 2.0 (1.3) 2.3 (0.8) Stress/Other 0.8 (0.8) 1.4 (0.9) 2.1 (0.7) Like Effects 0.7 (1.0) 1.4 (1.2) 2.6 (0.9) Health 1.4 (1.0) 2.0 (1.2) 2.2 (0.8) Dependence 2.1 (0.9) Legal 1.0 (1.1) 1.4 (1.1) 1.9 (0.8) Availability 0.9 (1.0) 1.3 (1.1) 1.7 (0.7) Cost 2.4 (0.7) Self Beliefs 2.6 (1.2) .001

Daily/near daily use (N = 44) Less frequent use (N = 104) Significance Morals 1.6 (0.5) 1.6 (0.6) ns Others 2.3 (0.7) 2.0 (0.9) .012 Lifestyle 2.2 (0.7) 2.6 (1.0) .015 Social 2.0 (0.5) 2.2 (0.8) Effects 1.8 (0.6) 2.5 (0.8) <.001 Stress/Other 2.4 (0.6) 2.1 (0.7) .016 Like Effects 2.9 (0.9) 2.5 (0.9) .004 Health Dependence 1.9 (0.7) Legal 1.8 (0.8) Availability Cost 2.4 (0.8) Self Beliefs 2.1 (0.8)

Dependent (N = 21) Non-dependent (N = 127) Significance Morals 1.7 (0.5) 1.6 (0.6) ns Others 2.6 (0.6) 2.0 (0.8) .002 Lifestyle 2.8 (0.6) 2.5 (1.0) Social 2.2 (0.5) 2.1 (0.8) Effects 2.1 (0.6) 2.3 (0.9) Stress/Other 2.4 (0.6) 2.1 (0.7) Like Effects 3.6 (0.7) 2.4 (0.9) <.001 Health 2.5 (0.7) Dependence 3.3 (0.8) 1.9 (0.7) Legal 1.8 (0.8) Availability 1.6 (0.4) 1.7 (0.8) Cost 2.4 (0.8) Self Beliefs 2.5 (0.6)

Study 3 Preliminary Findings Caveats Scale still in development Data collection on-going Constraints on Use Current Users differ from Past Users and Never Used groups on most constraints May be related to lack of applicability of some items to these groups Constraints appear associated more with regulation of Frequency of Use than of Dependence No differences at all on morals Strongest constraints: Never Used & Past Users: Self Beliefs Less Frequent & Non-dependent Users: Lifestyle Current, Daily/near daily & Dependent Users: Like Effects

Conclusions & Future Directions Controlling access to cannabis acts to delay early initiation of use, however, individuals’ lack of interest in using is a stronger factor how do we encourage this lack of interest? is it linked to Self Belief constraints? While there is some overlap, motives for use and constraints on use are more strongly associated with differences in frequency of use, than in dependence Why is this the case? Is this due to the strength of addiction process (e.g., habituation, withdrawal avoidance, etc.)? Reasons for use & non-use of cannabis are complex Environmental, social and individual factors at play As always, more research is needed