“If You Need to Light Up … You Gotta Do What You Gotta Do”: A Qualitative Study of Adolescent Attitudes Towards Cannabis Use and Comparison with Alcohol Attitudes

Abstract

Objective: Cannabis and alcohol are among the substances most frequently used by adolescents. Adolescents also frequently co-use these substances, with use of alcohol predicting subsequent initiation of cannabis use, and vice-versa. Minimal research has explored adolescents’ attitudes towards cannabis use qualitatively, and how these attitudes may directly/indirectly relate to attitudes towards alcohol use and vice versa.  Method: Forty U.S. adolescents (M_Age = 16.68, SD = 0.86) who had recently completed a study reporting their in-vivo exposure to substance use content in media completed follow-up interviews focused on substance depictions in media and attitudes towards substance use. Interviews were individual, semi-structured, and approximately one hour long. A priori codes were derived from the interview agenda. Interviews were transcribed and qualitatively coded by a team of three graduate students. Percent agreement across coders was 80%, suggesting substantial agreement. Results: Several themes emerged from analysis. Most adolescents reported that their approval/disapproval of cannabis use was contingent on several factors including legality, age, degree of use/problematic use, and purpose (i.e., medicinal/recreational). Participants more commonly endorsed cannabis use as more acceptable than alcohol. Common reasons for this comparative approval included perceived social and health impacts (e.g., alcohol poisoning, liver disease), perceived addictive potential, and different effects of intoxication. Conclusions: Results of the present study provide rich context to recent trends in adolescent cannabis and alcohol use and perceptions, as well as co-use and abstention. Understanding teens’ attitudes towards substance use may be beneficial in developing appropriate substance prevention and intervention strategies (e.g., effectively communicating health risks of cannabis use).