Showing papers by "Renee M. Johnson published in 2019"

Adolescent Marijuana Use, Marijuana-Related Perceptions, and Use of Other Substances Before and After Initiation of Retail Marijuana Sales in Colorado (2013-2015).

Abstract: Due to the recentness of changes to marijuana policies in a number of states, the effect on adolescent use and perceptions is not yet well understood. This study examines change in adolescent marijuana use and related perceptions in Colorado, before and after the implementation of legal commercial sale of recreational marijuana for adults starting on January 1, 2014. The data are from a repeated cross-sectional survey of a representative sample of Colorado high school students, with separately drawn samples surveyed in fall 2013 (prior to implementation) and fall 2015 (18 months after implementation). We examined change in the prevalence of adolescent marijuana use, measured by lifetime use, past 30-day use, frequent use, and use on school property. To consider the possibility of heterogeneity in the change in marijuana use, we examined change in past 30-day marijuana use by demographic characteristics (sex, grade, race/ethnicity), school characteristics (poverty, percent minority), urbanicity of the school district, and whether the city or county permitted retail marijuana stores. There was an absence of significant effects for change in lifetime or past 30-day marijuana use. Among those reporting past 30-day use, frequent use and use on school property declined. There was a significant decline in the perceived harm associated with marijuana use, but we did not find a significant effect for perceived wrongfulness, perceived ease of access, or perceived parental disapproval. We did not find significant variability in past 30-day use by demographic characteristics or by school and community factors from 2013 to 2015. We did not find a significant effect associated with the introduction of legal sales of recreational marijuana to adults in Colorado on adolescent (illegal) use, but ongoing monitoring is warranted, including consideration of heterogeneity in the effects of marijuana policies.

When Marijuana Is Used before Cigarettes or Alcohol: Demographic Predictors and Associations with Heavy Use, Cannabis Use Disorder, and Other Drug-related Outcomes.

Abstract: Recent loosening of state and federal policy restrictions on marijuana, along with changes in social norms regarding marijuana use and decreases in prevalence of other types of substance use, may lead to increases in youth initiating marijuana before other types of substances such as alcohol and tobacco. We investigated predictors and potential consequences of initiating marijuana before other drugs for youth aged 12–21-years in the USA. Nationally representative, cross-sectional survey data from the US National Survey on Drug Use and Health supplied self-reported age of first marijuana, cigarettes, alcohol, other tobacco, and other illegal drug use among 12–21-year-old samples from 2004 to 2014 (n = 275,559). We first examined the degree to which initiating marijuana use first was associated with sex, age, race/ethnicity, and survey year. Then, we examined whether using marijuana first predicted heavy marijuana use, cannabis use disorder (CUD), alcohol use disorder (AUD), nicotine dependence (ND), or lifetime use of other illegal drugs. Among all survey youth (substance users and non-users), the proportion using marijuana first increased from 4.8 to 8.8% from 2004 to 2014. Those using marijuana first (vs. alcohol or cigarettes first) were more likely to be male and older and Black, American Indian/Alaskan Native, multiracial, or Hispanic than White or Asian. Among substance users and adjusting for age of onset and the number of substances used, using marijuana first was associated higher odds of heavy current marijuana use and CUD. In recent years, youth have been increasingly likely to use marijuana as their first drug and sequence of initiation is associated with race/ethnicity, gender, and age. Using marijuana first might increase the chance of heavy use and CUD.

Race/Ethnicity Differences in Trends of Marijuana, Cigarette, and Alcohol Use Among 8th, 10th, and 12th Graders in Washington State, 2004–2016

Abstract: Accurate estimates of substance use in the teenage years by race/ethnicity may help identify when to intervene to prevent long-term substance use disparities. We examined trends in past 30-day use of marijuana, cigarette, and alcohol among 8th, 10th, and 12th graders in Washington State, which passed a recreational marijuana law in 2012 and initiated retail marijuana sales in 2014. Data are from the 2004–2016 Washington Healthy Youth Surveys (n = 161,992). We used time series regression models to assess linear and quadratic trends in substance use for the full sample and stratified on race/ethnicity and grade level and examined relative differences in prevalence of use by race/ethnicity. In Washington, across all racial/ethnic groups, marijuana use peaked in 2012. Although there was not a significant overall change in marijuana use for the full sample across the study period, there was a statistically significant increase in use among 12th graders and a statistically significant decrease among 8th graders. Relative to Whites, Asians had a lower prevalence of marijuana use, whereas all other race/ethnicity groups had a higher prevalence of use. Prevalence of marijuana use is particularly high among American Indian/Alaska Native and Black youth and has increased most rapidly among 12th grade Hispanic/Latinx youth. There were large and statistically significant decreases in alcohol and cigarette use across the study period for the full sample, as well as for each race/ethnicity group. These findings highlight the need for continued monitoring of trends in use among these groups and potentially warrant consideration of selective interventions that specifically focus on students of color and that include developmentally-appropriate strategies relevant to each grade.

Marijuana Use among Adolescents and Emerging Adults in the Midst of Policy Change: Introduction to the Special Issue

Abstract: The marijuana policy landscape in the US has changed rapidly at the state level over the past 25 years. The first state-level medical marijuana law (MML) was passed in California in 1996, and the first laws legalizing marijuana for non-medical use for those over the age of 21 (i.e., Brecreational^ marijuana laws, RMLs)were passed in Colorado andWashington State in 2012. As of October 2018, 31 states and the District of Columbia have comprehensive MMLs and 9 of these states and the District of Columbia also have RMLs (National Conference of State Legislatures [NCSL] 2018). There have also been significant changes in marijuana policy in Canada andMexico, the countries that border the US. Canada legalized marijuana for non-medical use in 2018 (Bilefsky 2018), and Mexico legalized medical use of low-THC (i.e., < 1%) marijuana in 2017 (Hecht 2018). Developing a comprehensive understanding of marijuana use within the context of policy changes is a public health priority. Such research is particularly needed for adolescents and emerging adults because they have among the highest rates of marijuana use across the lifespan (Fig. 1), and because more than 80% of adults (aged 26 and older) who report past-year marijuana use initiated use by 21 years of age (Substance Abuse and Mental Health Services Administration [SAMHSA] 2018). With this special issue, we seek to advance prevention science research on marijuana use among adolescents and emerging adults. The 10 original articles in this issue describe patterns of use among young people and provide new information about associated risk and protective factors at multiple ecological levels (Brooks-Russell et al. 2019; Cavazos-Rehg et al. 2019; Fairman et al. 2019; Guttmannova et al. 2019a; Johnson et al. 2019; Mauro et al. 2019; Nguyen et al. 2019; Reboussin et al. 2019; Thompson et al. 2019; Wen et al. 2019). An additional commentary describes the importance of using existing data to characterize the epidemiology of marijuana use in response to state laws (Guttmannova et al. 2019b).

Using Existing Data to Advance Knowledge About Adolescent and Emerging Adult Marijuana Use in the Context of Changes in Marijuana Policies

Abstract: Innovative analysis of existing social science and behavioral data has the potential to advance our understanding of the epidemiology and etiology of marijuana and other substance use among adolescents and emerging adults, so as to inform future policy, prevention, and intervention efforts. In this commentary, we highlight two commonly used and publicly available datasets, the National Survey on Drug Use and Health (NSDUH) and the Youth Risk Behavioral Survey (YRBS), in order to describe their usefulness for evaluation of the effects of changes in marijuana policy on adolescent and emerging adult substance use and marijuana-specific risk factors. We use recent examples of trend and quasi-experimental studies to highlight the unique strengths of each dataset. We also describe their limitations, identify gaps in existing knowledge, and offer recommendations for future research to answer emergent questions about the changing legal, social, and normative context related to marijuana and contribute to prevention efforts aimed at reducing substance use and related health risk behaviors among youth.

Modes of Marijuana Consumption Among Colorado High School Students Before and After the Initiation of Retail Marijuana Sales for Adults.

Abstract: Objective:This study aimed to estimate the prevalence of different modes of marijuana consumption (e.g., smoking, ingesting) overall and by sociodemographic factors, marijuana-related perceptions, ...

The Impact of the Urban Neighborhood Environment on Marijuana Trajectories During Emerging Adulthood.

Abstract: Although there is little difference in rates of marijuana use between White and Black youth, Blacks have significantly higher rates of marijuana use and disorder in young adulthood. Theory suggests that factors tied to social disadvantage may explain this disparity, and neighborhood setting may be a key exposure. This study sought to identify trajectories of marijuana use in an urban sample during emerging adulthood, neighborhood contexts that predict these trajectories and social role transitions or "turning points" that may redirect them. Data are from a longitudinal cohort study of 378 primarily Black emerging adults who were first sampled in childhood based on their residence in low-income neighborhoods in Baltimore City and followed up annually. Group-based trajectory modeling identified three groups: No Use (68.8%), Declining Use (19.6%), and Chronic Use (11.7%). Living in close proximity to an alcohol outlet, and living in a neighborhood with more female-headed households and higher rates of violent crime increased the odds of membership in the Chronic Use group relative to No Use. Living in a neighborhood with more positive social activity increased the odds of membership in the Declining Use group relative to No Use. Not receiving a high school diploma or GED, pregnancy, and parenting also increased the odds of membership in the Declining Use group relative to No Use. These findings provide support that minority youth living in socially toxic and disordered neighborhoods are at increased risk of continuing on a trajectory of marijuana use during emerging adulthood while positive social activity in neighborhoods has the potential to redirect these negative trajectories. Besides taking on the responsibilities of parenting, emerging adults in the marijuana user groups had similar educational and family outcomes, suggesting that early marijuana use may have long-term implications.

Does Marijuana Use at Ages 16–18 Predict Initiation of Daily Cigarette Smoking in Late Adolescence and Early Adulthood? A Propensity Score Analysis of Add Health Data

Abstract: Given the declining trend in adolescent cigarette smoking and increase in general access to marijuana, it is important to examine whether marijuana use in adolescence is a risk factor for subsequent cigarette smoking in late adolescence and early adulthood. Preliminary evidence from a very small number of studies suggests that marijuana use during adolescence is associated with later smoking; however, to control confounding, previously published studies used regression adjustment, which is susceptible to extrapolation when the confounder distributions differ between adolescent marijuana users and non-users. The current study uses propensity score weighting, a causal inference method not previously used in this area of research, to weight participants based on their estimated probability of exposure given confounders (the propensity score) to balance observed confounders between marijuana users and non-users. The sample consists of participants of Add Health (a nationally representative dataset of youth followed into adulthood) who were 16–18, with no history of daily cigarette smoking at baseline (n = 2928 for female and 2731 for male sub-samples). We assessed the effect of adolescent marijuana use (exposure, ascertained at wave 1) on any daily cigarette smoking during the subsequent 13 years (outcome, ascertained at wave 4). Analyses suggest that for females (but not males) who used marijuana in adolescence, marijuana use increased the risk for subsequent daily smoking: OR = 1.71, 95% CI = (1.13, 2.59). We recommend that adolescent marijuana use be viewed as a possible risk factor for subsequent initiation of daily cigarette smoking in women.

Changes in Prevalence of Marijuana Consumption Modes Among Colorado High School Students From 2015 to 2017

Abstract: This study examines data from the Health Kids Colorado Survey to assess changes in modes of marijuana consumption among high school students in Colorado from 2015 to 2017.

Social Support Moderates the Negative Association Between Reduced Driving and Life Satisfaction in Older Adults.

Abstract: When older adults reduce their driving, there can be subsequent decreases in life satisfaction. In this cross-sectional study, we used baseline data from the multi-site Longitudinal Research on Aging Drivers (LongROAD) study to examine whether social support moderates the negative association between reduced driving and life satisfaction. The outcome variable was life satisfaction, and the main predictor variable was past-year reduced driving (yes/no). Emotional, instrumental, and informational social support were measured using PROMIS v2.0 (Patient-Reported Outcomes Measurement Information System) items. We used generalized linear regression models to examine how social support moderated the association between reduced driving and life satisfaction. Statistical adjustment for social support attenuated the negative effect of reduced driving on life satisfaction by ~10% for all three types of social support.

Pathways linking intergenerational cultural dissonance and alcohol use among Asian American youth: The role of family conflict, parental involvement, and peer behavior.

Abstract: A difference in degree of acculturation between immigrant parents and children, known as intergenerational cultural dissonance (ICD), is a risk factor for adolescent alcohol use. We used path analy...

Adult Mental Disorders in Association with Socioeconomic Position, Race/Ethnicity, and Sexual and Gender Minority Status

Abstract: This chapter presents information about differences in risk for mood, anxiety, and substance use disorders across three demographic factors that are tied to social disadvantage: socioeconomic position, race/ethnicity, and sexual and gender minority status. It summarizes key results from studies of the general population, and presents information on prevalence and risk based on our analyses of national data sets. Systematic population subgroup differences exist. Persons in low socioeconomic position and sexual and gender minorities have higher odds of mental and behavioral disorders. Findings for racial/ethnic minorities were mixed. Although several studies showing that Black and Hispanic people have lower risk than Whites for mood, anxiety, and substance use disorders, research also shows that disorders among these groups are more severe and more persistent.

Neighborhood context and transitions in marijuana use among urban young adults

Abstract: Background In emerging adulthood when many youth are maturing out of marijuana use, Blacks continue to have high rates of use and disorder. Theory suggests that factors tied to neighborhood disadvantage may partially explain this phenomenon but research is limited. Objectives This study examines the influence of neighborhood physical and social disorder on transitions in marijuana use during emerging adulthood in a low-income urban sample. Methods 379 primarily Black young adults residing in low-income neighborhoods in Baltimore City were followed-up annually from ages 18 to 21. Neighborhood environment was evaluated using a valid and reliable field-rater assessment of the residential block. Longitudinal latent class and latent transition analyses were performed. Results Fit indices supported three-classes of marijuana use: no use, infrequent use and frequent use. Between ages 18 and 21, young adults tended to transition toward lower levels of use. However, neighborhood physical disorder was associated with transitioning to increased marijuana use (no use to frequent use; AOR = 2.712; p = .023) while positive neighborhood social activity was associated with a decreased risk (AOR = 0.002; p = .013). Neighborhood social activity was also associated with decreases in use (frequent to infrequent use; AOR = 2.342; p = .020). Conclusions/Importance: These findings demonstrate that physical disorder within the context of a low-income urban neighborhood adversely impacts marijuana use. However, even in the presence of physical disorder, interventions that foster collective efficacy among residents through positive social activity may prevent initiation and progression of marijuana use.

The Potential Impact of Driving Cessation for Rural and Urban Older Adults: AAA LongROAD Study

Abstract: The influence of driving on the well-being of older adults has been documented in multiple studies demonstrating the declines in social engagement, cognitive and physical function and survival following driving cessation (Choi, et al., 2013; Curl et al., 2014; Doebler, 2016; O’Connor et al., 2013; Tyrovolas et al., 2017). The motivation to continue driving may be especially pronounced for older adults in rural areas because of limited options for public and other alternative sources of transportation as well as the longer distances between regular destinations such as grocery stores, pharmacies, health care providers and locations for social activities (Byles & Gallienne, 2012; Donorfio et al., 2009; Johnson, 2002, Payyandadan et al., 2018). Thus, investigators speculate that older rural drivers may be more likely than urban drivers to continue driving despite various physical and cognitive limitations (e.g. Byles & Gallienne, 2012). This study examines whether there are urban-rural differences in how older adults rate the potential impact that driving cessation would have on their lives. Results confirm that older drivers from a rural area rate the prospect of driving cessation as more impactful on their lives and that these perceptions may influence their decision to continue driving despite health decline.