Are Co‐users of Alcohol and Marijuana More Willing to Experience Consequences From Drinking? A Longitudinal Examination Among First‐Year College Students

Abstract

Background: Alcohol and marijuana co-users are at heightened vulnerability for experiencing a variety of negative alcohol use outcomes including heavier alcohol use and driving under the influence. The current study explored willingness to experience negative consequences as a potential factor underlying the association between co-user status and negative consequences in an effort to guide future intervention work. From a longitudinal study of first-year college students, we examined willingness to experience consequences at Time 2 as a mediator of co-user status at Time 1 and experience of negative consequences at Time 3.Methods: First-year college student drinkers (n = 1,914) at a large university completed surveys in the fall and spring of their freshman year and the fall of their sophomore year.Results: Alcohol and marijuana co-users reported higher willingness to experience consequences than alcohol-only users. Willingness to experience consequences partially explained the association between alcohol and marijuana couse and consequences.Conclusions: The current study was the first to compare co-users of alcohol and marijuana to alcohol-only users on willingness to experience consequences, and examine the role of willingness as a mediator between co-user status and consequences experienced. Co-users were more willing to experience adverse effects from drinking, in turn predicting more consequences. Intervention work targeting consequences may be less effective for co-users; thus, additional work is needed to identify other potential mechanisms for change for this at-risk group.

Individual and Environmental Factors Associated with Tobacco Smoking, Alcohol Abuse and Illegal Drug Consumption in University Students: A Mediating Analysis

“…Overall, risky alcohol consumption behavior has an adverse effect across psychosocial wellbeing, academic performance, quality of life, and general health [9][10][11][12][13][14]41,77,78], but also contributes to increasing the risk of drug abuse in students who already smoke cigarettes. This is of utmost importance because most adolescents and young adults believe that intermittent tobacco smoking causes little or no harm, and therefore are at more risk of engaging in risky and unhealthy behaviors [79].…”

“…Moreover, both tobacco smoking and alcohol abuse increase the risk of illicit drug abuse in this population [1,6,[38][39][40]. Additionally, health problems occur more frequently and with more adverse consequences in polydrug using students [41]. Given that a high percentage of Spanish university students consume tobacco and show risky alcohol behavior [1,2,[4][5][6][7], this situation represents a major public health issue.…”

Alcohol and cannabis co-use and social context as risk pathways to sexual assault.

“…Moreover, for the last three decades, rates of co-use in young adults appear to be increasing (Terry-McElrath & Patrick, 2018). Co-use has been the topic of much interest in the empirical literature because it has been linked to greater intoxication (Metrik et al, 2018; Patrick et al, 2018; Sokolovsky et al, 2020), and at least in some studies, greater risk for harmful consequences on the occasions that it occurs relative to alcohol consumption alone (Egan et al, 2019; Lee et al, 2017; Linden-Carmichael et al, 2019; Mallett et al, 2017; Subbaraman & Kerr, 2015). Yet, we are unaware of research that has examined the role that co-use may play in SA risk.…”

Towards quantifying the reciprocal associations between frequency of cannabis use and alcohol consumption: a cross-lagged analysis from the CONSTANCES cohort

“…2 In addition, co-use of these substances may be associated with increased levels of consumption, dependency and deleterious health consequences. [3][4][5][6] Temporal relationships have been particularly described in the co-use of tobacco and cannabis in one hand, [7][8][9][10] and in the co-use of tobacco and alcohol in the other hand. 11 12 Although associations between cannabis and alcohol use have been also described, the literature poorly examined whether the consumption of one could increase the consumption of the other over time, besides acute intoxication.…”

“…At a population level, alcohol, tobacco and other drugs, especially cannabis, which is the most commonly illicit drug used, are among the leading risk factors for morbidity and mortality worldwide 2. In addition, co-use of these substances may be associated with increased levels of consumption, dependency and deleterious health consequences 3–6. Temporal relationships have been particularly described in the co-use of tobacco and cannabis in one hand,7–10 and in the co-use of tobacco and alcohol in the other hand 11 12.…”