Attitudes about cannabis mediate the relationship between cannabis knowledge and use in active adult athletes

Abstract

Background Little is known about how cannabis knowledge and attitudes impact cannabis use behavior. Objective To test the knowledge-attitudes-behavior paradigm in active adult athletes. Design The Athlete Pain, Exercise, and Cannabis Experience (PEACE) Survey, a cross-sectional survey study, used social media and email blasts to recruit participants and SurveyGizmo to collect data. Participants Self-defined active adult athletes ( n = 1161). Main measures Knowledge about cannabis was evaluated with four questions. Attitudes toward cannabis was evaluated with 11 questions. The attitudes questions were used in a TwoStep Cluster analysis in SPSS to assign group membership by attitudes. Chi-square was used to determine if there were differences in cluster membership by demographic factors and if knowledge about cannabis differed by cluster membership. Regression analysis was performed to determine if cannabis attitudes mediated the relationship between cannabis knowledge and cannabis use. Key results A three-cluster solution was the best fit to the data. The clusters were named Conservative ( n = 374, 32.2%), Unsure ( n = 533, 45.9%), and Liberal ( n = 254, 21.9). There was a significant difference among the clusters for all 11 attitude items (all p < 0.001). Attitude cluster membership was significantly different by age ( p < 0.001), primary sport ( p < 0.05), and knowledge about cannabis ( p < 0.001). Athletes in the liberal cluster answered the knowledge questions correctly most often. Attitudes mediated the relationship between cannabis knowledge and cannabis use [Never (32.4%), Past (41.6%), Current (26.0%)] with athletes in the liberal cluster showing more knowledge and greater likelihood to be a current cannabis user ( p < 0.001). Among current cannabis users there were differential patterns of cannabis use depending on their attitudes and knowledge; liberal athletes tended to co-use THC and CBD and used cannabis longer. ( p < 0.001). Conclusions Cannabis education needs to consider attitudes about cannabis, especially among those who might benefit from medical cannabis.

A content analysis of internet information sources on medical cannabis

“…Understanding of cannabis is generally modest among the general public (e.g., Zeiger et al 2020 ). Medical cannabis users have remarkably low to moderate knowledge of important aspects of cannabis such as medical effectiveness (Kruger et al 2020a ), cannabinoid content and effective dosages (Kruger et al 2020b ), and effective harm reduction techniques (Kruger et al 2020c ).…”

Cannabis attitudes and patterns of use among followers of the Allergy & Asthma Network

“…This is a similar pattern to what we observed in a study of athletes. 26 This presents an J o u r n a l P r e -p r o o f opportunity for physicians to not only educate themselves about cannabis use and its positive and adverse effects on their patients, but to also educate their patients who want to use cannabis on changing their route of administration from inhalation to non-inhalational consumption routes.…”

“…Attitudes toward cannabis were determined using a 10-item, three choice (yes, no, unsure) questionnaire that was previously reported and provided useful information for a TwoStep Cluster analysis. 26 Knowledge about cannabis was assessed using a 5-item, 5 choice (THC, CBD, Both, Neither, Don't know) questionnaire in which each question had a single correct answer, also used in a previous study (E-Supplement). 26…”

“…26 Knowledge about cannabis was assessed using a 5-item, 5 choice (THC, CBD, Both, Neither, Don't know) questionnaire in which each question had a single correct answer, also used in a previous study (E-Supplement). 26…”

“…(2) cannabis user-types and an exploratory factor analysis was used to create subjective effects scales. 11,26 The SPSS TwoStep Cluster method was used to determine both the number of clusters and to allocate subjects to their respective clusters as published previously 11,26,27 (See E-Supplement). Once clusters were identified, post-hoc ANOVA tests were conducted to determine whether there was adequate separation of the clusters to determine inter-cluster heterogeneity and intra-cluster homogeneity.…”