Event-level contextual and motivational risk factors for cannabis use: Evidence for differing associations based on individual-level patterns of cannabis use among sexual minority women and gender diverse individuals.

Abstract

Few studies have examined event-level contextual and motivational risk factors for cannabis use (CU) among sexual minority women and gender diverse individuals (SMWGD). While existing studies assume the same risk factors are relevant for all individuals regardless of their pattern of CU, this study tests two theories proposing variation in associations between event-level risk factors and CU based on individual-level characteristics, including an individual's typical CU frequency (Koob & Volkow, 2010) and how often they use for different reasons and in different contexts (Creswell, 2021). We used an EMA study of CU among SMWGD to examine: 1) unmoderated event-level associations between contexts and motives for use and CU outcomes (e.g., intoxication, consequences); and 2) whether these event-level associations (e.g., daily motives predicting same-day CU outcome) varied by individual-level characteristics, including typical frequency and how often an individual uses for different reasons and in different contexts (e.g., proportion of CU days with coping motives). When an individual reported social, enhancement, or coping motives on a given occasion, they reported higher cannabis consumption. Further, using in both social and solitary settings during the same period (e.g., an evening) was associated with higher consumption than using in only social or solitary settings. Several moderators were identified. For example, coping motives more strongly predicted intoxication for individuals who tended to endorse coping motives more often. Some event-level risk factors may differentially impact CU as a function of individual-level CU patterns. Findings can help to inform the development of CU interventions for SMWGD.