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Published in: Prevention Science 2/2019

01-02-2019

The Effect of Medical Marijuana Laws on Marijuana-Related Attitude and Perception Among US Adolescents and Young Adults

Authors: Hefei Wen, Jason M. Hockenberry, Benjamin G. Druss

Published in: Prevention Science | Issue 2/2019

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Abstract

Marijuana liberalization policies are gaining momentum in the USA, coupled with limited federal interference and growing dispensary industry. This evolving regulatory landscape underscores the importance of understanding the attitudinal/perceptual pathways from marijuana policy to marijuana use behavior, especially for adolescents and young adults. Our study uses the restricted-access National Survey on Drug Use and Health (NSDUH) 2004–2012 data and a difference-in-differences design to compare the pre-policy, post-policy changes in marijuana-related attitude/perception between adolescents and young adults from ten states that implemented medical marijuana laws during the study period and those from the remaining states. We examined four attitudinal/perception pathways that may play a role in adolescent and young adult marijuana use behavior, including (1) perceived availability of marijuana, (2) perceived acceptance of marijuana use, (3) perceived wrongfulness of recreational marijuana use, and (4) perceived harmfulness of marijuana use. We found that state implementation of medical marijuana laws between 2004 and 2012 was associated with a 4.72% point increase (95% CI 0.15, 9.28) in the probability that young adults perceived no/low health risk related to marijuana use. Medical marijuana law implementation is also associated with a 0.37% point decrease (95% CI − 0.72, − 0.03) in the probability that adolescents perceived parental acceptance of marijuana use. As more states permit medical marijuana use, marijuana-related attitude/perception need to be closely monitored, especially perceived harmfulness. The physical and psychological effects of marijuana use should be carefully investigated and clearly conveyed to the public.
Literature
go back to reference Anderson, D. M., Hansen, B., & Rees, D. I. (2013). Medical marijuana laws, traffic fatalities, and alcohol consumption. Journal of Law and Economics, 56, 333–369.CrossRef Anderson, D. M., Hansen, B., & Rees, D. I. (2013). Medical marijuana laws, traffic fatalities, and alcohol consumption. Journal of Law and Economics, 56, 333–369.CrossRef
go back to reference Becker, M. H. (1974). The health belief model and personal health behavior. Health Education Monographs, 2, 324–473.CrossRef Becker, M. H. (1974). The health belief model and personal health behavior. Health Education Monographs, 2, 324–473.CrossRef
go back to reference Bertrand, M., Duflo, E., & Mullainathan, S. (2004). How much should we trust differences-in-differences estimates? The Quarterly Journal of Economics, 119, 249–275.CrossRef Bertrand, M., Duflo, E., & Mullainathan, S. (2004). How much should we trust differences-in-differences estimates? The Quarterly Journal of Economics, 119, 249–275.CrossRef
go back to reference Cerdá, M., Wall, M., Keyes, K. M., Galea, S., & Hasin, D. (2012). Medical marijuana laws in 50 states: Investigating the relationship between state legalization of medical marijuana and marijuana use, abuse and dependence. Drug and Alcohol Dependence, 120, 22–27.CrossRefPubMed Cerdá, M., Wall, M., Keyes, K. M., Galea, S., & Hasin, D. (2012). Medical marijuana laws in 50 states: Investigating the relationship between state legalization of medical marijuana and marijuana use, abuse and dependence. Drug and Alcohol Dependence, 120, 22–27.CrossRefPubMed
go back to reference D'Souza, D. C., & Ranganathan, M. (2015). Medical marijuana: Is the cart before the horse? JAMA, 313, 2431–2432.CrossRefPubMed D'Souza, D. C., & Ranganathan, M. (2015). Medical marijuana: Is the cart before the horse? JAMA, 313, 2431–2432.CrossRefPubMed
go back to reference Hall, W. (2015). What has research over the past two decades revealed about the adverse health effects of recreational cannabis use? Addiction, 110, 19–35.CrossRefPubMed Hall, W. (2015). What has research over the past two decades revealed about the adverse health effects of recreational cannabis use? Addiction, 110, 19–35.CrossRefPubMed
go back to reference Hall, W., & Degenhardt, L. (2009). Adverse health effects of non-medical cannabis use. The Lancet, 374, 1383–1391.CrossRef Hall, W., & Degenhardt, L. (2009). Adverse health effects of non-medical cannabis use. The Lancet, 374, 1383–1391.CrossRef
go back to reference Hall, W., & Lynskey, M. (2016). Evaluating the public health impacts of legalizing recreational cannabis use in the United States. Addiction, 111, 1764–1773.CrossRefPubMed Hall, W., & Lynskey, M. (2016). Evaluating the public health impacts of legalizing recreational cannabis use in the United States. Addiction, 111, 1764–1773.CrossRefPubMed
go back to reference Hasin, D. S., Wall, M., Keyes, K. M., Cerdá, M., Schulenberg, J., O'Malley, P. M., Galea, S., Pacula, R., & Feng, T. (2015). Medical marijuana laws and adolescent marijuana use in the USA from 1991 to 2014: Results from annual, repeated cross-sectional surveys. The Lancet Psychiatry, 2, 601–608.CrossRefPubMedCentralPubMed Hasin, D. S., Wall, M., Keyes, K. M., Cerdá, M., Schulenberg, J., O'Malley, P. M., Galea, S., Pacula, R., & Feng, T. (2015). Medical marijuana laws and adolescent marijuana use in the USA from 1991 to 2014: Results from annual, repeated cross-sectional surveys. The Lancet Psychiatry, 2, 601–608.CrossRefPubMedCentralPubMed
go back to reference Hathaway, A. D., Comeau, N. C., & Erickson, P. G. (2011). Cannabis normalization and stigma: Contemporary practices of moral regulation. Criminology and Criminal Justice, 11, 451–469.CrossRef Hathaway, A. D., Comeau, N. C., & Erickson, P. G. (2011). Cannabis normalization and stigma: Contemporary practices of moral regulation. Criminology and Criminal Justice, 11, 451–469.CrossRef
go back to reference Hill, K. P. (2015). Medical marijuana for treatment of chronic pain and other medical and psychiatric problems: A clinical review. JAMA, 313, 2474–2483.CrossRefPubMed Hill, K. P. (2015). Medical marijuana for treatment of chronic pain and other medical and psychiatric problems: A clinical review. JAMA, 313, 2474–2483.CrossRefPubMed
go back to reference Hoffmann, D. E., & Weber, E. (2010). Medical marijuana and the law. New England Journal of Medicine, 362, 1453–1457.CrossRef Hoffmann, D. E., & Weber, E. (2010). Medical marijuana and the law. New England Journal of Medicine, 362, 1453–1457.CrossRef
go back to reference Janz, N. K., & Becker, M. H. (1984). The health belief model: A decade later. Health Education Quarterly, 11, 1–47.CrossRefPubMed Janz, N. K., & Becker, M. H. (1984). The health belief model: A decade later. Health Education Quarterly, 11, 1–47.CrossRefPubMed
go back to reference Johnson, T. P., Fendrich, M., & Mackesy-Amiti, M. E. (2010). Computer literacy and the accuracy of substance use reporting in an ACASI survey. Social Science Computer Review, 28, 515–523.CrossRef Johnson, T. P., Fendrich, M., & Mackesy-Amiti, M. E. (2010). Computer literacy and the accuracy of substance use reporting in an ACASI survey. Social Science Computer Review, 28, 515–523.CrossRef
go back to reference Johnson, J., Hodgkin, D., & Harris, S. K. (2017). The design of medical marijuana laws and adolescent use and heavy use of marijuana: Analysis of 45 states from 1991 to 2011. Drug and Alcohol Dependence, 170, 1–8.CrossRefPubMed Johnson, J., Hodgkin, D., & Harris, S. K. (2017). The design of medical marijuana laws and adolescent use and heavy use of marijuana: Analysis of 45 states from 1991 to 2011. Drug and Alcohol Dependence, 170, 1–8.CrossRefPubMed
go back to reference Keyes, K. M., Schulenberg, J. E., O'malley, P. M., Johnston, L. D., Bachman, J. G., Li, G., & Hasin, D. (2011). The social norms of birth cohorts and adolescent marijuana use in the United States, 1976–2007. Addiction, 106, 1790–1800.CrossRefPubMedCentralPubMed Keyes, K. M., Schulenberg, J. E., O'malley, P. M., Johnston, L. D., Bachman, J. G., Li, G., & Hasin, D. (2011). The social norms of birth cohorts and adolescent marijuana use in the United States, 1976–2007. Addiction, 106, 1790–1800.CrossRefPubMedCentralPubMed
go back to reference Keyes, K. M., Wall, M., Cerdá, M., Schulenberg, J., O'malley, P. M., Galea, S., Feng, T., & Hasin, D. S. (2016). How does state marijuana policy affect US youth? Medical marijuana laws, marijuana use and perceived harmfulness: 1991–2014. Addiction, 111, 2187–2195.CrossRefPubMedCentralPubMed Keyes, K. M., Wall, M., Cerdá, M., Schulenberg, J., O'malley, P. M., Galea, S., Feng, T., & Hasin, D. S. (2016). How does state marijuana policy affect US youth? Medical marijuana laws, marijuana use and perceived harmfulness: 1991–2014. Addiction, 111, 2187–2195.CrossRefPubMedCentralPubMed
go back to reference Khatapoush, S., & Hallfors, D. (2004). “Sending the wrong message”: Did medical marijuana legalization in California change attitudes about and use of marijuana? Journal of Drug Issues, 34, 751–770.CrossRef Khatapoush, S., & Hallfors, D. (2004). “Sending the wrong message”: Did medical marijuana legalization in California change attitudes about and use of marijuana? Journal of Drug Issues, 34, 751–770.CrossRef
go back to reference Kosterman, R., Bailey, J. A., Guttmannova, K., Jones, T. M., Eisenberg, N., Hill, K. G., & Hawkins, J. D. (2016). Marijuana legalization and parents’ attitudes, use, and parenting in Washington State. Journal of Adolescent Health, 59, 450–456.CrossRef Kosterman, R., Bailey, J. A., Guttmannova, K., Jones, T. M., Eisenberg, N., Hill, K. G., & Hawkins, J. D. (2016). Marijuana legalization and parents’ attitudes, use, and parenting in Washington State. Journal of Adolescent Health, 59, 450–456.CrossRef
go back to reference Martins, S. S., Mauro, C. M., Santaella-Tenorio, J., Kim, J. H., Cerda, M., Keyes, K. M., Hasin, D. S., Galea, S., & Wall, M. (2016). State-level medical marijuana laws, marijuana use and perceived availability of marijuana among the general US population. Drug and Alcohol Dependence, 169, 26–32.CrossRefPubMedCentralPubMed Martins, S. S., Mauro, C. M., Santaella-Tenorio, J., Kim, J. H., Cerda, M., Keyes, K. M., Hasin, D. S., Galea, S., & Wall, M. (2016). State-level medical marijuana laws, marijuana use and perceived availability of marijuana among the general US population. Drug and Alcohol Dependence, 169, 26–32.CrossRefPubMedCentralPubMed
go back to reference Miech, R. A., Johnston, L., O’Malley, P. M., Bachman, J. G., Schulenberg, J., & Patrick, M. E. (2015). Trends in use of marijuana and attitudes toward marijuana among youth before and after decriminalization: The case of California 2007–2013. The International Journal of Drug Policy, 26, 336–344.CrossRefPubMed Miech, R. A., Johnston, L., O’Malley, P. M., Bachman, J. G., Schulenberg, J., & Patrick, M. E. (2015). Trends in use of marijuana and attitudes toward marijuana among youth before and after decriminalization: The case of California 2007–2013. The International Journal of Drug Policy, 26, 336–344.CrossRefPubMed
go back to reference Pacula, R. L., Kilmer, B., Grossman, M., & Chaloupka, F. J. (2010). Risks and prices: The role of user sanctions in marijuana markets. The BE Journal of Economic Analysis & Policy, 10, 1–36. Pacula, R. L., Kilmer, B., Grossman, M., & Chaloupka, F. J. (2010). Risks and prices: The role of user sanctions in marijuana markets. The BE Journal of Economic Analysis & Policy, 10, 1–36.
go back to reference Pacula, R. L., Powell, D., Heaton, P., & Sevigny, E. L. (2015a). Assessing the effects of medical marijuana laws on marijuana use: The devil is in the details. Journal of Policy Analysis and Management, 34, 7–31.CrossRefPubMedCentralPubMed Pacula, R. L., Powell, D., Heaton, P., & Sevigny, E. L. (2015a). Assessing the effects of medical marijuana laws on marijuana use: The devil is in the details. Journal of Policy Analysis and Management, 34, 7–31.CrossRefPubMedCentralPubMed
go back to reference Pacula, R. L., Boustead, A. E., & Hunt, P. (2015b). Words can be deceiving: A review of variation among legally effective medical marijuana laws in the United States. Journal of Drug Policy Analysis, 7, 1–19.CrossRef Pacula, R. L., Boustead, A. E., & Hunt, P. (2015b). Words can be deceiving: A review of variation among legally effective medical marijuana laws in the United States. Journal of Drug Policy Analysis, 7, 1–19.CrossRef
go back to reference Paternoster, R. (1987). The deterrent effect of the perceived certainty and severity of punishment: A review of the evidence and issues. Justice Quarterly, 4, 173–217.CrossRef Paternoster, R. (1987). The deterrent effect of the perceived certainty and severity of punishment: A review of the evidence and issues. Justice Quarterly, 4, 173–217.CrossRef
go back to reference Ramo, D. E., Liu, H., & Prochaska, J. J. (2012). Reliability and validity of young adults’ anonymous online reports of marijuana use and thoughts about use. Psychology of Addictive Behaviors, 26, 801.CrossRefPubMed Ramo, D. E., Liu, H., & Prochaska, J. J. (2012). Reliability and validity of young adults’ anonymous online reports of marijuana use and thoughts about use. Psychology of Addictive Behaviors, 26, 801.CrossRefPubMed
go back to reference Schuermeyer, J., Salomonsen-Sautel, S., Price, R. K., Balan, S., Thurstone, C., Min, S. J., & Sakai, J. T. (2014). Temporal trends in marijuana attitudes, availability and use in Colorado compared to non-medical marijuana states: 2003–11. Drug and Alcohol Dependence, 140, 145–155.CrossRefPubMedCentralPubMed Schuermeyer, J., Salomonsen-Sautel, S., Price, R. K., Balan, S., Thurstone, C., Min, S. J., & Sakai, J. T. (2014). Temporal trends in marijuana attitudes, availability and use in Colorado compared to non-medical marijuana states: 2003–11. Drug and Alcohol Dependence, 140, 145–155.CrossRefPubMedCentralPubMed
go back to reference Sekhon, V. (2009). Highly uncertain times: an analysis of the executive branch's decision to not investigate or prosecute individuals in compliance with state medical marijuana laws. Hastings Const. LQ, 37, 553. Sekhon, V. (2009). Highly uncertain times: an analysis of the executive branch's decision to not investigate or prosecute individuals in compliance with state medical marijuana laws. Hastings Const. LQ, 37, 553.
go back to reference Volkow, N. D., Baler, R. D., Compton, W. M., & Weiss, S. R. (2014). Adverse health effects of marijuana use. New England Journal of Medicine, 370, 2219–2227.CrossRef Volkow, N. D., Baler, R. D., Compton, W. M., & Weiss, S. R. (2014). Adverse health effects of marijuana use. New England Journal of Medicine, 370, 2219–2227.CrossRef
go back to reference Wen, H., Hockenberry, J. M., & Cummings, J. R. (2015). The effect of medical marijuana laws on adolescent and adult use of marijuana, alcohol, and other substances. Journal of Health Economics, 42, 64–80.CrossRefPubMed Wen, H., Hockenberry, J. M., & Cummings, J. R. (2015). The effect of medical marijuana laws on adolescent and adult use of marijuana, alcohol, and other substances. Journal of Health Economics, 42, 64–80.CrossRefPubMed
go back to reference Williams, A. R., Santaella-Tenorio, J., Mauro, C. M., Levin, F. R., & Martins, S. S. (2017). Loose regulation of medical marijuana programs associated with higher rates of adult marijuana use but not cannabis use disorder. Addiction, 112, 1985–1991.CrossRefPubMedCentralPubMed Williams, A. R., Santaella-Tenorio, J., Mauro, C. M., Levin, F. R., & Martins, S. S. (2017). Loose regulation of medical marijuana programs associated with higher rates of adult marijuana use but not cannabis use disorder. Addiction, 112, 1985–1991.CrossRefPubMedCentralPubMed
go back to reference Wooldridge, J. M. (2010). Econometric analysis of cross section and panel data. Cambridge: MIT press. Wooldridge, J. M. (2010). Econometric analysis of cross section and panel data. Cambridge: MIT press.
Metadata
Title
The Effect of Medical Marijuana Laws on Marijuana-Related Attitude and Perception Among US Adolescents and Young Adults
Authors
Hefei Wen
Jason M. Hockenberry
Benjamin G. Druss
Publication date
01-02-2019
Publisher
Springer US
Published in
Prevention Science / Issue 2/2019
Print ISSN: 1389-4986
Electronic ISSN: 1573-6695
DOI
https://doi.org/10.1007/s11121-018-0903-8

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