Why do young people use cannabis – or decide not to?

Background: Because early cannabis use is associated with increased risk of negative consequences, better understanding of young people’s decisions to initiate and continue use is warranted. While multiple studies focus on the risks of cannabis use, there is a scarce literature on positive expectations associated with use decisions, and no study investigated young people’s reasons for not using, or not using cannabis more extensively. This study investigated these questions in a nationally representative sample of high school students from Norway.

Methods: A mixed-method approach included e-questionnaires administered to a sample of 3 490 high school students and further in-depth interviews with of 39 of these. Students reported their cannabis use histories, (non)agreement with positive expectancies of cannabis use, and reasons for not using cannabis (if non-users) or for not using more extensively (if ever used) by selecting from 18 pre-defined response categories.

Results: Tension reduction (i.e., relaxation (49%) and forgetting worries (38%)) and social facilitation (i.e., making things more fun (27%) and enjoyable (20%)) were the most commonly reported expectations of cannabis use, followed by social acceptance and physical/cognitive performance expectations. Different motivations were prioritized for not using and not using more frequently. Among non-users, the risk of negative health effects (74%), not wanting to disappoint parents (66%), the illegality of cannabis (64%) and the risk of arrest (53%) were the most frequently reported reasons for not using cannabis. Among users, the risk of arrest (48%), disappointing parents (44%) and addiction (41%) were the most frequently reported reasons for not using cannabis more extensively. Qualitative data supported and elaborated these findings.

Conclusion: The roles of positive cannabis expectations and diverging rationales for abstinence vs. more extensive cannabis use could be considered when designing, implementing and evaluating prevention strategies aimed at youth and drug policy more generally.