Variations in likelihood to use protective behavioral strategies for marijuana across physical and social contexts of use
Authors: Egan Kathleen , Cox Melissa 
Published: September 2022

Protective behavioral strategies for marijuana (PBSM) are intended to reduce harms associated with use of marijuana. Harms may vary based on the physical and social contexts in which individuals use marijuana resulting in people employing PBSM differentially across contexts. We examined where and with whom young adults are likely to employ PBSM when using marijuana. In Fall 2021, we conducted an online survey with 506 young adults who were current users of marijuana and lived in the U.S. (N=506; 55.6% female, 62.6% White). Participants were evenly distributed across states according to marijuana policy (33% each in recreational, medicinal, or neither). Participants rated their likelihood (‘not at all,’ ‘somewhat,’ or ‘extremely/very likely’) to engage in 8 strategies derived from the PBSM Scale that focused on using marijuana only with trusted peers, minimizing intoxication, and driving a vehicle after using marijuana. Participants indicated their likelihood to use each strategy in 4 physical contexts (own home, friend’s home, someone else’s home, public location) and 3 social contexts (alone, one or few closest friends, large group). We conducted generalized logit mixed models with a multinomial dependent variable, treating the respondent as a random effect, to assess differences in likelihood to use PBSM across physical and social contexts. Separate models were run for each PBSM by physical (referent: at own home) and social (referent: alone) context. Physical context: Odds of being ‘somewhat likely’ or ‘extremely likely’ (referent: ‘not at all likely’) to ‘use marijuana only among trusted peers’ were lower when using marijuana at someone else’s home or in a public location compared to their own home. Odds of being ‘somewhat likely’ or ‘extremely likely’ (referent: ‘not at all likely’) to ‘use a little marijuana and then wait to see how you feel before using more,’ ‘avoid mixing marijuana with other drugs,’ and ‘avoid driving a car after using marijuana’ were lower when using marijuana in public settings compared to their own home. Odds of being ‘somewhat likely’ (referent: ‘not at all likely’) to ‘limit the amount of marijuana they use in one setting’ were lower when using marijuana in public settings compared to their own home. Social context: Odds of being ‘somewhat likely’ (referent: ‘not at all likely’) to ‘avoid mixing marijuana with other alcohol’ were greater when using marijuana with a few close friends than alone. Odds of being ‘extremely likely’ (referent: ‘not at all likely’) to ‘use a little marijuana and then wait to see how you feel before using more’ and ‘avoid driving a car after using marijuana’ were lower when using marijuana at an event with a large number of people compared to alone. Our findings suggest that people differentially utilize PBSM based on the physical and social contexts in which they are using marijuana. People may be less likely to engage in PBSM in public locations and large groups of people compared to when they use marijuana at their home or alone. Interventions for young adult marijuana use should consider the context of use when providing behavioral intervention strategies.