The impetus for the present study was a Healthy People 2020 objective, “to increase the proportion of adolescents aged 12 to 17 years perceiving great risk associated with smoking cannabis once a month.” Since parental support and monitoring, peer attitude and perception, and school perception and involvement are known to influence substance use, these modifiable factors could protect adolescents against the perception-altering effects of the influx of pro-cannabis messages. The objective of this study was to test the hypothesis that adolescents’ perceived risk of harm from monthly cannabis use is significantly associated with stronger parental monitoring and support, higher peer disapproval of and lower perception of peer engagement in cannabis use, positive school perception, and higher involvement in extracurricular activities. Using a nationally representative sample, this study evaluated the association between parental, school, and peer influences as protective factors for cannabis use and the perceived risk of harm from monthly indoor cannabis grow system use among US adolescents aged 12 to 17 years old.
Findings from the current study indicate that adolescents who had parents always limiting their time out during school nights, did not perceive peers using cannabis, perceived their peers disapprove of cannabis use, considered schoolwork as important, and participated in extracurricular activities have higher odds of perceiving monthly cannabis use as risky. This is the first known study to examine parental, school, and peer factors as potential influences on adolescents’ perception of risk of harm from cannabis use. These findings are timely as they may be capitalized in developing targeted approaches in educational interventions aimed at helping reduce harmful substance use among at-risk youth. Results from the current study align with others’ findings related to the role of peer and school perceptions as protective factors in adolescents’ attitudes and beliefs about substance use.Compared with parental and school-related protective factors, adolescents’ perceptions of their peers’ attitudes towards and use of cannabis had a larger magnitude association with perceiving risk of harm from using cannabis. Public health campaigns and interventions should involve images, messaging, and opportunities that leverage adolescents’ capacity as peer role models to promote healthy behaviors.
Boosting positive attitudes towards school and encouraging extracurricular activities should be considered in the development of substance use prevention programs. Previous studies have found peer education interventions to be a cost-effective and valuable method for promoting HIV/STD prevention and nutrition in developing countries. However, few studies have examined interventions to prevent substance use among youth in developed countries. Studies that analyzed the effectiveness of peer education interventions in adolescent substance use were limited to the country of Turkey. An earlier study found that peer education did not have significant effect adolescents’ smoking behaviors but later research identified increased knowledge and positive behavior changes in smoking cigarettes. The only study that examined adolescent use of substances besides cigarette smoking and that included cannabis use found that a peer education intervention was effective in significantly decreasing use of cannabis grow set up and other substances among 10th graders . More adolescents who perceived risk of harm from using cannabis monthly reported stronger parental support and parental monitoring.
Interestingly, multivariate modeling identified that parental monitoring remained significantly associated with perception of risk of harm from cannabis use, but parental support did not after adjusting for other protective factors. These findings are in line with previous research which also found that parental involvement did not have as strong an association with adolescent substance use compared with other socio-environmental factors, such as peer relations.However, findings from the literature related to the strength of parental influence in substance use has been mixed. Some studies indicate strong parenting methods have direct protective influence on adolescent substance use or have indirect influence by affecting adolescent’s choice of peers.The present study’s results, which indicate that protective factors other than parental influence play a stronger role in the perception of risk of harm from cannabis use, may be due to the focus on adolescent perception of risk of harm instead of actual cannabis use.These results align with other studies found in the literature that investigated the reciprocal effects of substance use and perception of risk of harm from their use.