What's the Harm in Getting High? Evaluating Associations Between Marijuana and Harm as Predictors of Concurrent and Prospective Marijuana Use and Misuse.

Objective: Substantial research has demonstrated the importance of implicit cognitive processes underlying substance use. However, there is a scarcity of research on implicit processes related to marijuana use. We adapted and tested the predictive validity (concurrent and prospective) of an implicit measure evaluating the strength of associations between marijuana and harm based on research demonstrating less marijuana use among individuals who report stronger explicit attitudes of marijuana's harms.

Method: A community sample of 187 U.S. young adults living in a state with legal recreational marijuana use completed an Implicit Association Test (IAT) evaluating marijuana-harm associations and measures of marijuana use and risk of cannabis use disorder (CUD) over time.

Results: The marijuana-harm IAT had good internal consistency, and scores did not vary as a function of biological sex, legal age status for recreational marijuana use, or college student status. Scores did vary as a function of lifetime and recent use such that lifetime and current abstainers had stronger marijuana-harm associations. Zero-inflated negative binomial regression models demonstrated that marijuana-harm IAT scores significantly predicted concurrent risk of CUD and use such that stronger marijuana-harm associations were associated with less use and risk of CUD. Results evaluating outcomes longitudinally found limited support for IAT scores predicting increases in use over time and no support for predicting changes in risk of CUD over time.

Conclusions: Findings provide preliminary evidence that stronger marijuana-harm associations may act as a protective factor against marijuana use and risk of CUD.