A Multimethod Examination of Individual and Environment Contributors to Racial Inequities in Cannabis Use

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Project Summary Significance: Black relative to White young adults engage in heavier cannabis use and are more likely to experience cannabis use disorder. The reasons for these inequities, including the role of stress caused by systemic racism, are poorly understood and in critical need of empirical study. The proposed community- engaged R01 examines the dynamic transactions between stressors, reactivity (physiological and emotional), and cannabis cognitions (craving, motives) to identify the processes that contribute to inequities in cannabis use outcomes for Black young adults. Aims: Aim 1 will examine differences between Black and White young adults in cannabis cognitions and cannabis problems in relation to acute stressors. Aim 2 will test reactivity as a between- and within- person characteristic that tightens the effect of experiencing a stressor on cannabis cognitions and cannabis outcomes. Aim 3 will examine the transaction among cannabis use, cannabis cognitions, and reactivity from BL through 12-month follow-up. Hypotheses: We hypothesize that Black relative to White young adults will report higher cannabis craving, coping motives, and cannabis problems. These differences will be partially driven by acute stressors, including discrimination events. Additionally, as a function of systemic racism, Black relative to White young adults will have heightened reactivity to acute stressors, which will tighten the association between acute stress exposure and cannabis cognitions. Black more than White young adults will increase their cannabis use and problems through the 6- and 12-month follow-ups and this increase will be driven by higher baseline cannabis cognitions. Increases in cannabis use from baseline to 6-month follow-up will be associated with increased reactivity at 12-month follow-up. In turn, increased reactivity will relate to tightened associations between acute stress exposure and cannabis cognitions during the 12-month ecological momentary assessment (EMA). Approach: Young adults who use cannabis (weekly+ freq.; N=350; 18-25 years of age; 60% self-identifying as Black, 50% assigned female at birth; matched across race on past 30-day cannabis use freq.) will be recruited. Participants will complete an interview/questionnaires and a standardized stress task to assess reactivity (subjective, physiological: HF- HRV) and craving. Next, participants will complete a 17-day EMA protocol to record stress and discrimination events, reactivity (subjective and physiological), cannabis cognitions, and cannabis use/problems. Parallel lab and EMA protocols will be completed at a 12-month follow-up with a brief survey of cannabis use and problems at 6 months. This proposal is directly in line with NIDA’s strategic priorities on increasing health equity through community-engaged research and NIDA’s focus on addressing real-world complexities that contribute to substance use problems. This research takes a critical step towards identifying proximal points of intervention to reduce and ultimately eliminate the growing health inequities in cannabis use outcomes.