Abstract
Background and Objectives
Despite growing cannabis use rates among US rural-residing young adults, less research has examined associations of rural–urban residence with cannabis use influences (e.g., harm perceptions, peer use) or behaviors (e.g., use frequency, driving under the influence of cannabis [DUIC]).
Methods
Using 2023 online survey data from 1961 US young adults (aged 18–34) reporting past-month cannabis use (M
age = 26.86 [standard deviation = 4.61], 14.7% rural-residing, 38.2% racial/ethnic minority, 59.2% female), multivariable regressions controlling for sociodemographics and state non-medical cannabis legalization examined associations of (1) rural–urban residence with cannabis use influences (motives, perceptions, mental/physical health, parent/peer use, advertising exposure); and (2) rural–urban residence and use influences with use behaviors (past-month days of use, past 6-month DUIC, consequences).
Results
Rural (vs. urban) residence was associated with three use influences (i.e., greater coping motives, lower perceived harm of cannabis use, higher odds of a mental health diagnosis), more frequent cannabis use and DUIC, but fewer use consequences. All three influences were associated with more frequent use and having a mental health diagnosis was associated with more frequent DUIC. Greater coping motives and lower harm perceptions were associated with fewer consequences, and having a mental health diagnosis was associated with greater consequences.
Discussion and Conclusions
Rural (vs. urban) young adults reported more frequent cannabis use and DUIC, which may be associated with low cannabis-related harm perceptions and using cannabis to cope with stress/mental health symptoms.
Scientific Significance
Interventions targeting rural young adults that address mental health symptoms and risk perceptions, including DUIC-related risks, may be needed.