ABSTRACT
Aims To investigate the relationship of lifetime and repeated cannabis use with hypothalamic–pituitary–adrenal (HPA) axis reactivity to social stress in a general population sample of adolescents. Design Adolescents who reported lifetime or repeated cannabis use, lifetime or repeated tobacco use, and never use of either cannabis or tobacco were compared with respect to their HPA axis reactivity during the Groningen Social Stress Task (GSST), which was based on the Trier Social Stress Task. Setting A large prospective population study of Dutch adolescents (The TRacking Adolescents’ Individual Lives Survey (TRAILS) study). Participants 591 adolescents (51% male) who participated in the GSST, which was an additional measurement during the third assessment wave. Measurements HPA axis stress reactivity was indexed by four cortisol samples collected before, during and after the GSST. Furthermore, all adolescents in our study completed self-reported questionnaires on lifetime and repeated cannabis and tobacco use. Models were adjusted for sex, recent alcohol use, experimental session risk status, socioeconomic status, mood, and time of the experimental session. Findings Lifetime cannabis users had significantly lower stress reactivity levels when compared to abstainers (OR = 0.68, CI = 0.55-0.85, p < 0.01) and lifetime tobacco users (OR = 0.79, CI = 0.64-0.98, p < 0.05). In addition, repeated cannabis users also exhibited lower stress reactivity levels when compared to lifetime ever users of either tobacco or cannabis (OR = 0.74, CI = 0.53-0.98, p < 0.05). Conclusions Lower HPA-axis stress reactivity in adolescents is specifically related to lifetime and repeated cannabis use.