Factors associated with cannabis use among adolescents: the role of parents, peers, attitudes and skills

INTRODUCTION. Cannabis is the most frequently used illicit drug among adolescents. In order to prevent initiation of use, risk factors should be identified. OBJECTIVES. The purpose of this study is to investigate risk factors for adolescent lifetime cannabis use and to evaluate differences by gender and socio-economic status. METHODS. This is a secondary analysis of the baseline survey of the EU-Dap (European Drug Addition Prevention) randomized controlled trial. The analytical sample included 7,028 students 12-14 years old from seven European countries who participated in the baseline survey of the trial and answered the questions investigating lifetime cannabis use. Socio-demographic characteristics, friends’ substance use, knowledge, attitudes and beliefs toward substances, risk perceptions, refusal and decision making skills, self-esteem, parental tobacco smoking and alcohol drinking and related permissiveness, and family climate were studied as risk factors for lifetime cannabis use through a forward multivariate logistic regression model. RESULTS. Having friends who use cannabis was the strongest risk factor for lifetime cannabis use (OR 9.08, 95% CI 5.93-13.89), followed by a low risk perceptions (OR 3.57, 95% CI 2.40-5.30) and low refusal skills toward cannabis use (OR 3.30, 95% CI 2.50-4.37). One-parent household (OR 1.61, 95% CI 1.07-2.41), parental permissiveness to smoke (OR 2.05, 95% CI 1.39-3.03) and parental smoking (OR 1.31, 95% CI 1.00-1.72) were associated with the risk. Low refusal skills toward tobacco and alcohol use, low negative beliefs toward cannabis, high positive attitudes toward drugs and knowledge about cannabis were also significantly associated with lifetime cannabis use. Differences by gender and socio-economic status were observed. CONCLUSIONS. Friends’ use, risk perceptions, refusal skills, attitudes and beliefs, but also parental behaviors play a great role in adolescents’ initiation of cannabis use. These factors should be taken into account in orienting future prevention programs.