Project Summary/Abstract
Simultaneous use of alcohol and cannabis, or co-use (i.e., the use of both substances so that effects overlap),
is an increasingly significant public health concern among young adults between the ages of 18 and 25 in the
U.S. Compared to single substance use occasions of alcohol and cannabis, co-use occasions are associated
with greater negative consequences, including driving under the influence and blacking out. Given the steady
increase in the prevalence of co-use among young adults, there is a pressing need to understand factors
related to co-use that could inform intervention efforts in this population. Protective behavioral strategies (PBS;
i.e., tactics used to modify or limit substance use related harm) have been robustly linked to fewer
consequences (e.g., lower use quantity, frequency, and consequences) for alcohol- and cannabis-only
occasions. However, research has not examined PBS in the context of co-use occasions, despite a burgeoning
literature supporting that co-use occasions are associated with greater harms. Consequently, the goal of this
proposal is to examine the extent that alcohol and cannabis PBS are used and associated with alcohol and
cannabis use outcomes on co-use occasions relative to alcohol- and cannabis-only occasions. The proposed
research will conduct secondary data analyses of a NIH-funded project using ecological momentary
assessment (EMA) data collected from 123 college students over four consecutive weekends (Thursday-
Sunday; 16 total days). The proposed research has three specific aims: 1) To assess whether alcohol and
cannabis PBS are used more frequently on alcohol- or cannabis-only occasions relative to co-use occasions;
(2) To determine whether alcohol and cannabis PBS are associated with levels of alcohol use, cannabis use,
and consequences experienced on alcohol- and cannabis-only occasions relative to co-use occasions; and (3)
To identify daily factors (environmental context, social setting) related to alcohol and cannabis PBS on alcohol-
and cannabis-only occasions relative to co-use occasions. Findings from the proposal will inform our
understanding of alcohol and cannabis PBS during co-use occasions, including proximal factors (i.e., social
setting and environment) that impact the use of PBS. In alignment with the NIAAA strategic plan, findings will
help develop and improve strategies to reduce and prevent harms associated with co-use, particularly those
that may be delivered in-the-moment. Additionally, the proposed research would provide the applicant with
training that will inform her developing program of research on the association between co-use and PBS
among young adults through providing content training on alcohol and co-use behaviors among young adults,
ecological research methods, intensive longitudinal data analyses, and professional development activities.