Understanding the role of cannabis use on cigarette dependence severity among individuals with e-cigarette and combustible tobacco dual use.

BACKGROUND AND OBJECTIVES: The use of both electronic and combustible cigarettes is related to greater rates of cannabis use. Further, cannabis use is associated with worse combustible smoking-related outcomes, yet little research has identified mechanisms underlying such relations. It may be that negative-affect-related transdiagnostic factors such as emotion dysregulation, anxiety sensitivity, and/or distress intolerance play a mechanistic role in the cannabis-tobacco interrelations. METHODS: The current study tested this hypothesis among 400 adults who endorsed dual use, 33% of whom endorsed current (past 3 months) cannabis use. We conducted analyses of variance and indirect effects model using the PROCESS v4.1 macro in SPSS version 29. RESULTS: Results indicated that participants who use cannabis reported greater difficulty with emotion regulation, anxiety sensitivity, and cigarette dependence severity. Cannabis use was related to cigarette dependence severity indirectly via difficulty with emotion regulation and anxiety sensitivity. DISCUSSION AND CONCLUSIONS: These results indicate that specific transdiagnostic negative-affect-related factors of difficulty with emotion regulation and anxiety sensitivity are associated with cannabis use among adults who smoke combustible and electronic cigarettes. SCIENTIFIC SIGNIFICANCE: Given that these transdiagnostic factors are malleable, these findings suggest targeting and engaging such mechanisms may offer novel behavioral change strategies for this high-risk population.

Social Anxiety and Cannabis-Related Problems: The Serial Roles of Distress Tolerance and Cannabis Use Motives.

Background: Individuals with elevated social anxiety are vulnerable to experiencing negative consequences related to cannabis use. One transdiagnostic vulnerability factor that has received little attention in the social anxiety-cannabis problem relation is distress tolerance, which is associated with more cannabis use to manage negative affect broadly (i.e., coping motives) and cannabis-related problems. However, it is unknown whether distress tolerance is related to greater cannabis use to manage social anxiety specifically (i.e., social anxiety motives). Objectives: This study tested whether the relation between social anxiety and cannabis problems occurred via perceived distress tolerance among 309 (77.3% female) undergraduates who endorsed current (past three-month) cannabis use. Results: Social anxiety was negatively associated with distress tolerance and positively associated with cannabis problems, coping, and social anxiety motives. Social anxiety was indirectly (via distress tolerance) related to more cannabis problems and motives to cope with negative affect generally and to cope with social anxiety specifically. Social anxiety was indirectly related to more cannabis problems via the serial effects of distress tolerance and coping and social anxiety motives. Conclusions: Findings suggest that individuals with elevated social anxiety may be vulnerable to using cannabis to manage negative affect (generally and social anxiety specifically) due to low perceived ability to tolerate psychological distress, which may lead to more cannabis problems. Keywords: cannabis; marijuana; distress tolerance; social anxiety; motives; coping motives.

The relations of difficulties in emotion regulation and distress intolerance with cannabis problems: The role of protective behavioral strategies underutilization.

INTRODUCTION: Difficulties with emotion regulation and distress tolerance are related to more cannabis problems, yet little research has identified why this is the case. Cannabis-related protective behavioral strategies (PBS; behaviors used to mitigate cannabis related problems) are related to less cannabis consumption and related problems. Potentially, these individuals may use cannabis to alleviate the distress and/or in an attempt to regulate their emotions. Thus, the present study aimed to examine the mediational role of PBS on the relations of emotion dysregulation and distress intolerance with cannabis problems. METHODS: Undergraduate students who endorsed past-month cannabis use (N = 339, Mage = 19.33, SDage = 1.37; 77.9 % female) at a southern United States university completed a survey online via Qualtrics. RESULTS: More emotion dysregulation and less distress tolerance predicted less PBS use and more cannabis problems, but not cannabis use frequency. After statistically controlling for sex, the relation of each transdiagnostic factor with cannabis problems occurred indirectly via the relations of less PBS use and greater cannabis use frequency CONCLUSIONS: The present study supports previous claims that emotion dysregulation and distress intolerance are related to more cannabis problems. Additionally, results suggest that individuals with high levels of these problems underutilize PBS which, in turn, is associated with more frequent cannabis use and use-related problems. Clinical implications are discussed.