Investigating cannabis use normalization by distinguishing between experimental and regular use: A multilevel study in 31 countries

Objective: This research examined whether national population-level cannabis frequency rates moderate the strength of the relationship between individual-level psychosocial and behavioral risk factors (poor parental communication, bullying, fighting, etc.) and different levels of adolescent cannabis use (abstinence, experimental use, and regular use). Method: Data from the 2009/2010 Health Behaviour in School-Aged Children survey (N = 62,009, age = 15 years) from 31 countries were analyzed using multinomial hierarchical linear modeling. Results: Analyses showed that adolescents who reported experimental cannabis use and who lived in relatively high cannabis frequency countries were less likely than their counterparts in low cannabis frequency countries to present some of the cannabis-related psychosocial and behavioral risk factors. Conversely, regular cannabis use tended to occur among high-risk adolescents to an equal degree in high and low cannabis frequency countries. Conclusions: The findings suggest that the normality of cannabis use in the youth population is important to consider when investigating the relationship between risk factors and cannabis use.