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Multi-level patterns predict cannabis use onset among youth
Yixin Wang1, Robbie Fraser2, Laika Aguinaldo3
1Department of Bioengineering, Stanford University, Stanford, CA 94305, USA.
Developmental Cognitive Neuroscience
|November 11, 2025
Summary
Early cannabis use in youth increases risks for substance abuse and mental health issues. Key factors like stress coping and home alcohol access predict initiation and escalation to weekly use, offering prevention targets.
Area of Science:
- Neuroscience and developmental psychology.
- Adolescent substance use research.
- Public health and preventative medicine.
Background:
- Early cannabis initiation in youth is linked to adverse outcomes, including substance use disorders, mental health conditions, and cognitive deficits.
- Understanding the multifaceted influences on adolescent cannabis use is crucial for developing effective prevention strategies.
- Previous research highlights individual, social, and environmental factors, but a comprehensive, data-driven approach is needed.
Purpose of the Study:
- To identify key predictors of early cannabis use initiation and escalation to weekly use among adolescents.
- To analyze a wide range of influencing factors across individual, microsystem, and exosystem levels.
- To explore potential targets for prevention programs aimed at reducing adolescent cannabis use.
Main Methods:
- A data-driven analysis using Random Survival Forest was conducted on 450 cannabis-naïve youths (ages 12-21) from the National Consortium on Alcohol and NeuroDevelopment in Adolescence (NCANDA) cohort.
- 151 measurements across seven domains (biobehavior, cognition, brain MRI, family, peer, neighborhood, legal) were analyzed.
- Predictive models were developed for age of first cannabis use and age of weekly cannabis use onset.
Main Results:
- Random Survival Forest models accurately predicted age of first (C-index=0.68) and weekly cannabis use onset (C-index=0.69), significantly outperforming chance.
- First cannabis use onset was predicted by 13 factors, including lower positive thinking during stress coping.
- Escalation to weekly use was predicted by fewer factors (four), with shared predictors including cannabis outlet density, home alcohol access, and positive alcohol expectancies.
Conclusions:
- Adolescent cannabis use initiation is influenced by a broad range of factors, including psychological and environmental elements.
- Escalation to habitual (weekly) cannabis use appears driven by a smaller set of critical factors, suggesting specific targets for intervention.
- Factors such as home alcohol availability and neighborhood cannabis outlet density are significant predictors, highlighting the importance of environmental influences in prevention efforts.
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