Author ORCID Identifier

https://orcid.org/0000-0003-1133-7445

Semester

Spring

Date of Graduation

2023

Document Type

Dissertation

Degree Type

PhD

College

School of Public Health

Department

Epidemiology

Committee Chair

Toni Rudisill

Committee Member

Christa Lilly

Committee Member

Christiaan Abildso

Committee Member

Erin Winstanley

Abstract

Introduction: Adolescents and college-aged adults account for a large proportion of the United States population and are susceptible to drugs, including marijuana. Since the late 1960s in the United States, numerous states have legalized marijuana for medical and recreational purposes. These recent policy changes may alter people’s attitudes and behaviors about marijuana use, particularly young adults. The expansion of state-level marijuana legalization may also increase accessibility in younger populations and increase reckless driving behavior associated with marijuana use, including driving after marijuana use. During the COVID-19 pandemic, adolescents and young adults experienced heightened stress and anxiety, which have significantly contributed to increased drug use and increased risk behaviors that are positively associated with increased drug use, including drug-impaired driving. However, no published studies have investigated marijuana use among adolescents and young adults and driving after marijuana use among college-aged adults during the COVID-19 pandemic in the United States.

Methods: This study employed a systematic review to comprehensively summarize the recent literature about marijuana use among adolescents and young adults during the COVID-19 pandemic, a cross-sectional analysis of a national dataset of the United States college students who at least 18 years old and reported recent driving and marijuana use to assess the demographic and behavioral risk factors associated with driving after marijuana use, and a second cross-sectional study using a survey to assess the demographic and behavioral risk factors, as well as perceptions or attitudes toward driving after marijuana use and state of residence, associated with driving after marijuana use among active West Virginia University students who had recent driving history, had a valid driver’s license, and were at least 18 years old.

Results: Among 278 initiated database searches, fifteen studies included in the systematic review. The changes in marijuana use among adolescents and young adults during the pandemic in the systematic review were highly varied. Depression and anxiety related to pandemic were associated with increased marijuana use. During the pandemic, approximately 30% (n=4,947) of the US college student respondents reported driving after marijuana use. College students who were males (adjusted odds ratio, AOR: 1.64, 95% confidence interval, CI:1.48-1.82), non-Hispanic Black (AOR: 1.32, 95% CI:1.02-1.71), sexual minorities (AOR:1.19, 95% CI: 1.07-1.31), individuals with an alcohol or substance use disorder (AOR: 1.44, 95% CI:1.08-1.91), anxiety (AOR: 1.20, 95% CI: 1.06-1.36), higher suicidality (AOR: 1.18, 95% CI: 1.07-1.31), and those who also drank and drove (AOR: 3.18, 95% CI: 2.84-3.57) had a higher risk of driving after marijuana use. During the pandemic, 28.9% of West Virginia University students participants reported driving after marijuana use. Students who had a GPA of B (AOR: 2.17, 95% CI: 1.06-4.42), drove 1-2 hours on the weekend (AOR: 2.36, 95% CI: 1.10-5.06), smoked or ingested marijuana in the past year (AOR: 26.51, 95% CI: 10.27-68.39), were involved in a previous collision (AOR: 3.83, 95% CI: 1.37-10.70), drove after drinking (AOR: 2.38, 95% CI: 1.18-4.79), and used both marijuana and alcohol concurrently and then drove (AOR: 10.39, 95% CI: 2.32-46.54). Additionally, students who felt the behavior was somewhat dangerous (AOR: 9.06, 95% CI: 3.35-24.5) or not dangerous (AOR: 21.18, 95% CI: 5.4-83.17) or thought their peers approved (AOR: 2.31, 95% CI: 1.11-4.82) of this risky driving behavior showed significant associations with driving after marijuana use.

Conclusions: The findings of this research suggest numerous research and prevention implications. Continued surveillance of marijuana use trends and driving after marijuana use among college students is necessary. Additionally, prevention or intervention programs are also needed to raise awareness of the danger and potential consequences of driving after marijuana use on college campuses to reduce this risky behavior.

Embargo Reason

Publication Pending

Share

COinS