Abstract
The social perception of cannabis use in Spain is getting more tolerant among young people. This study aims to uncover the attitudes of university students toward cannabis and examine the differences in their attitudes according to their use status. We applied concept mapping, a mixed-methods approach. Participants were recruited from 12 universities. During the first stage, 5 focus groups were conducted with 56 participants to determine the ideas in the concept map. In the second stage, ideas were pile-sorted and rated by 140 participants (77% females; average age = 21.6). Hierarchical cluster analysis of the pile-sort data generated the cluster map. We used t-tests to explore differences in ratings by past-year users and non-users (abstainers and ex-users). Participants generated 70 ideas associated with cannabis during the brainstorming sessions and categorized them into six groups: risks and harms, information, legalization, motives, tobacco and cannabis, and normalization. Users and non-users agree that cannabis has health risks and that smoking it mixed with tobacco is the main route of administration, although they do not perceive that this mode increases the hazards. Both users and non-users demand more information. However, they strongly disagree regarding the rest of the clusters. Users distinguish between sensible and problem use. They associate frequent use and coping motives with difficulties, whereas they perceive that moderate use yields pleasures and benefits. They blame the lack of legalization for the social stigma they still suffer. Non-users reject these considerations. Spanish university students believe that cannabis use is normal among young people. Non-users are tolerant of peers who use cannabis, but users feel stigmatized. There is a divide between the two groups regarding the convenience of implementing legal reforms.
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References
Agrawal, A., Budney, A. J., & Lynskey, M. T. (2012). The co-occurring use and misuse of cannabis and tobacco: A review. Addiction, 107, 1221–1233. https://doi.org/10.1111/j.1360-0443.2012.03837.x
Ahern, J., Stuber, J., & Galea, S. (2007). Stigma, discrimination and the health of illicit drug users. Drug and Alcohol Dependence, 88(2–3), 188–196. https://doi.org/10.1016/j.drugalcdep.2006.10.014
Aldridge, J., Measham, F., & Williams, L. (2011). Illegal leisure revisited: Changing patterns of alcohol and drug use in adolescents and young adults. Routledge.
Alvarez, A., Gamella, J. F., & Parra, I. (2016). Cannabis cultivation in Spain. A profile of plantations, growers and production systems. International Journal of Drug Policy, 37, 70–81. https://doi.org/10.1016/j.drugpo.2016.08.003
Becker, H. S. (1953). Becoming a Marihuana user. American Journal of Sociology, 59(3), 235–242.
Blackman, S. (2004). Chilling Out: The cultural politics of substance consumption, youth and drug policy (Vol. 100). Open University Press.
Brochu, S., Lépine, P., Patenaude, C., & Erickson, P. (2018). Formal and informal control of cannabis: Regular users’ experience. Substance Use and Misuse, 53(10), 1657–1665. https://doi.org/10.1080/10826084.2018.1424911
Butters, J. E. (2004). The impact of peers and social disapproval on high-risk cannabis use: Gender differences and implications for drug education. Drugs: Education, Prevention and Policy, 11(5), 381–390. https://doi.org/10.1080/09687630410001704437
CIS (Centro de Investigaciones Sociológicas). (2021). Barómetro de abril 2021. Estudio no 3318. Retrieved from http://www.cis.es/cis/export/sites/default/-Archivos/Marginales/3300_3319/3318/es3318mar.pdf
Cox, C. (2018). The Canadian Cannabis Act legalizes and regulates recreational cannabis use in 2018. Health Policy, 122(3), 205–209. https://doi.org/10.1016/j.healthpol.2018.01.009
Coxon, A. P. M. (1999). Sorting data. Collection and analysis. Sage.
Dahl, S. L., & Sandberg, S. (2014). Female cannabis users and new masculinities: The gendering of cannabis use. Sociology, 49(4), 696–711. https://doi.org/10.1177/0038038514547896
Dioun, C. (2017). Making the medical marijuana market. In J. Beckert & M. Dewey (Eds.), The architecture of illegal markets: Towards an economic sociology of illegality in the economy (pp. 159–176). Oxford University Press.
Dioun, C. (2018). Negotiating moral boundaries: Social movements and the strategic (re)definition of the medical in cannabis markets. Research in the Sociology of Organizations, 56(May), 53–82. https://doi.org/10.1108/S0733-558X20180000056004
Duff, C., Asbridge, M., Brochu, S., Cousineau, M. M., Hathaway, A. D., Marsh, D., & Erickson, P. G. (2012). A Canadian perspective on cannabis normalization among adults. Addiction Research and Theory, 20(4), 271–283. https://doi.org/10.3109/16066359.2011.618957
Duff, C., & Erickson, P. G. (2014). Cannabis, risk and normalisation: Evidence from a Canadian study of socially integrated, adult cannabis users. Health, Risk and Society, 16(3), 210–226. https://doi.org/10.1080/13698575.2014.911823
EMCDDA (European Monitoring Centre for Drugs and Drug Addiction). (2019). EU Drug Markets Report 2019. https://doi.org/10.2810/216248
EMCDDA (European Monitoring Centre for Drugs and Drug Addiction). (2021). European drug report 2021. Trends and developments. Luxembourg: Publications Office of the European Union. Retrieved from https://www.emcdda.europa.eu/system/files/publications/13838/TDAT21001ENN.pdf
EMCDDA (European Monitoring Centre for Drugs and Drug Addiction. (2017) Drug trafficking penalties across the European Union. Retrieved from emcdda.europa.eu/publications/technical-reports/trafficking-penalties
Goffman, E. (1963). Stigma: Notes on the management of spoiled identity. Prentice-Hall.
Guiddens, A. (1990). The consequences of modernity. Polity Press.
Hall, W. D. (2009). The adverse health effects of cannabis use: What are they, and what are their implications for policy? International Journal of Drug Policy, 20(6), 458–466. https://doi.org/10.1016/j.drugpo.2009.02.013
Hathaway, A. (2004). Cannabis users’ informal rules for managing stigma and risk. Deviant Behavior, 25(6), 559–577. https://doi.org/10.1080/01639620490484095
Hathaway, A. (2019). Evidence-based policy development for cannabis? Insights on preventing use by youth. Canadian Public Administration, 62(4), 593–611. https://doi.org/10.1111/capa.12350
Hathaway, A., Comeau, N. C., & Erickson, P. G. (2011). Cannabis normalization and stigma: Contemporary practices of moral regulation. Criminology and Criminal Justice, 11(5), 451–469. https://doi.org/10.1177/1748895811415345
Hathaway, A., Mostaghim, A., Kolar, K., Erickson, P. G., & Osborne, G. (2015). A nuanced view of normalisation: Attitudes of cannabis non-users in a study of undergraduate students at three Canadian universities. Drugs: Education, Prevention and Policy, 23(3), 238–246. https://doi.org/10.3109/09687637.2015.1112362
Järvinen, M., & Ravn, S. (2014). Cannabis careers revisited: Applying Howard S. Becker’s theory to present-day cannabis use. Social Science and Medicine, 100, 133–140. https://doi.org/10.1016/j.socscimed.2013.11.002
Kane, M., & Trochim, W. M. K. (2007). Concept mapping for planning and evaluation. Sage.
Kassambara, A. (2017). Practical guide to cluster analysis in R. Unsupervised machine learning. Retrieved from https://www.datanovia.com/en/wp-content/uploads/dn-tutorials/book-preview/clustering_en_preview.pdf
Kilmer, B., & MacCoun, R. J. (2017). How medical marijuana smoothed the transition to marijuana legalization in the United States. Annual Review of Law and Social Science, 13(1), 181–202. https://doi.org/10.1146/annurev-lawsocsci-110615-084851
Kolar, K. (2021). Women’s use of and access to illicit cannabis: An investigation of gendered norms among college students in Canada. Sex Roles, 84(7–8), 418–438. https://doi.org/10.1007/s11199-020-01176-4
Lau, N., Sales, P., Averill, S., Murphy, F., Sato, S. O., & Murphy, S. (2015). Responsible and controlled use: Older cannabis users and harm reduction. International Journal of Drug Policy, 26(8), 709–718. https://doi.org/10.1016/j.drugpo.2015.03.008
Lemyre, A., Poliakova, N., & Bélanger, R. E. (2019). The relationship between tobacco and cannabis use: A review. Substance Use and Misuse, 54(1), 130–145. https://doi.org/10.1080/10826084.2018.1512623
MacCoun, R. J. (1993). Drugs and the law. A psychological analysis of drug prohibition. Psychological Bulletin, 113(3), 497–512.
McClure, E. A., Tomko, R. L., Salazar, C. A., Akbar, S. A., Squeglia, L. M., Herrmann, E., Carpenter, M. J., & Peters, E. N. (2019). Tobacco and cannabis co-use: Drug substitution, quit interest, and cessation preferences. Experimental and Clinical Psychopharmacology, 27(3), 265–275. https://doi.org/10.1037/pha0000244
Measham, F. (2002). "Doing gender " – " doing drugs ": Conceptualizing the gendering of drugs cultures. Contemporary Drug Problems, 29(2), 335–373.
Mostaghim, A., & Hathaway, A. D. (2013). Identity formation, marijuana and “the self”: A study of cannabis normalization among university students. Frontiers in Psychiatry, 4(DEC), 1–7. https://doi.org/10.3389/fpsyt.2013.00160
NASEM (National Academies of Sciences, Engineering, and Medicine. (2017). The health effects of cannabis and cannabinoids: The current state of evidence and recommendations for research. Washington, D.C.: The National Academies Press. https://doi.org/10.17226/24625
OEDA(Observatorio Español de las Drogas y las Adicciones). (2021). Informe 2021. Alcohol, tabaco y drogas ilegales en España. Madrid: Ministerio de Sanidad. Delegación del Gobierno para el Plan Nacional sobre Drogas. Retrieved from https://pnsd.sanidad.gob.es/profesionales/sistemasInformacion/sistemaInformacion/pdf/2019-20_Informe_EDADES.pdf
Parker, H. (2005). Normalization as a barometer: Recreational drug use and the consumption of leisure by younger Britons. Addiction Research and Theory, 13(3), 205–215. https://doi.org/10.1080/16066350500053703
Parker, H., Aldridge, J., & Measham, F. (1998). Illegal leisure: The normalization of adolescent drug use. Routledge.
Parker, H., Williams, L., & Aldridge, J. (2002). The normalisation of ‘sensible’ recreational drug use: Further evidence from the North West Longitudinal Study. Sociology, 36(4), 941–964. https://doi.org/10.4324/9781843926016
Peretti-Watel, P. (2003). Neutralization theory and the denial of risk: Some evidence from cannabis use among French adolescents. British Journal of Sociology, 54(1), 21–42. https://doi.org/10.1080/0007131032000045888
Robertson, K. J., & Tustin, K. (2020). Control of recreational cannabis in a New Zealand university sample: Perceptions of informal and formal controls. Substance Abuse: Research and Treatment. https://doi.org/10.1177/1178221820953397
Rosansky, J. A., & Rosenberg, H. (2019). Self-reported reasons for abstinence from illicit drugs. Substance Use and Misuse, 54(8), 1272–1285. https://doi.org/10.1080/10826084.2019.1566364
Rousseeuw, P. J. (1987). Silhouettes: A graphical aid to the interpretation and validation of cluster analysis. Journal of Computational and Applied Mathematics, 20, 53–65. https://doi.org/10.1016/0377-0427(87)90125-7
Sandberg, S. (2012). Is cannabis use normalized, celebrated or neutralized? Analysing talk as action. Addiction Research & Theory, 20(5), 372–381. https://doi.org/10.3109/16066359.2011.638147
Sandberg, S. (2013). Cannabis culture: A stable subculture in a changing world. Criminology and Criminal Justice, 13(1), 63–79. https://doi.org/10.1177/1748895812445620
Shildrick, T. (2002). Young people, illicit drug use and the question of normalization. Journal of Youth Studies, 5(1), 35–48. https://doi.org/10.1080/13676260120111751
Shiner, M., & Newburn, T. (1997). Definitely, maybe not? The normalisation of recreational drug use amongst young people. Sociology, 31(3), 511–529.
Skliamis, K., Benschop, A., & Korf, D. J. (2020). Cannabis users and stigma: A comparison of users from European countries with different cannabis policies. European Journal of Criminology. https://doi.org/10.1177/1477370820983560
Thake, J., & Davis, C. G. (2011). Assessing problematic cannabis use. Addiction Research and Theory, 19(5), 448–458. https://doi.org/10.3109/16066359.2010.545154
Trochim, W. M., & McLinden, D. (2017). Introduction to a special issue on concept mapping. Evaluation and Program Planning, 60, 166–175. https://doi.org/10.1016/j.evalprogplan.2016.10.006
UNODC. (2021). World Drug Report 2021. Drug Market Trends: Cannabis. Retrieved from https://www.unodc.org/res/wdr2021/field/WDR21_Booklet_3.pdf
Volkow, N. D., Baler, R. D., Compton, W. M., & Weiss, S. R. B. (2014). Adverse health effects of marijuana use. New England Journal of Medicine, 370(23), 2219–2227. https://doi.org/10.1056/NEJMra1402309
WHO (World Health Organization). (2016). The health and social effects of nonmedical cannabis use. Retrieved from http://who.int/substance_abuse/publications/msbcannabis.pdf?ua=1
Zinberg, N. E. (1984). Drug, set and setting. The basis for controlled intoxican use. Yale University Press.
Acknowledgements
We are grateful to Adelaida Lozano-Polo and Manuel Isorna Folgar for helping us recruit participants at their universities and to all the students who collaborated in the study.
Funding
This research was supported by the Research Project # 2017 | 52, “Intensive and frequent cannabis use in Spain” (CIRCE), funded by the Government Delegation for National Plan on Drugs, of the Ministry of Health, Social Services and Equality, Spain.
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Alvarez-Roldan, A., Parra, I. & Villanueva-Blasco, V.J. Attitudes Toward Cannabis of Users and Non-users in Spain: a Concept Mapping Study Among University Students. Int J Ment Health Addiction 21, 3952–3970 (2023). https://doi.org/10.1007/s11469-022-00835-9
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DOI: https://doi.org/10.1007/s11469-022-00835-9