{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T04:18:26Z","timestamp":1783397906144,"version":"3.54.6"},"reference-count":65,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T00:00:00Z","timestamp":1778716800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T00:00:00Z","timestamp":1783382400000},"content-version":"vor","delay-in-days":54,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Cannabis Res"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cannabis use and cannabis-related harms remain important public health concerns among college-age adults. However, nationally representative estimates that characterize the severity of problematic cannabis use in U.S. college students are limited. Using pooled American College Health Association-National College Health Assessment (ACHA-NCHA) III data, we developed a screening-based index of cannabis involvement severity and examined mental health and other correlates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cross-sectional study used pooled ACHA-NCHA III data from Fall 2019 to Spring 2024. Cannabis involvement severity was operationalized using cannabis-specific items from the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) module embedded in the ACHA-NCHA III (e.g., use frequency, craving\/urge, difficulty controlling use, role impairment, and cannabis-related problems). Indicator responses were summed and categorized as no\/low involvement (0\u20131), mild (2\u20133), moderate (4\u20135), or severe\/high involvement (\u2265\u20096). We estimated prevalence overall and among students with lifetime cannabis use. Ordinal logistic regression identified correlates of greater involvement severity among those with lifetime cannabis use. Modified Poisson and log-linear models assessed associations between involvement severity and mental health indicators among students with cannabis use history.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The prevalence of elevated problematic cannabis involvement (score\u2009\u2265\u20092) was 8.66% among all students and 20.77% among those with lifetime cannabis use; among students with cannabis use history, 7.32% had mild involvement, 6.88% moderate involvement, and 6.56% severe\/high involvement. Greater involvement severity was more common among males, American Indian\/Alaskan Native\/Non-Hispanic (NH) Black\/NH Other\/NH multiracial students (compared with NH White), undergraduates (compared with Master\u2019s\/PhD students), and those not living on campus, and was associated with greater co-occurring tobacco\/other substance use and greater counts of chronic mental health conditions. Compared to students with no\/low cannabis involvement, those with mild\/moderate\/severe involvement had higher prevalence of anxiety, depression, other mental health conditions, and mental health service receipt, as well as higher non-specific serious mental illness, loneliness, and suicide behavior scores.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Problematic cannabis involvement is common among U.S. college students and shows a graded association with adverse mental health indicators. These findings support targeted screening and integrated behavioral health services for students reporting more severe patterns of cannabis involvement.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s42238-026-00446-4","type":"journal-article","created":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T01:55:03Z","timestamp":1778723703000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Operationalizing ASSIST-based indicators to estimate the prevalence and correlates of problematic cannabis involvement among U.S. college students"],"prefix":"10.1186","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3376-220X","authenticated-orcid":false,"given":"Fares","family":"Qeadan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashlie","family":"McCunn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anumitha","family":"Aravindan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Tingey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,14]]},"reference":[{"issue":"6","key":"446_CR1","doi-asserted-by":"publisher","first-page":"609","DOI":"10.1001\/jamapsychiatry.2025.0432","volume":"82","author":"J Ahrens","year":"2025","unstructured":"Ahrens J, Ford SD, Schaefer B, Reese D, Khan AR, Tibbo P, Rabin R, Cassidy CM, Palaniyappan L. Convergence of Cannabis and Psychosis on the Dopamine System. JAMA Psychiatry. 2025;82(6):609\u201317. https:\/\/doi.org\/10.1001\/jamapsychiatry.2025.0432.","journal-title":"JAMA Psychiatry"},{"issue":"12","key":"446_CR2","doi-asserted-by":"publisher","first-page":"e32316","DOI":"10.7759\/cureus.32316","volume":"14","author":"M Alhammad","year":"2022","unstructured":"Alhammad M, Aljedani R, Alsaleh M, Atyia N, Alsmakh M, Alfaraj A, Alkhunaizi A, Alwabari J, Alzaidi M. Family, Individual, and Other Risk Factors Contributing to Risk of Substance Abuse in Young Adults: A Narrative Review. Cureus. 2022;14(12):e32316. https:\/\/doi.org\/10.7759\/cureus.32316.","journal-title":"Cureus"},{"issue":"3","key":"446_CR3","doi-asserted-by":"publisher","first-page":"1643","DOI":"10.1016\/j.addbeh.2012.10.002","volume":"38","author":"AM Arria","year":"2013","unstructured":"Arria AM, Wilcox HC, Caldeira KM, Vincent KB, Garnier-Dykstra LM, O\u2019Grady KE. Dispelling the myth of smart drugs: Cannabis and alcohol use problems predict nonmedical use of prescription stimulants for studying. Addict Behav. 2013;38(3):1643\u201350. https:\/\/doi.org\/10.1016\/j.addbeh.2012.10.002.","journal-title":"Addict Behav"},{"issue":"1","key":"446_CR4","doi-asserted-by":"publisher","first-page":"e1919792","DOI":"10.1001\/jamanetworkopen.2019.19792","volume":"3","author":"JL Barrington-Trimis","year":"2020","unstructured":"Barrington-Trimis JL, Cho J, Ewusi-Boisvert E, Hasin D, Unger JB, Miech RA, Leventhal AM. Risk of Persistence and Progression of Use of 5 Cannabis Products After Experimentation Among Adolescents. JAMA Netw Open. 2020;3(1):e1919792\u20131919792. https:\/\/doi.org\/10.1001\/jamanetworkopen.2019.19792.","journal-title":"JAMA Netw Open"},{"key":"446_CR5","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1016\/j.drugalcdep.2013.11.013","volume":"135","author":"LC Bidwell","year":"2014","unstructured":"Bidwell LC, Henry EA, Willcutt EG, Kinnear MK, Ito TA. Childhood and current ADHD symptom dimensions are associated with more severe cannabis outcomes in college students. Drug Alcohol Depend. 2014;135:88\u201394. https:\/\/doi.org\/10.1016\/j.drugalcdep.2013.11.013.","journal-title":"Drug Alcohol Depend"},{"issue":"6","key":"446_CR6","doi-asserted-by":"publisher","first-page":"900","DOI":"10.1111\/dar.13281","volume":"40","author":"LC Bidwell","year":"2021","unstructured":"Bidwell LC, Martin-Willett R, Karoly HC. Advancing the science on cannabis concentrates and behavioural health. Drug Alcohol Rev. 2021;40(6):900\u201313. https:\/\/doi.org\/10.1111\/dar.13281.","journal-title":"Drug Alcohol Rev"},{"issue":"4","key":"446_CR7","doi-asserted-by":"publisher","first-page":"388","DOI":"10.1001\/jamapsychiatry.2015.3229","volume":"73","author":"C Blanco","year":"2016","unstructured":"Blanco C, Hasin DS, Wall MM, Fl\u00f3rez-Salamanca L, Hoertel N, Wang S, Kerridge BT, Olfson M. Cannabis Use and Risk of Psychiatric Disorders: Prospective Evidence From a US National Longitudinal Study. JAMA Psychiatry. 2016;73(4):388\u201395. https:\/\/doi.org\/10.1001\/jamapsychiatry.2015.3229.","journal-title":"JAMA Psychiatry"},{"issue":"8","key":"446_CR8","doi-asserted-by":"publisher","first-page":"1537","DOI":"10.1016\/j.addbeh.2006.11.012","volume":"32","author":"J Brodbeck","year":"2007","unstructured":"Brodbeck J, Matter M, Page J, Moggi F. Motives for cannabis use as a moderator variable of distress among young adults. Addict Behav. 2007;32(8):1537\u201345. https:\/\/doi.org\/10.1016\/j.addbeh.2006.11.012.","journal-title":"Addict Behav"},{"issue":"5","key":"446_CR9","doi-asserted-by":"publisher","first-page":"720","DOI":"10.15288\/jsad.2013.74.720","volume":"74","author":"JD Buckner","year":"2013","unstructured":"Buckner JD. College Cannabis Use: The Unique Roles of Social Norms, Motives, and Expectancies. J Stud Alcohol Drug. 2013;74(5):720\u20136. https:\/\/doi.org\/10.15288\/jsad.2013.74.720.","journal-title":"J Stud Alcohol Drug"},{"issue":"3","key":"446_CR10","doi-asserted-by":"publisher","first-page":"397","DOI":"10.1016\/j.addbeh.2007.10.001","volume":"33","author":"KM Caldeira","year":"2008","unstructured":"Caldeira KM, Arria AM, O\u2019Grady KE, Vincent KB, Wish ED. The occurrence of cannabis use disorders and other cannabis-related problems among first-year college students. Addict Behav. 2008;33(3):397\u2013411. https:\/\/doi.org\/10.1016\/j.addbeh.2007.10.001.","journal-title":"Addict Behav"},{"issue":"10","key":"446_CR11","doi-asserted-by":"publisher","first-page":"1811","DOI":"10.1007\/s10552-013-0259-0","volume":"24","author":"RC Callaghan","year":"2013","unstructured":"Callaghan RC, Allebeck P, Sidorchuk A. Marijuana use and risk of lung cancer: a 40-year cohort study. Cancer Causes Control. 2013;24(10):1811\u201320. https:\/\/doi.org\/10.1007\/s10552-013-0259-0.","journal-title":"Cancer Causes Control"},{"issue":"2","key":"446_CR12","doi-asserted-by":"publisher","first-page":"165","DOI":"10.1001\/jamapsychiatry.2019.3254","volume":"77","author":"M Cerd\u00e1","year":"2020","unstructured":"Cerd\u00e1 M, Mauro C, Hamilton A, Levy NS, Santaella-Tenorio J, Hasin D, Wall MM, Keyes KM, Martins SS. Association Between Recreational Marijuana Legalization in the United States and Changes in Marijuana Use and Cannabis Use Disorder From 2008 to 2016. JAMA Psychiatry. 2020;77(2):165\u201371. https:\/\/doi.org\/10.1001\/jamapsychiatry.2019.3254.","journal-title":"JAMA Psychiatry"},{"key":"446_CR13","doi-asserted-by":"publisher","unstructured":"Choi NG, Moore J, Choi BY. Cannabis use disorder and substance use treatment among U.S. adults. J Subst Use Addict Treat. 2024;167. https:\/\/doi.org\/10.1016\/j.josat.2024.209486.","DOI":"10.1016\/j.josat.2024.209486"},{"issue":"2","key":"446_CR14","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1002\/da.10113","volume":"18","author":"KM Connor","year":"2003","unstructured":"Connor KM, Davidson JRT. Development of a new resilience scale: The Connor-Davidson Resilience Scale (CD-RISC). Depress Anxiety. 2003;18(2):76\u201382. https:\/\/doi.org\/10.1002\/da.10113.","journal-title":"Depress Anxiety"},{"key":"446_CR43","unstructured":"MPG Consulting , University of Colorado Boulder Leeds School of Business. &. 2020 Regulated Marijuana Market Update. 2021. https:\/\/sbg.colorado.gov\/sites\/sbg\/files\/2020-Regulated-Marijuana-Market-Update-Final.pdf"},{"issue":"2","key":"446_CR15","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1007\/s11205-009-9493-y","volume":"97","author":"E Diener","year":"2010","unstructured":"Diener E, Wirtz D, Tov W, Kim-Prieto C, Choi D-w, Oishi S, Biswas-Diener R. New Well-being Measures: Short Scales to Assess Flourishing and Positive and Negative Feelings. Soc Indic Res. 2010;97(2):143\u201356. https:\/\/doi.org\/10.1007\/s11205-009-9493-y.","journal-title":"Soc Indic Res"},{"key":"446_CR16","doi-asserted-by":"publisher","first-page":"108476","DOI":"10.1016\/j.addbeh.2025.108476","volume":"171","author":"T Ebling","year":"2025","unstructured":"Ebling T, de Silva GSR, Azagba S. Housing instability, race\/ethnicity, and sexual identity as intersectional factors in adolescent cannabis use. Addict Behav. 2025;171:108476. https:\/\/doi.org\/10.1016\/j.addbeh.2025.108476.","journal-title":"Addict Behav"},{"issue":"5","key":"446_CR17","doi-asserted-by":"publisher","first-page":"600","DOI":"10.1038\/s41593-020-0611-0","volume":"23","author":"J-MN Ferland","year":"2020","unstructured":"Ferland J-MN, Hurd YL. Deconstructing the neurobiology of cannabis use disorder. Nat Neurosci. 2020;23(5):600\u201310. https:\/\/doi.org\/10.1038\/s41593-020-0611-0.","journal-title":"Nat Neurosci"},{"key":"446_CR18","doi-asserted-by":"publisher","first-page":"106188","DOI":"10.1016\/j.addbeh.2019.106188","volume":"102","author":"NC Glodosky","year":"2020","unstructured":"Glodosky NC, Cuttler C. Motives Matter: Cannabis use motives moderate the associations between stress and negative affect. Addict Behav. 2020;102:106188. https:\/\/doi.org\/10.1016\/j.addbeh.2019.106188.","journal-title":"Addict Behav"},{"issue":"3","key":"446_CR19","doi-asserted-by":"publisher","first-page":"479","DOI":"10.1016\/j.jadohealth.2023.10.003","volume":"74","author":"I Gripe","year":"2024","unstructured":"Gripe I, Pape H, Norstr\u00f6m T. Associations Between Cannabis Use and Mental Distress in Young People: A Longitudinal Study. J Adolesc Health. 2024;74(3):479\u201386. https:\/\/doi.org\/10.1016\/j.jadohealth.2023.10.003.","journal-title":"J Adolesc Health"},{"issue":"3","key":"446_CR20","doi-asserted-by":"publisher","first-page":"221","DOI":"10.1080\/09540261.2020.1713056","volume":"32","author":"CJ Hammond","year":"2020","unstructured":"Hammond CJ, Chaney A, Hendrickson B, Sharma P. Cannabis use among U.S. adolescents in the era of marijuana legalization: a review of changing use patterns, comorbidity, and health correlates. Int Rev Psychiatry. 2020;32(3):221\u201334. https:\/\/doi.org\/10.1080\/09540261.2020.1713056.","journal-title":"Int Rev Psychiatry"},{"issue":"6","key":"446_CR21","doi-asserted-by":"publisher","first-page":"e2113025","DOI":"10.1001\/jamanetworkopen.2021.13025","volume":"4","author":"B Han","year":"2021","unstructured":"Han B, Compton WM, Einstein EB, Volkow ND. Associations of Suicidality Trends With Cannabis Use as a Function of Sex and Depression Status. JAMA Netw Open. 2021;4(6):e2113025\u20132113025. https:\/\/doi.org\/10.1001\/jamanetworkopen.2021.13025.","journal-title":"JAMA Netw Open"},{"issue":"12","key":"446_CR24","doi-asserted-by":"publisher","first-page":"1235","DOI":"10.1001\/jamapsychiatry.2015.1858","volume":"72","author":"DS Hasin","year":"2015","unstructured":"Hasin DS, Saha TD, Kerridge BT, Goldstein RB, Chou SP, Zhang H, Jung J, Pickering RP, Ruan WJ, Smith SM, Huang B, Grant BF. Prevalence of Marijuana Use Disorders in the United States Between 2001\u20132002 and 2012\u20132013. JAMA Psychiatry. 2015;72(12):1235\u201342. https:\/\/doi.org\/10.1001\/jamapsychiatry.2015.1858.","journal-title":"JAMA Psychiatry"},{"issue":"6","key":"446_CR23","doi-asserted-by":"publisher","first-page":"588","DOI":"10.1176\/appi.ajp.2015.15070907","volume":"173","author":"DS Hasin","year":"2016","unstructured":"Hasin DS, Kerridge BT, Saha TD, Huang B, Pickering R, Smith SM, Jung J, Zhang H, Grant BF. Prevalence and Correlates of DSM-5 Cannabis Use Disorder, 2012\u20132013: Findings from the National Epidemiologic Survey on Alcohol and Related Conditions\u2013III. Am J Psychiatry. 2016;173(6):588\u201399. https:\/\/doi.org\/10.1176\/appi.ajp.2015.15070907.","journal-title":"Am J Psychiatry"},{"key":"446_CR22","doi-asserted-by":"publisher","first-page":"834","DOI":"10.1176\/appi.ajp.2013.12060782","volume":"170","author":"S Hasin Deborah","year":"2013","unstructured":"Hasin Deborah S, O\u2019Brien Charles P, Auriacombe M, Borges G, Bucholz K, Budney A, Wilson C, Crowley M, Ling T, Petry Nancy W, Schuckit M, M., Grant Bridget F. DSM-5 Criteria for Substance Use Disorders: Recommendations and Rationale. Am J Psychiatry. 2013;170:834\u201351. https:\/\/doi.org\/10.1176\/appi.ajp.2013.12060782.","journal-title":"Am J Psychiatry"},{"issue":"1","key":"446_CR26","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1016\/j.jaacop.2023.02.002","volume":"1","author":"JD Hinckley","year":"2023","unstructured":"Hinckley JD, Mikulich-Gilbertson SK, He J-P, Bhatia D, Ellingson JM, Vu BN, Merikangas KR, Sakai JT. Cannabis Use Is Associated With Depression Severity and Suicidality in the National Comorbidity Survey\u2013Adolescent Supplement. JAACAP Open. 2023;1(1):24\u201335. https:\/\/doi.org\/10.1016\/j.jaacop.2023.02.002.","journal-title":"JAACAP Open"},{"issue":"5","key":"446_CR25","doi-asserted-by":"publisher","first-page":"353","DOI":"10.1176\/appi.ajp.20231006","volume":"181","author":"JD Hinckley","year":"2024","unstructured":"Hinckley JD, Ferland J-MN, Hurd YL. The Developmental Trajectory to Cannabis Use Disorder. Am J Psychiatry. 2024;181(5):353\u20138. https:\/\/doi.org\/10.1176\/appi.ajp.20231006.","journal-title":"Am J Psychiatry"},{"issue":"10","key":"446_CR27","doi-asserted-by":"publisher","first-page":"1044","DOI":"10.1001\/jamapsychiatry.2020.1035","volume":"77","author":"LA Hines","year":"2020","unstructured":"Hines LA, Freeman TP, Gage SH, Zammit S, Hickman M, Cannon M, Munafo M, MacLeod J, Heron J. Association of High-Potency Cannabis Use With Mental Health and Substance Use in Adolescence. JAMA Psychiatry. 2020;77(10):1044\u201351. https:\/\/doi.org\/10.1001\/jamapsychiatry.2020.1035.","journal-title":"JAMA Psychiatry"},{"issue":"6","key":"446_CR28","doi-asserted-by":"publisher","first-page":"655","DOI":"10.1177\/0164027504268574","volume":"26","author":"ME Hughes","year":"2004","unstructured":"Hughes ME, Waite LJ, Hawkley LC, Cacioppo JT. A Short Scale for Measuring Loneliness in Large Surveys: Results From Two Population-Based Studies. Res Aging. 2004;26(6):655\u201372. https:\/\/doi.org\/10.1177\/0164027504268574.","journal-title":"Res Aging"},{"issue":"6","key":"446_CR29","doi-asserted-by":"publisher","first-page":"1039","DOI":"10.1111\/j.1360-0443.2007.02114.x","volume":"103","author":"R Humeniuk","year":"2008","unstructured":"Humeniuk R, Ali R, Babor TF, Farrell M, Formigoni ML, Jittiwutikarn J, De Lacerda RB, Ling W, Marsden J, Monteiro M, Nhiwatiwa S, Pal H, Poznyak V, Simon S. Validation of the alcohol, smoking and substance involvement screening test (ASSIST). Addiction. 2008;103(6):1039\u201347. https:\/\/doi.org\/10.1111\/j.1360-0443.2007.02114.x.","journal-title":"Addiction"},{"key":"446_CR30","unstructured":"Humeniuk R, Henry-Edwards S, Ali R, Poznyak V, Monteiro MG. The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST): manual for use in primary care. World Health Organization. Retrieved September 23 from 2010. https:\/\/iris.who.int\/bitstream\/handle\/10665\/44320\/9789241599382_eng.pdf."},{"issue":"1","key":"446_CR31","doi-asserted-by":"publisher","first-page":"136","DOI":"10.1186\/1471-244X-14-136","volume":"14","author":"KK Kedzior","year":"2014","unstructured":"Kedzior KK, Laeber LT. A positive association between anxiety disorders and cannabis use or cannabis use disorders in the general population- a meta-analysis of 31 studies. BMC Psychiatry. 2014;14(1):136. https:\/\/doi.org\/10.1186\/1471-244X-14-136.","journal-title":"BMC Psychiatry"},{"issue":"6","key":"446_CR32","doi-asserted-by":"publisher","first-page":"499","DOI":"10.1111\/ajad.12201","volume":"24","author":"DR Keith","year":"2015","unstructured":"Keith DR, Hart CL, McNeil MP, Silver R, Goodwin RD. Frequent marijuana use, binge drinking and mental health problems among undergraduates. Am J Addictions. 2015;24(6):499\u2013506. https:\/\/doi.org\/10.1111\/ajad.12201.","journal-title":"Am J Addictions"},{"issue":"6","key":"446_CR33","doi-asserted-by":"publisher","first-page":"959","DOI":"10.1017\/S0033291702006074","volume":"32","author":"RC Kessler","year":"2002","unstructured":"Kessler RC, Andrews G, Colpe LJ, Hiripi E, Mroczek DK, Normand SLT, Walters EE, Zaslavsky AM. Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychol Med. 2002;32(6):959\u201376. https:\/\/doi.org\/10.1017\/S0033291702006074.","journal-title":"Psychol Med"},{"issue":"3","key":"446_CR34","doi-asserted-by":"publisher","first-page":"559","DOI":"10.1111\/add.14776","volume":"115","author":"E Kroon","year":"2020","unstructured":"Kroon E, Kuhns L, Hoch E, Cousijn J. Heavy cannabis use, dependence and the brain: a clinical perspective. Addiction. 2020;115(3):559\u201372. https:\/\/doi.org\/10.1111\/add.14776.","journal-title":"Addiction"},{"issue":"6","key":"446_CR35","doi-asserted-by":"publisher","first-page":"1606","DOI":"10.1080\/07448481.2020.1834401","volume":"70","author":"AM Lederer","year":"2022","unstructured":"Lederer AM, Hoban MT. The development of the American College Health Association-National College Health Assessment III: An improved tool to assess and enhance the health and well-being of college students. J Am Coll Health. 2022;70(6):1606\u201310. https:\/\/doi.org\/10.1080\/07448481.2020.1834401.","journal-title":"J Am Coll Health"},{"issue":"1","key":"446_CR36","doi-asserted-by":"publisher","first-page":"31","DOI":"10.35946\/arcr.v39.1.06","volume":"39","author":"MR Lee","year":"2018","unstructured":"Lee MR, Sher KJ. Maturing Out of Binge and Problem Drinking. Alcohol Res. 2018;39(1):31\u201342. https:\/\/doi.org\/10.35946\/arcr.v39.1.06.","journal-title":"Alcohol Res"},{"key":"446_CR37","doi-asserted-by":"publisher","first-page":"106479","DOI":"10.1016\/j.addbeh.2020.106479","volume":"109","author":"J Leung","year":"2020","unstructured":"Leung J, Chan GCK, Hides L, Hall WD. What is the prevalence and risk of cannabis use disorders among people who use cannabis? a systematic review and meta-analysis. Addict Behav. 2020;109:106479. https:\/\/doi.org\/10.1016\/j.addbeh.2020.106479.","journal-title":"Addict Behav"},{"issue":"1","key":"446_CR38","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1007\/s00406-018-0970-7","volume":"269","author":"DJE Lowe","year":"2019","unstructured":"Lowe DJE, Sasiadek JD, Coles AS, George TP. Cannabis and mental illness: a review. Eur Arch Psychiatry Clin NeuroSci. 2019;269(1):107\u201320. https:\/\/doi.org\/10.1007\/s00406-018-0970-7.","journal-title":"Eur Arch Psychiatry Clin NeuroSci"},{"key":"446_CR39","doi-asserted-by":"publisher","first-page":"109795","DOI":"10.1016\/j.drugalcdep.2023.109795","volume":"244","author":"CK Lui","year":"2023","unstructured":"Lui CK, Witbrodt J, Li L, Tam CC, Williams E, Guo Z, Mulia N. Associations between early childhood adversity and behavioral, substance use, and academic outcomes in childhood through adolescence in a U.S. longitudinal cohort. Drug Alcohol Depend. 2023;244:109795. https:\/\/doi.org\/10.1016\/j.drugalcdep.2023.109795.","journal-title":"Drug Alcohol Depend"},{"issue":"3","key":"446_CR40","doi-asserted-by":"publisher","first-page":"560","DOI":"10.1111\/add.15177","volume":"116","author":"S Marmet","year":"2021","unstructured":"Marmet S, Studer J, Wicki M, Gmel G. Cannabis use disorder trajectories and their prospective predictors in a large population-based sample of young Swiss men. Addiction. 2021;116(3):560\u201370. https:\/\/doi.org\/10.1111\/add.15177.","journal-title":"Addiction"},{"key":"446_CR41","doi-asserted-by":"publisher","unstructured":"McKinnon II, Krause KH, Robin L, King A, Leon-Nguyen M, Zavala E, Suarez NA, Lim C, Smith-Grant J, Underwood M. Experiences of Unstable Housing Among High School Students \u2014 Youth Risk Behavior Survey, United States, 2021. MMWR supplements, 2023;72;29\u201336. https:\/\/doi.org\/10.15585\/mmwr.su7201a4.","DOI":"10.15585\/mmwr.su7201a4"},{"issue":"9","key":"446_CR42","doi-asserted-by":"publisher","first-page":"3196","DOI":"10.1080\/07448481.2022.2155058","volume":"72","author":"SB Morissette","year":"2024","unstructured":"Morissette SB, Blessing A, Russell P, Hale W. Cannabis use disorder uniquely predicts educational impairment in college students over and above other mental health disorders. J Am Coll Health. 2024;72(9):3196\u2013203. https:\/\/doi.org\/10.1080\/07448481.2022.2155058.","journal-title":"J Am Coll Health"},{"issue":"4","key":"446_CR44","first-page":"202","volume":"28","author":"PM O\u2019Malley","year":"2004","unstructured":"O\u2019Malley PM. Maturing out of problematic alcohol use. Alcohol Res Health. 2004;28(4):202. https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC6601682\/pdf\/202-204.pdf.","journal-title":"Alcohol Res Health"},{"issue":"4","key":"446_CR45","doi-asserted-by":"publisher","first-page":"443","DOI":"10.1177\/107319110100800409","volume":"8","author":"A Osman","year":"2001","unstructured":"Osman A, Bagge CL, Gutierrez PM, Konick LC, Kopper BA, Barrios FX. The Suicidal Behaviors Questionnaire-Revised (SBQ-R):Validation with Clinical and Nonclinical Samples. Assessment. 2001;8(4):443\u201354. https:\/\/doi.org\/10.1177\/107319110100800409.","journal-title":"Assessment"},{"key":"446_CR46","doi-asserted-by":"crossref","unstructured":"Patrick ME, Miech RA, Johnston LD, O\u2019Malley PM. Monitoring the Future Panel Study annual report: National data on substance use among adults ages 19 to 65, 1976\u20132023 (Monitoring the Future Monograph Series, Issue. 2024. https:\/\/monitoringthefuture.org\/wp-content\/uploads\/2024\/07\/mtfpanel2024.pdf.","DOI":"10.7826\/ISR-UM.06.585140.002.07.0003.2024"},{"issue":"9","key":"446_CR47","doi-asserted-by":"publisher","first-page":"736","DOI":"10.1016\/S2215-0366(22)00161-4","volume":"9","author":"K Petrilli","year":"2022","unstructured":"Petrilli K, Ofori S, Hines L, Taylor G, Adams S, Freeman TP. Association of cannabis potency with mental ill health and addiction: a systematic review. Lancet Psychiatry. 2022;9(9):736\u201350. https:\/\/doi.org\/10.1016\/S2215-0366(22)00161-4.","journal-title":"Lancet Psychiatry"},{"issue":"3","key":"446_CR48","doi-asserted-by":"publisher","first-page":"477","DOI":"10.1080\/10826084.2017.1341923","volume":"53","author":"KT Phillips","year":"2018","unstructured":"Phillips KT, Phillips MM, Duck KD. Factors Associated With Marijuana use and Problems Among College Students in Colorado. Subst Use Misuse. 2018;53(3):477\u201383. https:\/\/doi.org\/10.1080\/10826084.2017.1341923.","journal-title":"Subst Use Misuse"},{"key":"446_CR49","doi-asserted-by":"publisher","first-page":"108148","DOI":"10.1016\/j.ypmed.2024.108148","volume":"189","author":"SA Pitman","year":"2024","unstructured":"Pitman SA, Pasch KE, Poulos NS, Velazquez CE. Food insecurity and substance use among young adults in the United States. Prev Med. 2024;189:108148. https:\/\/doi.org\/10.1016\/j.ypmed.2024.108148.","journal-title":"Prev Med"},{"key":"446_CR50","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2025.06.037","author":"IC Rhew","year":"2025","unstructured":"Rhew IC, Cadigan JM, Guttmannova K, Caouette JD, Kuklinski MR, Oesterle S. The Longitudinal Relationship of Loneliness With Frequency and Problematic Use of Alcohol and Cannabis Among Young Adults. J Adolesc Health. 2025. https:\/\/doi.org\/10.1016\/j.jadohealth.2025.06.037.","journal-title":"J Adolesc Health"},{"issue":"12","key":"446_CR51","doi-asserted-by":"publisher","first-page":"1362","DOI":"10.1177\/02698811221115760","volume":"36","author":"KL Rock","year":"2022","unstructured":"Rock KL, Englund A, Morley S, Rice K, Copeland CS. Can cannabis kill? Characteristics of deaths following cannabis use in England (1998\u20132020). J Psychopharmacol. 2022;36(12):1362\u201370. https:\/\/doi.org\/10.1177\/02698811221115760.","journal-title":"J Psychopharmacol"},{"issue":"11","key":"446_CR52","doi-asserted-by":"publisher","first-page":"1040","DOI":"10.1007\/s00115-020-00930-z","volume":"91","author":"A-K Seidel","year":"2020","unstructured":"Seidel A-K, Morgenstern M, Hanewinkel R. Risikofaktoren f\u00fcr einen riskanten Cannabiskonsum. Nervenarzt. 2020;91(11):1040\u20136. https:\/\/doi.org\/10.1007\/s00115-020-00930-z.","journal-title":"Nervenarzt"},{"key":"446_CR53","doi-asserted-by":"publisher","unstructured":"Shah S, Patel S, Paulraj S, Chaudhuri D. Association of marijuana use and cardiovascular disease: a behavioral risk factor surveillance system data analysis of 133,706 US adults. Am J Med. 2021;134(5):614\u201320. https:\/\/doi.org\/10.1016\/j.amjmed.2020.10.019.","DOI":"10.1016\/j.amjmed.2020.10.019"},{"issue":"1","key":"446_CR54","doi-asserted-by":"publisher","first-page":"300","DOI":"10.1038\/s43856-025-01018-y","volume":"5","author":"M Skumlien","year":"2025","unstructured":"Skumlien M, Jones D, Mokrysz C, Lees R, Petrilli K, Ofori S, Lawn W, Curran HV, Freeman TP. Longitudinal study of risk factors predicting cannabis use disorder in UK young adults and adolescents. Commun Med. 2025;5(1):300. https:\/\/doi.org\/10.1038\/s43856-025-01018-y.","journal-title":"Commun Med"},{"issue":"12","key":"446_CR55","doi-asserted-by":"publisher","first-page":"2167","DOI":"10.1111\/add.13886","volume":"112","author":"R Smart","year":"2017","unstructured":"Smart R, Caulkins JP, Kilmer B, Davenport S, Midgette G. Variation in cannabis potency and prices in a newly legal market: evidence from 30 million cannabis sales in Washington state. Addiction. 2017;112(12):2167\u201377. https:\/\/doi.org\/10.1111\/add.13886.","journal-title":"Addiction"},{"key":"446_CR56","unstructured":"Substance Abuse and Mental Health Services Administration. Key substance use and mental health indicators in the United States: Results from the 2024 National Survey on Drug Use and Health. Center for Behavioral Health Statistics and Quality Substance Abuse and Mental Health Services Administration. Retrieved July 22 from 2025. https:\/\/www.samhsa.gov\/data\/sites\/default\/files\/reports\/rpt56287\/2024-nsduh-annual-national-report.pdf."},{"key":"446_CR57","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1016\/j.drugalcdep.2016.02.041","volume":"162","author":"CK Suerken","year":"2016","unstructured":"Suerken CK, Reboussin BA, Egan KL, Sutfin EL, Wagoner KG, Spangler J, Wolfson M. Marijuana use trajectories and academic outcomes among college students. Drug Alcohol Depend. 2016;162:137\u201345. https:\/\/doi.org\/10.1016\/j.drugalcdep.2016.02.041.","journal-title":"Drug Alcohol Depend"},{"issue":"5","key":"446_CR58","doi-asserted-by":"publisher","first-page":"e2311294","DOI":"10.1001\/jamanetworkopen.2023.11294","volume":"6","author":"RS Sultan","year":"2023","unstructured":"Sultan RS, Zhang AW, Olfson M, Kwizera MH, Levin FR. Nondisordered Cannabis Use Among US Adolescents. JAMA Netw Open. 2023;6(5):e2311294\u20132311294. https:\/\/doi.org\/10.1001\/jamanetworkopen.2023.11294.","journal-title":"JAMA Netw Open"},{"issue":"3","key":"446_CR59","doi-asserted-by":"publisher","first-page":"709","DOI":"10.1007\/s10902-016-9742-0","volume":"18","author":"S Tartaglia","year":"2017","unstructured":"Tartaglia S, Miglietta A, Gattino S. Life Satisfaction and Cannabis Use: A Study on Young Adults. J Happiness Stud. 2017;18(3):709\u201318. https:\/\/doi.org\/10.1007\/s10902-016-9742-0.","journal-title":"J Happiness Stud"},{"issue":"2","key":"446_CR60","doi-asserted-by":"publisher","first-page":"257","DOI":"10.1007\/s11121-018-0904-7","volume":"20","author":"K Thompson","year":"2019","unstructured":"Thompson K, Leadbeater B, Ames M, Merrin GJ. Associations Between Marijuana Use Trajectories and Educational and Occupational Success in Young Adulthood. Prev Sci. 2019;20(2):257\u201369. https:\/\/doi.org\/10.1007\/s11121-018-0904-7.","journal-title":"Prev Sci"},{"issue":"2","key":"446_CR61","doi-asserted-by":"publisher","first-page":"293","DOI":"10.1016\/j.psychres.2007.01.006","volume":"152","author":"S Vaishnavi","year":"2007","unstructured":"Vaishnavi S, Connor K, Davidson JRT. An abbreviated version of the Connor-Davidson Resilience Scale (CD-RISC), the CD-RISC2: Psychometric properties and applications in psychopharmacological trials. Psychiatry Res. 2007;152(2):293\u20137. https:\/\/doi.org\/10.1016\/j.psychres.2007.01.006.","journal-title":"Psychiatry Res"},{"issue":"1","key":"446_CR62","doi-asserted-by":"publisher","first-page":"46528","DOI":"10.1038\/srep46528","volume":"7","author":"D Vergara","year":"2017","unstructured":"Vergara D, Bidwell LC, Gaudino R, Torres A, Du G, Ruthenburg TC, deCesare K, Land DP, Hutchison KE, Kane NC. Compromised External Validity: Federally Produced Cannabis Does Not Reflect Legal Markets. Sci Rep. 2017;7(1):46528. https:\/\/doi.org\/10.1038\/srep46528.","journal-title":"Sci Rep"},{"issue":"1","key":"446_CR63","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1016\/j.chc.2022.07.004","volume":"32","author":"ML West","year":"2023","unstructured":"West ML, Sharif S. Cannabis and Psychosis. Child Adolesc Psychiatr Clin N Am. 2023;32(1):69\u201383. https:\/\/doi.org\/10.1016\/j.chc.2022.07.004.","journal-title":"Child Adolesc Psychiatr Clin N Am"},{"key":"446_CR64","doi-asserted-by":"publisher","first-page":"S60","DOI":"10.1016\/j.drugalcdep.2006.12.013","volume":"88","author":"H-U Wittchen","year":"2007","unstructured":"Wittchen H-U, Fr\u00f6hlich C, Behrendt S, G\u00fcnther A, Rehm J, Zimmermann P, Lieb R, Perkonigg A. Cannabis use and cannabis use disorders and their relationship to mental disorders: A 10-year prospective-longitudinal community study in adolescents. Drug Alcohol Depend. 2007;88:S60\u201370. https:\/\/doi.org\/10.1016\/j.drugalcdep.2006.12.013.","journal-title":"Drug Alcohol Depend"},{"issue":"1","key":"446_CR65","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1007\/s10964-016-0566-3","volume":"46","author":"K Wolitzky-Taylor","year":"2017","unstructured":"Wolitzky-Taylor K, Sewart A, Vrshek-Schallhorn S, Zinbarg R, Mineka S, Hammen C, Bobova L, Adam EK, Craske MG. The Effects of Childhood and Adolescent Adversity on Substance Use Disorders and Poor Health in Early Adulthood. J Youth Adolesc. 2017;46(1):15\u201327. https:\/\/doi.org\/10.1007\/s10964-016-0566-3.","journal-title":"J Youth Adolesc"}],"container-title":["Journal of Cannabis Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s42238-026-00446-4","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s42238-026-00446-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s42238-026-00446-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T04:01:52Z","timestamp":1783396912000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s42238-026-00446-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,14]]},"references-count":65,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["446"],"URL":"https:\/\/doi.org\/10.1186\/s42238-026-00446-4","relation":{},"ISSN":["2522-5782"],"issn-type":[{"value":"2522-5782","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,14]]},"assertion":[{"value":"27 January 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 April 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 May 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This secondary analysis was reviewed by the Loyola University Chicago Institutional Review Board and determined to be exempt from IRB review (LU# 219802) under 45 CFR 46.104(d)(4) for secondary research. The IRB waived the requirement for informed consent because the study used deidentified survey data obtained under a data use agreement with the American College Health Association. All procedures were conducted in accordance with the Declaration of Helsinki and its later amendments.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable; the manuscript does not contain any individual person\u2019s data in any form (including individual details, images, or videos).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"81"}}