Cannabis craving in response to alcohol cues in the laboratory and in daily life among adolescents ages 15–17 years

Abstract

BackgroundMost adolescents who drink alcohol also use cannabis, and adolescents who use both substances experience worse long‐term outcomes than adolescents who only use one or the other. Recent work from clinical trials with adolescents and emerging adults found that alcohol cues are associated with elevated cannabis craving in the natural environment but not in the laboratory, highlighting cross‐cue reactivity as a potential intervention target. The present study extends this work to a younger sample of adolescents at an earlier stage of substance use to examine generalizability of prior findings and inform etiological mechanisms.MethodParticipants were 81 adolescents ages 15 to 17 who endorsed past‐month alcohol and lifetime cannabis use. They completed a laboratory cue reactivity protocol where they rated their cannabis craving during alcohol cue and control conditions. They also completed 24 days of ecological momentary assessment where they reported multiple times per day on their cannabis craving and whether alcohol cues were visible.ResultsMixed models demonstrated lower cannabis craving following alcohol cue presentation in the laboratory compared to control cues, but higher cannabis craving during moments when alcohol was visible in daily life compared to moments when alcohol was not visible. Frequency of cannabis use at baseline was associated with greater cannabis craving in the laboratory and in daily life regardless of cue type or alcohol visibility, and cannabis craving following alcohol cue presentation in the laboratory was positively related to daily‐life cannabis craving across contexts.ConclusionsThe present study adds to prior work suggesting that daily‐life cannabis craving is elevated when alcohol cues are visible. This cross‐cue reactivity may be one factor that drives and maintains alcohol and cannabis use in adolescence.