Un enfoque conductual integrado para comprender los determinantes sociocognitivos y los perfiles de riesgo del consumo de cannabis en adolescentes An integrated behavioral approach to understanding sociocognitive determinants and risk profiles of cannabis use in adolescents

Autores/as

  • María-Carmen Torrejón-Guirado University of Seville / Maastricht University
  • Shahab Jolani Maastricht University
  • Marta Lima-Serrano Universidad de Sevilla
  • Liesbeth Mercken Open University Heerlen
  • Hein de Vries Maastricht University

DOI:

https://doi.org/10.20882/adicciones.1961

Palabras clave:

cannabis, determinantes sociales para la salud, conducta del adolescente, promoción de la salud Cannabis, Social Determinants of Health, Adolescent Behavior, Health Promotion

Resumen

La experimentación con el cannabis suele comenzar en la adolescencia, y se relaciona con el desarrollo de trastornos mentales y con un consumo habitual en la edad adulta. El objetivo de este estudio fue comprender los determinantes y las trayectorias de consumo de cannabis en adolescentes. Se realizó un estudio longitudinal con 1.051 adolescentes de 14 a 18 años que completaron una encuesta inicial y otra a los 6 meses, basada en el Modelo I-Change. Se realizaron dos análisis de regresión transversales y uno longitudinal para identificar qué determinantes están asociados al consumo de cannabis. Finalmente, las cinco trayectorias de consumo de cannabis que se identificaron se compararon mediante ANOVA con comparaciones post hoc de Tukey. Los resultados de este estudio muestran que, a los 6 meses de seguimiento, 669 adolescentes permanecieron como no consumidores, mientras que 187 adolescentes iniciaron el consumo de cannabis: 121 experimentalmente y 66 regularmente. El análisis de datos reveló la influencia en el consumo de cannabis de tener pareja, de querer buscar sensaciones nuevas, de no estar convencido de las desventajas del consumo de cannabis, de la influencia de los pares de iguales, y de tener una intención positiva de consumir cannabis en el futuro. Al inicio del estudio, los no consumidores difirieron de los consumidores consistentes en las percepciones sobre los factores sociocognitivos, pero no difirieron de los nuevos consumidores. Al comparar estos factores a los 6 meses, el escenario cambió, siendo los nuevos consumidores quienes mostraron mayores percepciones sociocognitivas a favor del cannabis. Considerar los determinantes del consumo de cannabis desde un enfoque conductual integrado puede ser útil para desarrollar campañas de prevención, donde se proporcionen alternativas saludables a la búsqueda de sensaciones, reforzar una actitud negativa hacia el cannabis, incidir en la influencia de los pares de iguales y en la autoeficacia del adolescente ante situaciones/emociones de riego que inviten al consumo.
Cannabis experimentation usually begins during adolescence, and it is associated with the development of mental disorders, and regular use in adulthood. This study aims to analyze the determinants and the trajectories of cannabis use in adolescence. A longitudinal study was conducted with 1,051 adolescents aged 14–18 years who completed a baseline and 6-month follow-up survey based on the I-Change Model. Two cross-sectional and one longitudinal regression analyses were performed to identify which determinants are associated with cannabis use. Then, the five cannabis use trajectories that were found were compared using ANOVA with Tukey’s post hoc comparisons. The results showed that at 6 months of follow-up, 669 adolescents had remained non-users, while 187 non-users became users, of whom 121 were experimental and 66 regular users. Data analysis revealed the influence on cannabis use of having boyfriend/girlfriend, sensation seeking, not being convinced about the disadvantages of cannabis use, having peer influence favoring cannabis use and a positive intention to use cannabis in the future. At the beginning, non-users differed on perceptions about the sociocognitive factors from consistent users, but not of the new users. When comparing sociocognitive factors at follow-up, the scenario change, and they are the new users who showed more sociocognitive perceptions favoring cannabis than non-users. Considering the determinants of cannabis use from an integrated behavioral approach can be useful to develop prevention campaigns for this substance. This should provide healthy alternatives to the search for sensations, reinforce a negative attitude towards cannabis use, and influence peer influence and self-efficacy in risky situations/emotions that invite its consumption.

Biografía del autor/a

María-Carmen Torrejón-Guirado, University of Seville / Maastricht University

Departamento de Enfermería. Universidad de Sevilla. Escuela de Enfermería, Fisioterapia y Podología, Instituto de Biomedicina de Sevilla (IBiS), Sevilla (España) y Departamento de Promoción de la Salud. Universidad de Maastricht. Care and Public Health Research Institute CAPHRI, Maastricht (Países Bajos).

Shahab Jolani, Maastricht University

Departamento de Metodología y Estadística. Universidad de Maastricht. Care and Public Health Research Institute CAPHRI, Maastricht (Países Bajos).

Marta Lima-Serrano, Universidad de Sevilla

Departamento de Enfermería. Universidad de Sevilla. Escuela de Enfermería, Fisioterapia y Podología, Instituto de Biomedicina de Sevilla (IBiS), Sevilla.

Liesbeth Mercken, Open University Heerlen

Departamento de Psicología de la Salud, Open University Heerlen, Heerlen.

Hein de Vries, Maastricht University

Departamento de Promoción de la Salud. Maastricht University. Care and Public Health Research Institute CAPHRI, Maastricht.

Citas

Agency for Social Services and Dependency of Andalusia. (2018). The Andalusian population against drugs XIV. Spain: Ministry of Equality and Social Policies.

Ajzen, I. (1991). The theory of planned behavior. Organizational Behavior and Human Decision Processes, 50(2), 179–211.

Alameda-Bailén, J. R., Salguero-Alcañiz, P., Merchán-Clavellino, A. y Paíno-Quesada, S. (2018). Age of onset of cannabis use and decision making under uncertainty. PeerJ, 6, e5201. https://doi.org/10.7717/peerj.5201

Alarcó-Rosales, R., Sánchez-SanSegundo, M., Ferrer-Cascales, R., Albaladejo-Blázquez, N., Ruiz-Robledillo, N., Delvecchio, E. y Oltra-Cucarella, J. (2019). Relationships between problematic cannabis use and risky behaviors in Spanish adolescents. International journal of environmental research and public health, 16(17), 3029. https://doi.org/10.3390/ijerph16173029

Andalusian Government (2020). Indicator admissions to treatment for substance abuse or dependence or for behavioral addictions in Andalusia. Andalusian Health and Family Ministry.

Belzunegui-Eraso, A., Pastor-Gosálbez, I., Raigal-Aran, L., Valls-Fonayet, F., Fernández-Aliseda, S. y Torres-Coronas, T. (2020). Substance Use among Spanish adolescents: The information paradox. International journal of environmental research and public health, 17(2), 627. https://doi.org/10.3390/ijerph17020627

Boden, J. M., Dhakal, B., Foulds, J. A. y Horwood, L. J. (2020). Life-course trajectories of cannabis use: A latent class analysis of a New Zealand birth cohort. Addiction (Abingdon, England), 115(2), 279–290. https://doi.org/10.1111/add.14814

Brook, J. S., Lee, J. Y., Brown, E. N., Finch, S. J. y Brook, D. W. (2011). Developmental trajectories of marijuana use from adolescence to adulthood: Personality and social role outcomes. Psychological reports, 108(2), 339-357.

Burdzovic Andreas, J., Pape, H. y Bretteville-Jensen, A. L. (2016). Who are the adolescents saying “no” to cannabis offers. Drug and Alcohol Dependence, 163, 64– 70. https://doi.org/10.1016/j.drugalcdep.2016.03.025

Chen, K. y Kandel, D. B. (1998). Predictors of cessation of marijuana use: An event history analysis. Drug and alcohol dependence, 50(2), 109-121.

Connor, J. P., Stjepanović, D., Le Foll, B., Hoch, E., Budney, A. J. y Hall, W. D. (2021). Cannabis use and cannabis use disorder. Nature reviews. Disease primers, 7(1), 16. https://doi.org/10.1038/s41572-021-00247-4

De Vries, H. (2017). An integrated approach for understanding health behavior; the I-change model as an example. Psychol Behav Sci Int J, 2(2), 555-585.

Epstein, M., Hill, K. G., Nevell, A. M., Guttmannova, K., Bailey, J. A., Abbott, R. D., Kosterman, R. y Hawkins, J. D. (2015). Trajectories of marijuana use from adolescence into adulthood: Environmental and individual correlates. Developmental psychology, 51(11), 1650–1663. https://doi.org/10.1037/dev0000054

Estrada, G., Fatjó‐Vilas, M., Munoz, M. J., Pulido, G., Minano, M. J., Toledo, E. y Fananas, L. (2011). Cannabis use and age at onset of psychosis: Further evidence of interaction with COMT Val158Met polymorphism. Acta Psychiatrica Scandinavica, 123(6), 485-492.

European Monitoring Centre for Drugs and Drug Addiction. (2021). European Drug Report 2021: Trends and Developments, Publications Office of the European Union, Luxembourg.

Faggiano, F., Allara, E., Giannotta, F., Molinar, R., Sumnall, H., Wiers, R., Michie, S., Collins, L. y Conrod, P. (2014). Europe needs a central, transparent, and evidence-based approval process for behavioural prevention interventions. PLoS medicine, 11(10), e1001740. https://doi.org/10.1371/journal.pmed.1001740

Fernández-Calderón, F., Díaz-Batanero, C., Rojas-Tejada, A. J., Castellanos-Ryan, N. y Lozano-Rojas, Ó. M. (2018). Adaptation to the Spanish population of the Substance Use Risk Profile Scale (SURPS) and psychometric properties. Adicciones, 30(3), 208–218.

Field, A. P. (2017) Discovering Statistics Using IBM SPSS Statistics. UK: SAGE edge.

González-Cano-Caballero, M., Torrejón-Guirado, M. C., Cano-Caballero, M. D., Mac Fadden, I., Barrera-Villalba, M. D. y Lima-Serrano, M. (2023). Adolescents and youths’ opinions about the factors associated with cannabis use: A qualitative study based on the I-Change model. BMC nursing, 22(1), 114. https://doi.org/10.1186/s12912-023-01283-z

Guxens, M., Nebot, M., Ariza, C. y Ochoa, D. (2007a). Factors associated with the onset of cannabis use: A systematic review of cohort studies. Gaceta sanitaria, 21(3), 252–260. https://doi.org/10.1157/13106811

Guxens, M., Nebot, M. y Ariza, C. (2007b). Age and sex differences in factors associated with the onset of cannabis use: A cohort study. Drug and alcohol dependence, 88(2-3), 234-243.

Hall, W. (2015). What has research over the past two decades revealed about the adverse health effects of recreational cannabis use? Addiction (Abingdon, England), 110(1), 19–35. https://doi.org/10.1111/add.12703

Hartley, J. E., Levin, K. y Currie, C. (2016). A new version of the HBSC Family Affluence Scale - FAS III: Scottish Qualitative Findings from the International FAS Development Study. Child indicators research, 9, 233–245. https://doi.org/10.1007/s12187-015-9325-3

Hayatbakhsh, M. R., Najman, J. M., Bor, W., O’Callaghan, M. J. y Williams, G. M. (2009). Multiple risk factor model predicting cannabis use and use disorders: A longitudinal study. The American journal of drug and alcohol abuse, 35(6), 399–407. https://doi.org/10.3109/00952990903353415

IBM Corp. Released 2020. IBM SPSS Statistics for Windows, Version 27.0. Armonk, NY: IBM Corp.

Jalilian, F., Mirzaei-Alavijeh, M., Ahmadpanah, M., Mostafaei, S., Kargar, M., Pirouzeh, R., Sadeghi Bahmani, D. y Brand, S. (2020). Extension of the Theory of Planned Behavior (TPB) to predict patterns of marijuana use among young Iranian adults. International journal of environmental research and public health, 17(6), 1981. https://doi.org/10.3390/ijerph17061981

Janz, N. K. y Becker, M. H. (1984). The health belief model: A decade later. Health Education Quarterly, 11(1), 1–47. https://doi.org/10.1177/109019818401100101

Järvinen, M. y Ravn, S. (2011). From recreational to regular drug use: qualitative interviews with young clubbers. Sociology of health & illness, 33(4), 554–569. https://doi.org/10.1111/j.1467-9566.2010.01303.x

Kelly, B. C. y Vuolo, M. (2019). Cognitive aptitude, peers, and trajectories of marijuana use from adolescence through young adulthood. PloS one, 14(10), e0223152. https://doi.org/10.1371/journal.pone.0223152

Mayfield, B. L. y Fogger, S. A. (2022). Risk reduction strategies for adolescent cannabis use considering COVID-19 stressors. Journal of Addictions Nursing, 33(1), 45–50.

Martinez-Montilla, J. M., Mercken, L., de Vries, H., Candel, M., Lima-Rodríguez, J. S. y Lima-Serrano, M. (2020). A web-based, computer-tailored intervention to reduce alcohol consumption and binge drinking among Spanish adolescents: Cluster randomized controlled trial. Journal of Medical Internet Research, 22(1), e15438. https://doi.org/10.2196/15438

Pahl, K., Brook, J. S. y Koppel, J. (2011). Trajectories of marijuana use and psychological adjustment among urban African American and Puerto Rican women. Psychological medicine, 41(8), 1775–1783. https://doi.org/10.1017/S0033291710002345

Pérez, A., Ariza, C., Sánchez-Martínez, F. y Nebot, M. (2010). Cannabis consumption initiation among adolescents: A longitudinal study. Addictive behaviors, 35(2), 129–134. https://doi.org/10.1016/j.addbeh.2009.09.018

Raitasalo, K., Karjalainen, K., Ollila, H., Ruokolainen, O. y Hakkarainen, P. (2021). Smoke in the air - Associations between experimentation with cannabis and the use of tobacco and nicotine products among 15-16-year-old school students. Addictive behaviors, 114, 106714. https://doi.org/10.1016/j.addbeh.2020.106714

Rial, A., Burkhart, G., Isorna, M., Barreiro, C., Varela, J. y Golpe, S. (2019). Cannabis use among adolescents: Risk pattern, implications and possible explanatory variables. Adicciones, 31(1), 64–77. https://doi.org/10.20882/adicciones.1212

Schober, P., Boer, C. y Schwarte, LA. (2018). Correlation coefficients: Appropriate use and interpretation. Anesthesia & Analgesia, 126 (5), 1763-1768. doi:10.1213/ANE.0000000000002864

Spanish National Plan on Drugs. (2021). Survey on Drug Use in Secondary Education in Spain (ESTUDES 1994/2021). Madrid, Spain: Ministry of Health.

Spanish National Plan on Drugs. (2022). Survey on Drug Use in Secondary Education in Spain (ESTUDES 1994/2021). Madrid, Spain: Ministry of Health.

Smilkstein, G., Ashworth, C. y Montano, D. (1982). Validity and reliability of the family APGAR as a test of family functioning. The Journal of family practice, 15(2), 303–311.

Smit, E. S., Brinkhues, S., de Vries, H. y Hoving, C. (2018). Subgroups among smokers in preparation: A cluster analysis using the I-Change Model. Substance use & misuse, 53(3), 400–411. https://doi.org/10.1080/10826084.2017.1334062

Suárez-Maldonado, M. T., Domínguez-Martínez, T. y Benjet, C. (2022). Why do some people become more involved in cannabis use than others? A systematic narrative review on cannabis use transition predictors. Journal of Studies on Alcohol and Drugs, 83(6), 781–792.

Swart, D., Panday, S., Reddy, S. P., Bergström, E. y de Vries, H. (2006). Access point analysis: What do adolescents in South Africa say about tobacco control programmes? Health education research, 21(3), 393–406. https://doi.org/10.1093/her/cyl042

Sznitman, S. R., Kolobov, T., ter Bogt, T., Kuntsche, E., Walsh, S. D. y Harel-Fisch, Y. (2015). Investigating cannabis use normalization by distinguishing between experimental and regular use: A multilevel study in 31 countries. Journal of studies on alcohol and drugs, 76(2), 181–189. https://doi.org/10.15288/jsad.2015.76.181

Tan, F.E.S. y Jolani, S. (2022). Applied linear regression for longitudinal data: With an emphasis on missing observations (1st ed.). Chapman and Hall/CRC. https://doi.org/10.1201/9781003121381

Torrejón-Guirado, M. C., Baena-Jiménez, M.Á., Lima-Serrano, M., de Vries, H. y Mercken, L. (2023a). The influence of peer’s social networks on adolescent’s cannabis use: A systematic review of longitudinal studies. Frontiers in Psychiatry 14. doi:10.3389/fpsyt.2023.1306439

Torrejón-Guirado, M. C., Lima-Serrano, M., Mercken, L. y de Vries, H. (2023b). Which factors are associated with cannabis use among adolescents in Andalusia? An application of the I-Change model. Journal of nursing scholarship: An official publication of Sigma Theta Tau International Honor Society of Nursing, 55(3), 739–750. https://doi.org/10.1111/jnu.12806

Vázquez Morejón, A. J., Jiménez García-Bóveda, R. y Vázquez-Morejón, R. (2004). Rosenberg self-esteem scale: Reliability and validity in the Spanish clinical population. Psychology notes, 22 (2), 247-255.

Villanueva, V. J., Puig-Perez, S. y Becoña, E. (2021). Efficacy of the “Sé tú mismo” (Be yourself) Program in prevention of cannabis use in adolescents. International Journal Mental Health Addiction, 19, 1214–1226. https://doi.org/10.1007/s11469-019-00219-6

Vitoria, P. D., Kremers, S. P., Mudde, A. N., Pais-Clemente, M. y de Vries, H. (2006). Psychosocial factors related with smoking behaviour in Portuguese adolescents. European Journal of Cancer Prevention, 531-540.

World Drug Report (United Nations publication, Sales No. E.21.XI.8), 2021.

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Publicado

2025-05-30

Número

Vol. 37 Núm. 2 (2025)

Sección

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