As the rates of cannabis consumption continue to climb for college-aged adults, the demand for use attenuation and intervention has also increased. The current literature regarding cannabis cessation is very underdeveloped compared to that of tobacco and alcohol cessation, and it is unknown if effective mechanisms for the latter substances will translate to the former. A potential target of cannabis use and mitigation is that of craving management. Within this context, 4 primary strategies which fall under the umbrella of craving management have been posited: mindfulness, coping style, experiential avoidance, and craving beliefs. The purpose of this study was to investigate the potential mediating effects of students’ craving management strategies as it relates to their experience of momentary cravings and subsequent use patterns by employing ecological momentary assessment.
The study’s sample was composed of 80 undergraduate students from a large university in the northwestern United States who were interested in decreasing their cannabis use while using ecological momentary assessment (EMA) techniques (N=80, 40.7% female). EMA involves participants recording their target subjective experience, in this case cannabis craving, in real time rather than using recall at the end of the day, etc. Participants’ baseline measures for craving management strategies were recorded and scored using the following breakdown: mindfulness via Five Facet Mindfulness Questionnaire (FFMQ), coping styles via an abbreviated version of the Brief COPE scale, experiential avoidance via the Avoidance and Inflexibility Scale (AIS), and craving beliefs via the Appraisal of Cravings Questionnaire (ACQ). Following this baseline assessment, participants were instructed to complete 4 prepared surveys on their smartphones throughout the day regarding their instantaneous cravings for cannabis (using Craving Scale), and their craving management outcome (use, non-use) in that respective moment. Values measured for craving management included behavioral disengagement, self-distraction, acceptance, and valued action, all pulled from different scales mentioned above. Data was analyzed using a multilevel modeling approach.
Results of the study found that average cravings over time increased momentary cravings for participants (Odds Ratio = 0.77, 95% CI: 0.67-0.90), and that momentary craving is positively related to cannabis use (OR = 4.91, 95% CI: 3.96-6.20). The study also found associations between two of the five facets of the mindfulness scale (FFMQ) and cannabis use. The first, a facet named non-reactivity, was positively related to cannabis use (OR = 0.32, 95% CI: 0.14-0.73), while the second called non-judgmentalness, was negatively associated with cannabis use (OR = 0.27, 95% CI: 0.16-0.44). Lastly, negative beliefs about cravings were associated, counterintuitively, with decreased cannabis use following momentary craving (OR = 0.82, 95% CI: 0.73-0.93).
Takeaway: when providing interventions to college students seeking to decrease their cannabis use, strategies that focus on mindfulness, especially those examining individual non-reactivity to their experience and elevated attitudes of non-judgmentalness may be effective. Similar literature is not entirely consistent concerning how negative craving beliefs influence cannabis use, so more research is required to elucidate the relationship.
Enkema MC, Hallgren KA, Bowen S, Lee CM, Larimer ME. Craving management: Exploring factors that influence momentary craving-related risk of cannabis use among young adults. Addictive Behaviors. 2021;115:106750. doi:10.1016/j.addbeh.2020.106750