Cannabis is the most widely used psychoactive substance globally, with its use steadily increasing among young adults, posing significant public health challenges. Notably, cannabis use has been identified as a major factor contributing to the development of severe and long-term mental illnesses in high-risk populations, such as individuals at risk of psychosis. Mobile (app-based) approaches have emerged as a novel strategy to address the limitations of existing interventions aimed at reducing cannabis use. According to previous studies, these interventions alleviate temporal and spatial constraints, facilitate integrated care, and demonstrate measurable effectiveness in reducing cannabis use. However, as these interventions have predominantly targeted non-clinical populations, research focusing on individuals at risk of psychosis remains scarce. Therefore, the current study aims to explore the experiences of young adults at risk of psychosis in their efforts to quit or reduce cannabis use, investigate the barriers and facilitators encountered during this process, and develop a mobile app-based intervention informed by their needs and suggestions for effective functionality.
The study was conducted with 20 young adults aged 18-28 who were receiving treatment for mental health symptoms (e.g., depression, anxiety, psychosis) in an outpatient program at Butler Hospital, located in Rhode Island, United States. Participants were selected based on their use of cannabis at least once per week and endorsement of six or more items on the 16-item Prodromal Questionnaire. Data were collected through semi-structured interviews, which lasted approximately one hour and focused on identifying barriers and facilitators to reducing or quitting cannabis use, as well as suggestions for the development of a mobile app to support cannabis reduction efforts. The recorded interviews were transcribed verbatim and analyzed using thematic analysis with the assistance of NVivo software.
The findings indicate that barriers to reducing cannabis use encompass habitual use as a coping mechanism for stress and anxiety, the widespread accessibility of cannabis, negative social influences such as insufficient support or pressure from peers and family, psychological and physiological dependence, and ambivalence toward cessation. Conversely, facilitators for reducing cannabis use included heightened awareness of its negative consequences, clearly defined goals and motivation, supportive social networks, and employing coping strategies like substitutions and setting limits. Participants emphasized the significance of incorporating personalized features into a mobile app designed to facilitate cannabis use reduction. Key recommendations included mechanisms for goal-setting and feedback, tracking cannabis consumption and emotional states to provide actionable insights, delivering affirming and non-judgmental messaging, and ensuring a user-friendly, interactive interface. Additionally, the integration of gamification elements, suggestions for alternative activities, and motivational messages were identified as essential components for enhancing user engagement and promoting sustained behavioral change. These findings underscore the necessity of a structured and customized approach to effectively support cannabis use reduction.
Takeaway: Effective cannabis use reduction necessitates a systematic and individualized approach that addresses barriers, harnesses facilitators, and integrates tailored app features to support engagement and foster behavioral change.