Treating Young Adult Cannabis Use Disorder with Text Message-Delivered Peer Network Counseling

The novel coronavirus disease (COVID-19) pandemic of 2020 has disrupted normal daily functioning forpeople across the globe as governments have sought to limit community spread of the disease. Because thevirus affects the respiratory tract, individuals with compromised lung function, such as those with COPD or lungdisease associated with smoking or vaping may also be at elevated risk. Preliminary evidence suggests thatsmokers are at higher risk for severe COVID-19 illness and death (Guan et al., 2020). Public health messagesurge people to quit smoking (Forster, 2020, and the World Health Organization recommends not smoking orusing other substances to cope with stress during the pandemic (WHO, 2020). At the same time, studiesindicate that individuals are likely in increase their smoking, alcohol intake and substance use during periods ofhigh stress or traumatic events such as Hurricane Katrina or 911 (Flory et al., 2009). Given the urgency andstressful nature of this pandemic, there is a critical need for research investigating the influence of thepandemic on cannabis and tobacco smoking/vaping and other substance use. Directly building upon ourNIDA-funded (1 R01 DA044206-01A1, Treating young adult cannabis use disorder with text messageddeliveredPeer Network Counseling) RCT, we propose to follow a sample of 262 young adults from Tennessee(n = 139) and Colorado (n = 123) who screened positive for cannabis use disorder (CUD) and participated in asub-study named the Cannabis Culture Study. Participants completed surveys about cannabis use behaviors,cannabis use motivations, and cannabis use attitudes between January 9 and February 3, 2020, immediatelyprior to increases in media attention and public health regulations regarding COVID-19. We propose tocapitalize on this longitudinal natural experiment to understand the health risk effects of the COVID-19pandemic on young adults with cannabis use disorder by assessing participants every 3 months for 24 months.Because the funded RCT will also be conducted during the naturally occurring socio-economic and personalchanges in response to the COVID-19 pandemic, this sample of youth will provide a natural comparison groupof how youths' cannabis use attitudes and behaviors change in the context of COVID-19 but outside theexperimental intervention activities. Our specific aims are:Aim1: Examine changes in cannabis, tobacco smoking/vaping, and other substance use as a functionof the COVID-19 pandemic among young adults meeting criteria for CUD.Aim2: Examine mediated pathways by which COVID-19 pandemic affect changes in cannabis, tobaccosmoking/vaping, and other substance use.Aim3: Examine whether the mediated pathways by which COVID-19 pandemic affect changes incannabis, tobacco smoking/vaping, and other substance use are conditioned on sex and stateresidence.