How are pro- and anti-cannabis messaging exposures related to US young adult cannabis use-related factors?

Given the diverse sources of cannabis messaging and potential differential effects, this study examined pro- and anti-cannabis messaging exposure overall and via specific channels in relation to cannabis-related perceptions (social acceptability and harm) and behaviors (use status, intentions and frequency; past-year quit attempts). Multivariable regression analyses of 2023 survey data from 4031 US young adults (Mage = 26.29, 59.4% female, 19.0% Hispanic, 13.5% Black and 13.6% Asian) used independent variables representing overall exposure and via specific sources (stores, online, billboards/posters/flyers, TV/movies/radio, print and direct communication), respectively. Greater pro-cannabis messaging exposure correlated with greater perceived social acceptability, lower perceived harm, past-month use, greater use intentions among those reporting past-month nonuse and more days used and fewer quit attempts among those reporting use. Less anti-cannabis messaging exposure correlated with these outcomes, except intentions. Particularly, influential sources of pro-cannabis messaging were online (associated with perceptions, use status, intentions and frequency) and direct communication (perceptions, use, use frequency and quit attempts), and those of anti-cannabis messaging were online (harm and use intentions), direct communication (acceptability, quit attempts) and stores (perceptions, use and quit attempts). Exposure differed by sociodemographics (e.g. sex, race/ethnicity and education). The impact of digital media and targeted communications overall and stores in communicating cannabis-related risks suggest the need for regulation and monitoring.