Continuing cannabis use after initiation: The role of social context, craving and problem severity during acute cannabis use episodes.

Waddell J.; Okey S.; Metrik J.; Corbin W. · Addiction (Abingdon, England) · 2026

**Background & Methods** This ecological momentary assessment (EMA) study followed 104 participants (mean age 36.16; 53% female) in Arizona over 14 days to examine relationships between social context, cannabis craving, and continued use. Participants completed baseline assessments and random daily reports plus event-contingent reports shortly after cannabis initiation, with follow-up assessments at 1.5 and 3 hours post-use to track continuation patterns. **Key Findings** • Higher cannabis craving during initial use episodes was significantly associated with increased likelihood of continued cannabis use within the subsequent 3-hour window (standardized β = 0.22, 95% BCI = 0.09-0.33). • A significant interaction emerged between social context and cannabis problem severity: social (versus solitary) use contexts were associated with elevated craving, but exclusively among individuals reporting above-average (not below-average) cannabis use problems (β = 0.36, 95% BCI = 0.12-0.56). • Social context indirectly predicted continued use through amplified craving only in individuals with more severe cannabis problems (β = 0.06, 95% BCI = 0.01-0.16), with no significant indirect effect observed for those with less severe problems. **Dosage & Administration** Not reported. The study assessed cannabis potency and product type (flower versus edibles) as variables but did not examine specific dose-response relationships. **Safety & Adverse Effects** Not reported. The study focused on craving and use continuation patterns rather than adverse health outcomes or safety parameters. **Evidence Quality** This naturalistic study provides valuable within-subject, real-world data using EMA methodology, strengthening ecological validity. However, limitations include the relatively small sample size (N=104), cross-sectional nature of associations that cannot establish causality, and restriction to a single U.S. geographic location reducing generalizability. The conditional indirect pathway suggests social context effects are moderated by problem severity, requiring replication. The study cannot address long-term consequences or determine whether observed craving-continuation associations reflect causal mechanisms or reverse causality. Classification as a review rather than a primary research report warrants verification of methodology details.

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