Association between viewing more media war content and higher intention to use cannabis in adolescents: the indirect effect of post-traumatic stress.

Milane M.; Hallit S.; Obeid S.; Hallit R.; Malaeb D.; Sakr F.; Dabbous M.; Haddad G.; Fekih-Romdhane F. · Substance abuse treatment, prevention, and policy · 2026

**Background & Methods** This cross-sectional study examined 758 Lebanese adolescents (mean age 16 years) from the general population to investigate whether post-traumatic stress disorder (PTSD) mediates the relationship between exposure to war media content and intention to use cannabis. Participants completed surveys assessing war media exposure, PTSD symptoms, and cannabis use intentions. **Key Findings** • PTSD fully mediated the association between war media exposure and cannabis use intention, with a significant indirect effect (Beta = 0.01, BootSE = 0.01, 95% CI 0.001, 0.02). • Higher exposure to graphic war content was significantly associated with increased PTSD symptoms, and elevated PTSD was significantly associated with greater cannabis use intentions. • War media exposure showed no direct significant association with cannabis use intentions when PTSD was not considered, indicating that PTSD is the primary mechanistic pathway. **Dosage & Administration** Not reported. **Safety & Adverse Effects** Not reported. The study focused on cannabis use intention rather than actual use or clinical outcomes. However, the research identifies PTSD as a significant mental health consequence of war media exposure that may motivate cannabis-seeking behavior as a maladaptive coping mechanism. **Evidence Quality** This study has several important limitations. As a cross-sectional design, it cannot establish causality or temporal relationships between variables. The sample was restricted to Lebanese adolescents, limiting generalizability to other populations and conflict contexts. The study relies on self-reported survey data, which is subject to recall bias and social desirability bias. The measurement of "cannabis use intention" rather than actual use behavior represents a preliminary outcome measure. Additionally, the study did not assess other potential confounding variables (e.g., family history of substance use, socioeconomic factors, peer influence) that may influence both PTSD and cannabis intentions. The indirect effect size, while statistically significant, is relatively small. Overall, this represents low-to-moderate quality evidence suitable for generating hypotheses rather than establishing definitive clinical recommendations. Future prospective studies with longer follow-up periods and validated clinical assessments are needed to confirm these findings.

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