Community Activity Involvement Among Adolescents and Its Association with Marijuana Use Across the United States

Abstract

Background: Community activity involvement has a significant impact on adolescents' mental and physical health as well as substance use behaviors. The relationship between community activity involvement and marijuana use among youth has not been fully described. In this study, we investigated the prevalence of community activity involvement among youth, and its association with recent marijuana use overall and among demographically defined population groups. We also examined whether demographics modify associations of community activity involvement with recent marijuana use. Methods: We used data from the 2021-2024 cross-sectional National Survey on Drug Use and Health across the United States. Participants were a stratified, multistage area probability sample of youth aged 12-17 years. Community activity involvement, categorized into two groups (0-1 community activity involvement vs. 2+ community activity involvement), was the exposure. The outcome was marijuana youth over the last 30 days (ranging from 0 days to 30 days). The outcome was categorized into two groups: none (0 days) and any (1-30 days). Prevalence of community activity involvement was calculated overall, and by race, ethnicity, age, and sex across years (2021-2024). Unadjusted and adjusted logistic regression models were fit to estimate odds ratios (OR) and corresponding 95% confidence intervals (CIs) for associations of community activity involvement with any marijuana use. Adjusted models included year, sex, race, ethnicity, age, and income. Models with interaction terms as well as stratified models were used to examine effect modification of the associations by year, race, ethnicity, sex, and age. Results: The study population (N=44,997) was 54% female, 57% Non-Hispanic White, and 46% of youth had a family income of $75,000 or more. About a third of participants each were in the 12-13-, 14-15-, and 16-17- year age group. Among participants, 79.6% participated in 2+ community activities. Percentages of participants who engaged in +2 community activity increased slightly from 2021 to 2024 (75.6% and 79.4%, respectively). Compared with proportions among participants with 0-1 community activity involvement, the proportions of Non-Hispanic Whites, Non-Hispanic Asians, females, and 12-13-year-old were higher among participants with 2+ community activity involvement, while the proportions of Hispanics, males, and 16-17-year-olds were lower. Higher proportion of participants with no marijuana use had 2+ community activity involvement (79.1%) compared with a similar proportion among participants with any marijuana use (71.3%). (p-value<0.05). Participants with 2+ community activity involvement had 31% lower odds of any marijuana use, compared with participant with 0-1 community activity involvement (Adjusted OR: 0.69, 95% CI: 0.63-0.76). Similarly, lower odds of any marijuana use was observed among participants with 2+ community activity involvement, compared with 0+1 community activity involvement, for most groups defined by age, sex, race ethnicity and across years. None of the interaction p-values were significant. Conclusion: In the current study, we observed variation in percentage of 2+ community activity involvement among youth across calendar year, race, ethnicity, sex, and age. Community activity involvement was inversely associated with any marijuana use in this population. We did not observe any significant variations in the association across sub-populations defined by age, sex, race, ethnicity, and calendar year. Positive social involvement through community activities may provide a space for youth to grow and reduce their use and/or exposure to marijuana.