Prospective Analysis of Prevalence, Trajectories of Change, and Correlates of Cannabis Misuse in Older Adolescents from Coastal Touristic Regions in Croatia

Abstract

The prevalence of illicit drug misuse, including cannabis, in Croatian touristic regions is alarming. This study aimed to identify the prevalence of cannabis consumption (CC), to identify associations between sociodemographic and sport factors and CC, and to evaluate the predictors of CC initiation in adolescents residing in touristic regions. This study enrolled 644 adolescents from two touristic regions in Croatia (Split-Dalmatia and Dubrovnik-Neretva County) who were tested at baseline (16 years of age) and follow-up (18 years of age). The study instrument consisted of questions focused on predictors (age, gender (male, female), place of residence (urban or rural environment), familial social status, and different sport-related factors) and CC outcome. The results indicated a high prevalence of cannabis consumption (>30% of adolescents consumed cannabis), with a higher prevalence in males, and adolescents from rural communities. The prevalence of CC increased by 10% during the study period, with no significant differences between genders in trajectories of changes. Quitting sports was a risk factor for CC at baseline and follow-up. Better sport competitive results (odds ratio (OR): 0.80, 95% confidence interval (CI): 0.65–0.96) and familial social status (socioeconomic status: OR: 0.66, 95% CI: 0.39–0.91; maternal education: OR: 0.65, 95% CI: 0.48–0.88) were associated with lower likelihood of CC at baseline. The adolescents who reported better sport competitive results were at increased risk for initiation of CC during the course of the study (OR: 1.40, 95% CI: 1.03–2.01). The protective effects of sports at baseline were most likely related to various factors that prevent the consumption of substances in youth athletes (i.e., commitment to results, adult supervision); with the end of active participation, adolescent athletes are at high risk for CC initiation.