Exploring Recreational Cannabis Use Cessation Intentions among Adults in the United States Using the Multi-Theory Model of Health Behavior Change

Introduction: Rates of recreational cannabis (ie, marijuana) use in the United States have increased in recent years as have rates of cannabis use disorder. The aim of this study was to assess theoretical correlates of intentions to initiate and sustain marijuana cessation among adult user—using domains of the Multi-Theory Model (MTM) of health behavior change. Methods: A cross-sectional survey was administered to a sample of adult cannabis users (n = 227; mean age = 40.9 years; 48.5% female; 85.5% non-Hispanic white). We assessed intention to quit cannabis using MTM constructs of initiation (participatory dialogue, behavioral confidence, changes in physical environment) and sustenance (emotional transformation, practice for change, changes in social environment). The structure of the MTM scale was assessed using confirmatory factor analysis. Hierarchical linear regression models were used to assess constructs of initiation and sustenance of cannabis use controlling for demographic characteristics and Cannabis Use Disorder Identification Test score (12). Results: The MTM scale evidenced good reliability (Cronbach’s alphas > .7) and good model fit. Results indicated that only the change in physical environment construct was significantly associated with the intention of initiating cannabis cessation ( B = 0.27, P < .001) while practice for change ( B = 0.27, P < .001) and changes in social environment (B = 0.19, P = .001) was positively associated with the intentions of sustaining cannabis cessation. Conclusions: Results indicate that changes to physical and social environment are key features of initiating and sustaining cannabis use cessation, which aligns with research on tobacco cessation. Future research should explore how these factors interact and investigate additional influences on long-term cessation success.