Intertemporal tradeoffs: perceiving the risk in the benefits of marijuana in a prospective study of adolescents and young adults.
OBJECTIVE
Intertemporal tradeoffs characterize the decision to use drugs: pleasure now traded off against the possibility of pain later. Traditional approaches have examined whether individuals use drugs because they either seek immediate benefit or fail to appreciate long-term risk. We asked whether risk taking might also result from failing to appreciate benefits. We refer to this as risk in the benefits (RIBs), an understanding that one's first drug experience can be so good, that a person may not want (or be able) to stop, putting him/her on a path that leads directly to addiction.


METHODS
In total, 304 participants, 160 adolescents and 144 young adults, participated in a longitudinal study on marijuana use and other risky health behaviors.


RESULTS
The failure to perceive the RIBs of marijuana use led to increased risk taking 1 year later within 3 different health behaviors: alcohol, tobacco, and sexual risk-taking. Greater appreciation of RIBs predicted significantly less future risk taking over-and-above all the traditional cognitive and behavioral predictors, and RIBs were the only significant cognitive predictor when all were included in 1 model. RIBs also partially mediated the relationship between past and future risk taking, over and above the strongest predictors of risk taking.


CONCLUSIONS
Failing to appreciate the impact of short-term benefits within the context of long-term risk increased future risk taking. Interventions that enhance the salience of RIBs may represent a new approach to reducing the likelihood that individuals will take risks with their health.
Goldberg
Julie H
JH
Department of Medical Education, University of Illinois at Chicago, Chicago, IL 60612, USA. julieg@uic.edu
Millstein
Susan
S
Schwartz
Alan
A
Halpern-Felsher
Bonnie
B
D000293:Adolescent; D000294:Adolescent Behavior; D000328:Adult; D000367:Age Factors; D003657:Decision Making; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D008385:Marijuana Smoking / Q000523:psychology*; D011446:Prospective Studies; D018570:Risk Assessment; D019966:Substance-Related Disorders / Q000523:psychology; D013997:Time Factors; D055815:Young Adult