title: Development of risk perception and substance use of tobacco, alcohol and cannabis among adolescents and emerging adults: evidence of directional influences.
abstract: BACKGROUND
  While several studies have investigated the relationship between risk perception and substance use, surprisingly little is known about mutual influences between both variables over time.
  
  
  OBJECTIVE
  The present study aimed to explore two different hypotheses separately for tobacco, alcohol and cannabis: influences from risk perception on behavior (motivational hypothesis) and influences from behavior on risk perception (risk reappraisal hypothesis).
  
  
  METHODS
  A prospective and longitudinal cross-lagged panel design was used with substance use and risk perception measured five times over the course of 10 years. Participants were 318 German youths aged 14-15 at the beginning of the study. Risk perception and substance use frequency were measured using self-reports.
  
  
  RESULTS
  Structural equation modeling indicated significant influences of risk perception on substance use behavior for all substances, which supports the motivational hypothesis. Changes in risk perception predict changes in future substance use of tobacco, alcohol and cannabis. Specifically for cannabis, influences of substance use on risk perception can also be shown, thus, supporting the risk reappraisal hypothesis.
  
  
  CONCLUSIONS
  While there is support for the rationale behind adequate risk perception as a goal of preventive interventions, the possibility of risk reappraisal should not be neglected, especially regarding illicit substances.
authors.affiliation: Institute of Medical Psychology, University Hospital Heidelberg, Heidelberg, Germany.
authors.forename: Dennis
authors.initials: D
authors.lastname: Grevenstein
authors.forename: Ede
authors.initials: E
authors.lastname: Nagy
authors.forename: Henrik
authors.initials: H
authors.lastname: Kroeninger-Jungaberle
mesh_terms: D000293:Adolescent; D000328:Adult; D000437:Alcoholism / Q000523:psychology*; D000704:Analysis of Variance; D005260:Female; D005858:Germany; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D002189:Marijuana Abuse / Q000523:psychology*; D010465:Perception; D012306:Risk; D057566:Self Report; D012907:Smoking / Q000523:psychology*; D055815:Young Adult
keywords: alcohol; cannabis; cross-lagged; longitudinal; risk perception; tobacco