title: Marijuana use trajectories during college predict health outcomes nine years post-matriculation.
abstract: BACKGROUND
  Several studies have linked marijuana use with a variety of health outcomes among young adults. Information about marijuana's long-term health effects is critically needed.
  
  
  METHODS
  Data are from a ten-year study of 1253 young adults originally recruited as first-year college students and assessed annually thereafter. Six trajectories of marijuana use during college (Non-Use, Low-Stable, Early-Decline, College-Peak, Late-Increase, Chronic) were previously derived using latent variable growth mixture modeling. Nine health outcomes assessed in Year 10 (modal age 27) were regressed on a group membership variable for the six group trajectories, holding constant demographics, baseline health status, and alcohol and tobacco trajectory group membership.
  
  
  RESULTS
  Marijuana trajectory groups differed significantly on seven of the nine outcomes (functional impairment due to injury, illness, or emotional problems; psychological distress; subjective well-being; and mental and physical health service utilization; all ps<.001), but not on general health rating or body mass index. Non-users fared better than the Late-Increase and Chronic groups on most physical and mental health outcomes. The declining groups (Early-Decline, College-Peak) fared better than the Chronic group on mental health outcomes. The Late-Increase group fared significantly worse than the stable groups (Non-Use, Low-Stable, Chronic) on both physical and mental health outcomes.
  
  
  CONCLUSIONS
  Even occasional or time-limited marijuana use might have adverse effects on physical and mental health, perhaps enduring after several years of moderation or abstinence. Reducing marijuana use frequency might mitigate such effects. Individuals who escalate their marijuana use in their early twenties might be at especially high risk for adverse outcomes.
authors.affiliation: Center on Young Adult Health and Development, University of Maryland School of Public Health, Department of Behavioral and Community Health, 2387 School of Public Health Building, College Park, MD 20742, USA. Electronic address: aarria@umd.edu.
authors.forename: Amelia M
authors.initials: AM
authors.lastname: Arria
authors.affiliation: Center on Young Adult Health and Development, University of Maryland School of Public Health, Department of Behavioral and Community Health, 2387 School of Public Health Building, College Park, MD 20742, USA. Electronic address: caldeira@umd.edu.
authors.forename: Kimberly M
authors.initials: KM
authors.lastname: Caldeira
authors.affiliation: Center on Young Adult Health and Development, University of Maryland School of Public Health, Department of Behavioral and Community Health, 2387 School of Public Health Building, College Park, MD 20742, USA. Electronic address: bbugbee@umd.edu.
authors.forename: Brittany A
authors.initials: BA
authors.lastname: Bugbee
authors.affiliation: Center on Young Adult Health and Development, University of Maryland School of Public Health, Department of Behavioral and Community Health, 2387 School of Public Health Building, College Park, MD 20742, USA. Electronic address: kvincent@umd.edu.
authors.forename: Kathryn B
authors.initials: KB
authors.lastname: Vincent
authors.affiliation: Department of Psychology, University of Maryland, 3109 Biology-Psychology Building, College Park, MD 20742, USA. Electronic address: ogrady@umd.edu.
authors.forename: Kevin E
authors.initials: KE
authors.lastname: O'Grady
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000067292:Alcohol Drinking in College / Q000523:psychology*; D015897:Comorbidity; D005260:Female; D006304:Health Status; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008385:Marijuana Smoking / Q000453:epidemiology* / Q000523:psychology / Q000639:trends; D008396:Maryland / Q000453:epidemiology; D001523:Mental Disorders / Q000453:epidemiology*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D064424:Tobacco Use / Q000453:epidemiology* / Q000523:psychology*; D055815:Young Adult
keywords: Cannabis; Health care utilization; Health outcomes; Longitudinal studies; Mental health; Physical health