title: Environmental cues and attempts to change in daily cannabis users: An intensive longitudinal study.
abstract: BACKGROUND
  We tested whether environmental cues prompt or inhibit quit or reduction attempts among heavy cannabis users.
  
  
  METHODS
  We recruited 196 daily cannabis users who intended to stop or reduce at some point in the next 3 months. Users called an Interactive Voice Response system daily over 3 months to report on cues that might prompt an attempt to quit or reduce (e.g., a request to stop), cues that might inhibit a quit/reduction attempt (e.g., someone offering cannabis), cannabis use, and attempts to stop or reduce cannabis. No treatment was provided.
  
  
  RESULTS
  Our major findings were (a) cost and health/psychological problems were the most common prompting cues, and seeing others use and being offered cannabis were the most common inhibiting cues, (b) the number of different types of prompting cues prospectively predicted an increase in attempts to change in a dose-related manner, (c) more proximal cues appeared to be more strongly related to change, (d) requests to stop or reduce, and physical or psychological problems from cannabis, best predicted change attempts, and (e) inhibiting cues did not consistently predict the probability of an attempt to change.
  
  
  CONCLUSIONS
  These preliminary results suggest several environmental cues prompt attempts to change cannabis use. Thus, interventions to increase the frequency of these cues, and specifically requests to stop or reduce cannabis use, and reinforcing concerns about health and mental adverse events from cannabis use, may increase cannabis reduction or cessation.
authors.affiliation: Center for Behavior and Health, Departments of Psychiatry and Psychological Science, University of Vermont, Burlington, VT 05401, United States. Electronic address: john.hughes@uvm.edu.
authors.forename: John R
authors.initials: JR
authors.lastname: Hughes
authors.affiliation: Department of Mathematics and Statistics, University of Vermont, Burlington, VT 05401, United States.
authors.forename: Shelly
authors.initials: S
authors.lastname: Naud
authors.affiliation: Department of Psychiatry, Geisel School of Medicine, Hanover, NH 03755, United States.
authors.forename: Alan J
authors.initials: AJ
authors.lastname: Budney
authors.affiliation: Center for Behavior and Health, Departments of Psychiatry and Psychological Science, University of Vermont, Burlington, VT 05401, United States.
authors.forename: James R
authors.initials: JR
authors.lastname: Fingar
authors.affiliation: Department of Mathematics and Statistics, University of Vermont, Burlington, VT 05401, United States.
authors.forename: Peter W
authors.initials: PW
authors.lastname: Callas
mesh_terms: D000328:Adult; D002188:Cannabis; D003463:Cues; D055030:Drug Users / Q000523:psychology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D055815:Young Adult
keywords: Cannabis; Marijuana; Natural history; Reduction; Self-change