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. Author manuscript; available in PMC: 2020 Aug 1.
Published in final edited form as: Addict Behav. 2019 Mar 3;95:64–69. doi: 10.1016/j.addbeh.2019.03.001

Does Morning Affect Contribute to Daily Cannabis Use?

Maria Testa a, Weijun Wang a, Jaye L Derrick b, Whitney C Brown a, R Lorraine Collins c
PMCID: PMC6545134  NIHMSID: NIHMS1523566  PMID: 30856545

Abstract

Several theories posit that cannabis and other substances are used to reduce negative affect. This daily report study considered whether variations in positive and negative affect, reported each morning, contributed to the likelihood of cannabis use later that day. We also explored whether levels of positive and negative affect reported immediately after cannabis use improved, relative to that day’s morning levels. The sample included 183 men and 183 women representing heterosexual, cannabis-using couples from the community. Participants made independent, daily reports of affect and cannabis use episodes for 30 consecutive days. Using multilevel modeling, we modeled men’s and women’s use of cannabis on a given day as a function of morning levels of positive, hostile, and anxious affect, accounting for partner cannabis use that day, and mean levels of positive and negative affect. Men and women were more likely to use cannabis on a given day when morning positive affect was lower than typical for the person and when partner used cannabis that day. Neither hostile nor anxious affect contributed to later use of cannabis. Immediately after cannabis use, positive affect increased, and hostile and anxious affect decreased relative to that day’s morning levels. The improved affect immediately after use suggests a mechanism of positive reinforcement.

Keywords: cannabis, affect, daily diary, reinforcement

Substance use is commonly viewed as being motivated by a desire to relieve tension, stress, or negative emotions. The idea that people use anxiolytic substances as a way of reducing their psychological discomfort is common to several influential theories of substance use, including the Tension Reduction Hypothesis (Greeley & Oei, 1999), Stress Response Dampening (Levenson et al., 1980), and Self-Medication Hypothesis (Khantzian, 1997). Although survey and experimental studies provide support for these theories, daily report studies permit a more sensitive, naturalistic test of the short-term impact of daily affect on subsequent substance use. The present study examined whether morning levels of negative and positive affect contribute to the likelihood of cannabis use later that day among a sample of regular cannabis users. We also considered whether, in accordance with principles of these theories, users experience greater positive and lower negative affect following use of cannabis, relative to their earlier levels.

Consistent with the notion that people who experience higher levels or more frequent bouts of negative affect than others use substances to relieve their symptoms, longitudinal studies reveal that people with depression, PTSD, and anxiety use more alcohol and other drugs over time (e.g. Leeies, Pagura, Sareen, & Bolton, 2010; Sarvet et al., 2018, see Hussong, Ennett, Cox, & Haroon, 2017 for a review). However, survey studies cannot address whether substances are used as an acute means of self-medication when negative affect or psychological symptoms are particularly elevated. Experimental studies have tested whether negative affect increases desire or use of substances by inducing negative affect or exposing people to stressors in the laboratory and considering craving or use of alcohol following this manipulation (e.g., Hogarth, Hardy, Mathew, & Hitsman, 2018). A meta-analysis concluded that experimental induction of negative affect increases subsequent craving for and use of alcohol (Bresin, Mekawi, & Verona, 2018). Laboratory studies of cannabis craving reveal similar findings. Social interaction or an expectation of social interaction increased cannabis craving among socially-anxious people (Buckner, Ecker, & Vinci, 2013; Buckner, Zvolensky, Ecker, & Jeffries, 2016) and negative affect increased cannabis craving in the laboratory among people low in distress tolerance (Buckner, Walukevich, Dienst, & Zvolensky, 2018). Although experimental literature supports tenets of self-medication or tension reduction, different methods are necessary for testing the hypothesis that people use substances when they experience negative emotions in their daily lives.

Daily process or ecological momentary assessment (EMA) methods offer the ability to appropriately model the hypothesized dynamic relationship between fluctuating affective states and substance use within the next few hours (Mohr, Armeli, Tennen, & Todd, 2010). An advantage of this methodology is the ability to distinguish between-person mood effects from within-person effects. People with chronically negative mood relative to others (e.g., depressed people) may use substances more than others, a between-person effect. However, this does not tell us if people are more likely to use substances when they are experiencing symptoms of depression or other negative affective states compared with other times. Daily process data allow us to determine whether substance use is more likely when negative affect is greater than one’s own mean, a stringent test of the self-medication hypothesis.

Studies using daily process methods findings yield a mixed picture. Some studies found increased desire to drink and odds of drinking when negative mood was higher than typical but also when positive mood was higher than typical (Armeli, Tennen, Affleck, & Kranzler, 2000; Kaysen et al., 2014; Park, Armeli, & Tennen, 2004). Other daily process studies found drinking in response to higher positive affect but not negative affect (Chakroun, Johnson, & Swendsen, 2010; Dvorak et al., 2018; Howard, Patrick, & Maggs, 2015).

Studies considering daily affect as a predictor of later cannabis use have yielded similarly mixed results. Chakroun and colleagues (2010) found that positive mood predicted higher odds of subsequent later cannabis use and negative mood predicted lower odds, the opposite of what would be predicted by the self-medication model. It is possible that higher positive affect prior to use reflects anticipation of positive experiences related to substance use (see Dvorak et al, 2018), because cannabis users report liking the drug’s effects and finding use pleasurable (Green, Kavanagh, & Young, 2003). After accounting for the effects of contextual variables (e.g., cannabis availability, location, companions), neither negative nor positive affect had a significant linear association with concurrent desire to use cannabis (Shrier, Walls, Kendall, & Blood, 2012). However, there was a curvilinear relationship with positive affect: desire increased as affect increased, but then decreased at higher levels. In contrast, Shrier, Ross, and Blood (2014) found that negative affect was higher in the 24 hours prior to cannabis use than in periods not culminating in use, whereas positive affect did not differ during the 24 hours prior to use. Buckner et al. (2015) did not find evidence for either positive or negative affect as contributors to subsequent cannabis use. However, in another study, anxiety positively predicted cannabis craving and was weakly associated with subsequent use (Buckner, Crosby, Silgado, Wonderlich, & Schmidt, 2012).

Presumably people use cannabis for mood enhancement, either to counteract negative affect or to enhance positive affect, thereby reinforcing drug use. Laboratory studies involving acute administration have found increased positive affect following cannabis use (Cooper & Haney, 2014; Weinstein et al., 2008) but also more complicated patterns, depending on expectancy set (Metrik, Kahler, McGeary, Monti, & Rohsenow, 2011). Findings from daily report studies are mixed, with studies showing both reduced negative affect after cannabis use (Buckner et al., 2015; Cuttler, Spradlin & McLaughlin, 2018) and increased negative affect after use (Ross et al., 2018). Cannabis use resulted in increased impulsivity and hostility, both in a community sample (Ansell, Laws, Roche, & Sinha, 2015) and in a sample of patients with borderline personality disorder (Trull, Wycoff, Lane, Carpenter, & Brown, 2016). However, in another study, cannabis improved mood among individuals with bipolar disorder, but not among users more generally (Gruber et al. 2012). In brief, the limited number of daily report studies on affect and cannabis use provide inconsistent findings regarding the consequences of use on later affect as well as regarding whether affective states contribute to cannabis use.

The Present Study

The present study considered whether positive and negative affect, reported each morning for 30 consecutive days, influenced the likelihood of cannabis use later that day within a community sample of couples in which at least one partner was a frequent cannabis user. Consistent with the self-medication model, we tested the hypothesis that cannabis use would be more likely on days in which morning negative affect was higher and positive affect lower than one’s average. However, it is also possible that cannabis use is more likely on days in which morning positive affect is higher than one’s average, suggesting substance use for enhancement (e.g., Dvorak et al., 2018). As a secondary goal, we tested the hypothesis that cannabis use episodes would result in increased positive affect and decreased negative affect immediately after use relative to morning levels. Although self-medication and tension-reduction models suggest improved affect following cannabis use, some studies have found increased negative hostility and impulsivity following use (Ansell et al., 2015; Trull et al., 2016). Although we have no a priori hypotheses regarding gender, we tested hypotheses separately for men and for women. However, because participants were derived from a sample of couples, we accounted for the effects of partner’s daily cannabis use, hypothesizing that individuals are more likely to use cannabis when their partner uses.

Method

Sample and Recruitment

Participants consisted of 183 men and 183 women representing 183 heterosexual couples in which at least one partner used cannabis at least twice weekly (see Testa et al., 2018). Couples were recruited from a medium-sized metropolitan area in the Northeast, primarily via Facebook ads (146/183, 79.8%) or print ads in local free arts newspapers (22/183, 12.0%) seeking couples, ages 18–30 who use cannabis; the rest were referred by others who had seen the ad or participated previously (15/183, 8.2%). Recruitment via Facebook advertisements has been shown to be a cost-effective way of recruiting a sample who meet restrictive eligibility criteria (Derrick, Eliseo-Arras, Hanny, Britton, & Haddad, 2017). Couples were screened for eligibility by telephone. To be eligible, the couple had to be married or cohabiting for at least 6 months, both partners had to be between 18 and 30 years old, and at least one partner had to use cannabis at least twice weekly with no intention to quit or seek treatment. Couples were excluded if either partner reported receiving psychiatric treatment, use of cocaine or stimulants, or pregnancy. Couples were also excluded if either reported experiencing intimate partner violence that caused fear for one’s life or required medical care; they were provided referral information.

Participants averaged 24.61 (SD = 3.13) years of age. Most self-identified as European-American (78.1%), African-American (9.3%), or mixed race (6.6%). The majority were cohabiting (84.2%) rather than married (15.8%), with average length of marriage or cohabitation of 2.50 years (range = 0.17–10.25, SD = 2.19). Most had completed at least some college (71.9%, 24.0% currently enrolled) and were employed full- or part-time (82.8%).

Procedures

Eligible couples completed a 90-minute in-person orientation prior to beginning the 30-day reporting period. After study procedures were described, partners were escorted to private rooms for informed consent procedures and independent completion of computerized baseline questionnaires. Couples were then reunited for instruction on how to make independent, confidential reports on a secure web-based portal via study-provided smartphone. All study procedures were approved by the university’s Institutional Review Board.

Participants were instructed to make a daily report each morning. Text messages were sent at 7:00 AM and 12:00 PM each day reminding them to complete their daily report by 3:00 PM. Whenever possible, staff contacted participants who failed to report by 3:00 PM to address any reporting problems and complete the daily report by telephone. On average, participants completed morning reports between 10 and 11 AM (M = 10.70, SD = 2.51 hours). Participants were sent weekly texts thanking them for participation and reminding them of monetary bonuses they had earned based on completion of morning reports ($1 per daily report, $10 weekly bonus for completing at least 6/7 morning reports, $30 for completing 4 weeks of reports, maximum of $100). Of 10,980 possible daily reports (30 days × 183 couples), men reported on 5,133/5,490 days (93.5%, M = 28.05 days, SD = 4.35) and women on 5,253/5,490 days (95.7%, M = 28.70 days, SD = 3.09).

Measures

Daily Cannabis Use Episodes.

Participants were asked to make an event-triggered report every time they were about to use cannabis and again immediately after they finished. These were time-stamped and included information about the episode (e.g., location, presence of others) as well as post-use affect (described below). To ensure that we captured all episodes, on each morning report, participants were asked whether they had used cannabis on any occasion since the previous day’s report. If they had used cannabis but failed to complete a report, they were asked the time of use. Combining event-triggered and morning reports provided a complete accounting of all cannabis use episodes and time of each episode over all 30 days of the study.

Daily Affect.

Each morning report began by asking “Right now do you feel…” followed by 11 items. These included 8 items based on the Positive and Negative Affect Schedule (PANAS, (Watson & Clark, 1994): irritable, stressed out, happy, angry, sad, relaxed, overwhelmed, and anxious/nervous. We also included restless or fidgety, impulsive or reckless, and confused or mentally fuzzy, which have been associated specifically with cannabis use (Ansell et al., 2015; Lee, Cadigan, & Patrick, 2017). All items were rated using 5-point scales (0 = not at all; 4 = very much). The same items were used to assess feelings immediately after cannabis use on the after-cannabis event-triggered report. These reports were made, on average, 6–15 minutes after completing use (M = 1.76, SD = 0.83, Median = 2; on a 3-point: 1 = 5 minutes ago; 2 = 6–15 minutes ago; 3 = more than 15 minutes ago).

Data Analytic Strategy

To consider the impact of positive and negative morning affect on men’s and women’s use of cannabis later that day, we used multilevel modeling, using maximum likelihood estimation with robust standard errors in Mplus Version 8.1 (Muthén & Muthén, 2017). To ensure interpretable temporal ordering, we considered a cannabis episode as an outcome if it occurred after the time at which the morning report was completed that day (5,577/7,808; 71.4%). Any cannabis use episode that occurred earlier than the time of the morning report (1,661/7,808; 21.3%) or did not include time of use (570/7,080; 7.3%) was coded as 0 (no use).

At Level 1 (the daily level), we included morning positive, hostile, and anxious affect (centered within-person) as predictors. We also included day of the study (1 – 30), grand mean centered, to control for the tendency for daily reports to decline over time (Testa et al., 2018). At Level 2 (the person level), we controlled for mean affect levels (grand mean centered) across the study, so that we could distinguish between-person from within-person effects of affect. To be conservative, we controlled for total days of cannabis use at Level 2, which controls for the tendency for some individuals to use cannabis more frequently. Although the sample consisted of couples, because hypotheses concerned individual processes, we conducted analyses separately for men and women. Conducting analyses using individuals also helps to minimize the introduction of missing data, as dyadic analyses would require that both partners complete mood assessments at a given time. However, because cannabis use can be influenced by social factors, such as the presence and substance use of companions (e.g., Phillips, Phillips, Lalonde, & Prince, 2018; Shreier et al., 2012), we included in our models partner’s use of cannabis at the daily level. We hypothesized that an individual would be more likely to use cannabis when his or her partner used cannabis at the same hour or within 2 hours prior (uncentered). We also controlled for partner total days of cannabis use at the person level (grand mean centered).

Results

The 366 participants reported 7,808 episodes of cannabis use over 30 days, using an event-triggered report (n = 1,560) or on the next day’s morning report (n = 6,248). Men reported more cannabis episodes (4,159 events) and averaged more days of use (M = 17.74 days, SD = 8.98) than women (3,649 events; M = 15.62 cannabis days, SD = 9.85), t(10,978) = 12.436, p < .001.

We performed exploratory factor analysis of daily affect items. When all 11 items were included, fit was poor. However, when four items that did not load were omitted (confused, sad, impulsive, restless), items loaded on three factors, and model fit was good, (CFI/TLI = 0.977/0.955, RMSEA = 0.076 [90% CIs, 0.071, 0.082], SRMR = 0.024), with 77.63% of the variance explained (Hu & Bentler, 1999; Schermelleh-Engel, Moosbrugger, & Müller, 2003). The three factors - positive (happy, relaxed), hostile (irritable, angry), and anxious (anxious/nervous, overwhelmed, stressed out) affect - were used as predictors of daily cannabis use. Hostile and anxious affect were positively correlated with each other (r = .60, p < .01) and negatively correlated with positive affect (r = −.45 and r = −.46, p < .01).

Does Morning Mood Predict Cannabis Use Later that Day?

The primary analysis involved testing whether morning affect contributed to the odds of cannabis use later that day. As shown in Table 1, at Level 1, there were robust effects of positive morning mood on the likelihood of cannabis use later that day for men and women. Cannabis use was more likely on days in which positive affect was lower than one’s own average. Neither hostile nor anxious morning affect level contributed to later cannabis use. As expected, cannabis use was more likely when the partner used cannabis at the same hour or within 2 hours prior. Level 2 effects of affect (i.e., between-person differences in mean positive, hostile, anxious mood) were not associated with cannabis use. Individuals with more cannabis use days were more likely to report cannabis use at a given hour; however, total days of partner cannabis use did not predict daily cannabis use. Results were virtually identical when number of cannabis episodes each day was used as the dependent variable.

Table 1.

Daily Cannabis Use as a Function of Morning Affect

Variable Men Women
Estimate (S.E.) 95% CI Estimate (S.E.) 95% CI
Morning positive affect −0.197 (0.053)*** [−0.301, −0.092] −0.187 (0.061)** [−0.307, −0.067]
Morning hostile affect 0.036 (0.088) [−0.135, 0.208] −0.027 (0.064) [−0.152, 0.098]
Morning anxious affect −0.085 (0.091) [−0.263, 0.093] −0.117 (0.070) [−0.255, 0.020]
Day of the study a −0.025 (0.006)*** [−0.038, −0.013] −0.024 (0.006)*** [−0.037, −0.011]
Partner cannabis use b 1.581 (0.275)*** [1.042, 2.121] 1.647 (0.328)*** [1.004, 2.290]
Mean positive affect c −0.171 (0.157) [−0.478, 0.136] 0.004 (0.173) [−0.335, 0.343]
Mean hostile affect c 0.077 (0.402) [−0.712, 0.865] −0.253 (0.374) [−0.985, 0.480]
Mean anxious affect c −0.173 (0.335) [−0.830, 0.485] 0.079 (0.246) [−0.403, 0.560]
Total cannabis use days 0.067 (0.008)*** [0.051, 0.084] 0.087 (0.013)*** [0.062, 0.113]
Total partner cannabis use days −0.015 (0.017) [−0.048, 0.018] −0.027 (0.025) [−0.075, 0.021]
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***

p < .001

**

p < .01

*

p < .05

a

Day of the study (1–30)

b

Partner use within prior 2 hours (including at the same hour)

c

Mean morning affect over 30 days; grand mean centered

Does Cannabis Use Improve Affect?

A secondary goal of the study was to consider whether affect immediately after cannabis use was improved relative to that morning’s levels. For this analysis, we were limited to event-triggered cannabis episodes that were reported immediately after use (N = 1,560), since we did not assess post-cannabis affect for episodes reported retrospectively on the next day’s report. Analyses were performed separately for positive, hostile, and anxious affect as outcomes. If more than one event-triggered report was made on a given day, we used only the first report. At Level 1 (i.e., daily), we considered the normative changes in affect before (morning) and immediately after cannabis use on that day, represented as a Time effect (0 = morning, 1 = after cannabis use). At Level 1, we also included day of the study (1–30; grand mean centered) and a dichotomous indicator of partner cannabis use (at same hour or within 2 hours prior), allowing us to determine whether post-cannabis affect was sensitive to partner’s use as well as one’s own use. At Level 1, we controlled for morning levels of the affect outcome. At Level 2 (i.e., person level), we included the mean morning affect scores over 30 days (grand mean centered) to control for possible between-person variation. As shown in Table 2, there were significant Time (i.e., cannabis) effects for all three outcomes: positive affect increased and hostile and anxious affect decreased after cannabis use relative to that day’s morning report. Results were identical for men and women. Partner use had no effect on post-cannabis mood.

Table 2.

Time Effects on Post-Cannabis Affect

Variable Positive affect
Men Women
Estimate (SE) CI 95% Estimate (SE) CI 95%
Time a 0.780 (0.075)*** [0.634, 0.926] 0.900 (0.087)*** [0.730, 1.070]
Day of study b 0.002 (0.002) [−0.002, 0.006] 0.001 (0.003) [−0.005, 0.006]
Morning positive affect c 0.537 (0.025)*** [0.489, 0.585] 0.499 (0.018)*** [0.464, 0.534]
Partner cannabis use that day d 0.029 (0.043) [−0.055, 0.113] 0.046 (0.039) [−0.031, 0.122]
Mean positive affecte 0.750 (0.045)*** [0.634, 0.839] 0.787 (0.049)*** [0.691, 0.883]
Variable Hostile affect
Men Women
Estimate (SE) CI 95% Estimate (SE) CI 95%
Time a −0.186 (0.043)*** [−0.270, −0.103] −0.271 (0.046)*** [−0.360, −0.181]
Day of study b −0.002 (0.001) [−0.004, 0.000] −0.002 (0.001) [−0.004, 0.001]
Morning hostile affect c 0.506 (0.019)*** [0.468, 0.544] 0.468 (0.019)*** [0.431, 0.504]
Partner cannabis used 0.028 (0.033) [−0.036, 0.092] 0.013 (0.029) [−0.044, 0.069]
Mean hostile affecte 0.692 (0.061)*** [0.573, 0.812] 0.624 (0.060)*** [0.506, 0.742]
Variable Anxious Affect
Men Women
Estimate (SE) CI 95% Estimate (SE) CI 95%
Time a −0.109 (0.043)* [−0.193, −0.025] −0.339 (0.073)*** [−0.483, −0.196]
Day of study b −0.001 (0.002) [−0.005, 0.002] −0.002 (0.001) [−0.005, 0.001]
Morning anxious affect c 0.557 (0.029)*** [0.500, 0.613] 0.516 (0.044)*** [0.428, 0.603]
Partner cannabis used 0.011 (0.029) [−0.047, 0.068] −0.019 (0.034) [−0.086, 0.048]
Mean anxious affecte 0.745 (0.054)*** [0.639, 0.850] 0.747 (0.027)*** [0.695, 0.799]
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Note:

a

Time (0 = morning; 1 = after cannabis use)

b

Day of study (1–30); grand mean centered

c

Morning assessment of DV, person-mean centered

d

Partner cannabis use (within 2 hours or same hour)

e

Morning mean scores of the outcome variable over 30 days; grand mean centered

***

p < .001

**

p < .01

*

p < .05

To examine whether cannabis use on a given day influenced the next morning’s mood, we repeated the above analyses using next day reports of positive, hostile, and anxious mood as the dependent variable. There were no lagged effects of cannabis use (or partner cannabis use) on next day positive, hostile, or anxious mood for men or women.

Discussion

The study considered whether daily levels of positive, hostile, and anxious affect contributed to cannabis use later that day. For both men and women, the likelihood of using cannabis on a given day was greater when morning positive affect was lower than one’s average, suggesting that people may use the drug to restore positive affect to more typical levels. However, results do not provide convincing support for the self-medication hypothesis because neither hostile nor anxious mood contributed to later cannabis use. Findings add to an already mixed pattern of results: studies showing daily cannabis use predicted by higher positive affect (Chakroun et al., 2010), higher negative affect (Shrier et al., 2014), and neither (Buckner et al., 2015). Differences across studies may reflect diversity of samples with respect to age, chronicity of cannabis use, and other factors. Methodological differences may also be at play. For example, we assessed pre-cannabis mood only in the morning, rather than in response to random prompts throughout the day (see Buckner et al., 2012; Chakroun et al, 2010). Affect closer to the time of use may have had a different and potentially larger impact.

We found robust evidence that both men and women were more likely to use cannabis when their intimate partners used cannabis. This pattern replicates and extends prior work showing that college students are more likely to use cannabis when with companions (Phillips et al., 2018). While not particularly surprising given the social aspects of substance use, it is significant that accounting for partner influence did not eliminate the effect of positive affect; daily cannabis use reflected both individual and social influences.

Immediately following cannabis use, men and women reported higher positive and lower negative affect than they did that morning. These positive consequences probably reflect the immediate “good drug” feelings associated with cannabis (e.g., Green et al., 2003) and point toward positive reinforcement contributing to continued use among regular cannabis users. However, we found no lagged effects of cannabis use on the next morning’s affect, suggesting that the improved mood effects may be short-lived. Prior EMA studies have shown mixed results, with cannabis episodes resulting both in decreased (Buckner et al., 2015;) and increased negative affect in the short term (e.g., Ross et al., 2018; Trull et al., 2016), as well as immediate improvements in post-use mood coupled with longer term increases in depression over time (Cuttler et al., 2018). Differences in sample and in the time frame between pre- and post-use affect may account for inconsistencies across studies.

The study had unique and notable strengths—the large community sample of cannabis-users, followed over 30 days—as well as limitations. As noted above, the timing of affect assessments may have contributed to the pattern of findings. Because post-cannabis affect was not available for most cannabis episodes, which were reported retrospectively rather than as event-triggered reports, caution is necessary in generalizing findings regarding post-use affect. Moreover, because we did not assess affect later in the day for days on which there was no cannabis use, we cannot state unequivocally that post-cannabis improvement in affect is the result of the drug; it may reflect naturally-occurring diurnal patterns (see Peeters, Berkhof, Delespaul, Rottenberg, & Nicolson, 2006). Although this was a fairly diverse community sample, findings may not generalize to other samples of less habitual cannabis users. However, even within this sample of regular cannabis-using couples, in which we accounted for partner use, it is notable that we still found evidence that within-person fluctuations in morning positive affect contributed to the likelihood of using cannabis later that day.

Highlights.

  • Lower positive morning affect predicted greater odds of cannabis use later that day.

  • Morning hostile and anxious affect did not predict later cannabis use.

  • Cannabis use was more likely when one’s intimate partner used cannabis that day.

  • After cannabis use, positive affect was higher than morning levels.

  • After cannabis use, hostile and anxious affect were lower than morning levels.

Acknowledgements

This work was supported by a National Institute on Drug Abuse grant R01DA033994 to Maria Testa and by National Institute on Alcohol Abuse and Alcoholism grant T32AA007583.

Footnotes

Declarations of interest: None

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