Order of Cannabis and Alcohol Use on Pregaming and Non-Pregaming Days Among College Students.

Objective: Pregaming is common among college students and is associated with heavy drinking and negative alcohol-related consequences. The use of cannabis on pregaming days may exacerbate negative alcohol-related consequences, and the ordering of when cannabis is used on these days may buffer against or intensify these consequences. Considering the growing rates of simultaneous use of cannabis and alcohol among college students, it is necessary to examine the role of pregaming behaviors in the context of cannabis use and its effects on alcohol-related consequences.

Method: In the present study, college students ( = 485) completed a baseline survey and 14 days of daily surveys, reporting on daily alcohol and cannabis use and alcohol-related negative consequences. Multilevel structural equation models were fit to evaluate cannabis outcomes on pregaming versus non-pregaming drinking days and ordering effects on alcohol-related consequences, controlling for number of drinks, age, and sex.

Results: Across all drinking days, pregaming on that day as well as cannabis use during drinking on that day were associated with a greater risk for alcohol-related consequences. On days that did not involve pregaming, the use of cannabis before drinking was associated with a greater risk for negative alcohol-related consequences, whereas cannabis use after drinking was associated with less risk for consequences. These effects were observed on non-pregaming days only and not on days with pregaming.

Conclusions: Findings have implications for brief interventions with students, as analyses suggested that both cannabis use and pregaming--independent of number of drinks consumed--are risky behaviors associated with alcohol-related consequences.