Addressing Youth Perceptions of Harm in Marijuana Prevention Programming

The inverse relationship between perception of harm and substance use is clearly supported by decades of research – youth are less likely to engage in substance use when it is seen as harmful. However, despite strong theoretical and practical reasons to focus on perception of harm as a change-producer in prevention programming, little is known about what is effective in impacting perception of harm for youth marijuana use. To investigate the impact of existing prevention efforts designed to influence youth perception of harm and, consequently, youth marijuana use, we reviewed seven privately- or federally-funded online registries (e.g., Blueprints for Healthy Youth Development, Substance Abuse and Mental Health Administration’s National Registry of Evidence Based Programs and Practices) to identify evidence-based programs with marijuana-related outcomes for youth. We found 36 registry-identified programs with demonstrated impact on youth marijuana use. Although many of these programs may have actively or passively sought to alter perception of harm, only ten measured marijuana- or drug-related perception of harm as an intermediate outcome. Drawing on the commonalities of evidence-based programs with significant impacts on youth marijuana perception of harm, as well as lessons learned from other health behavior change efforts, we recommend best practices to provide state and local decision-makers with information on altering youth perception of harm for marijuana and on evaluating the impact of these efforts.