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Study breakdown

Teen Cannabis Use Predicted Loneliness After High School in Rural Communities

Longitudinal CohortModerate evidence
The takeaway

Among youth in rural reservation-based communities, cannabis use and other substance use in 12th grade predicted a 21-24% increased risk of loneliness six months after high school.

School counselors, youth prevention program designers, rural health researchers, tribal health advocates

21-24% increased loneliness risk from 12th-grade substance use

What the researchers found

Cannabis use in 12th grade was associated with a 21-24% increased risk of loneliness post-high school, similar to alcohol, binge drinking, and vaping. Anxiety and depressive symptoms in 12th grade also predicted loneliness, with 5-point increases associated with 15% and 21% greater risk respectively.

Why it matters

Loneliness is a growing public health concern among emerging adults, and rural reservation-based communities face unique challenges. Understanding that substance use predicts post-graduation loneliness can inform prevention timing.

The numbers in context

483 participants. Cannabis use, alcohol use, binge drinking, and vaping each associated with 21-24% increased risk of loneliness. 5-point increase in anxiety symptoms: 15% greater loneliness risk. 5-point increase in depressive symptoms: 21% greater risk.

How the study worked

Longitudinal study of 483 participants from rural reservation-based communities surveyed in 12th grade (Spring 2024) and again six months into young adulthood (Fall 2024). Generalized estimating equations with Poisson distribution assessed predictors of post-high-school loneliness.

What this study cannot tell us

Six-month follow-up is short. Specific to rural reservation-based communities, which may limit generalizability. Cannot determine whether substance use caused loneliness or whether shared factors drive both.

How to read the evidence

Moderate: prospective longitudinal design with a specific population, but short follow-up and limited generalizability

When this study was published

Published in 2025 using 2024 survey data

The bigger picture

The transition from high school to young adulthood is a vulnerable period, especially in rural communities with limited support resources. Substance use during high school may both signal and contribute to social disconnection that manifests as loneliness later.

Questions still open

  • Does the loneliness persist beyond six months? Would addressing substance use before graduation reduce loneliness? What community-specific factors contribute to this pattern?

Common questions

Does cannabis use cause loneliness?
This study found that cannabis use in 12th grade predicted loneliness six months later, but cannot determine causation. Substance use and loneliness may share common risk factors, or substance use may contribute to social isolation that becomes loneliness after graduation.
Were specific substances worse than others?
No. Cannabis use, alcohol use, binge drinking, and vaping all predicted similar increases in loneliness risk (21-24%). The pattern was consistent across substances.

Read the original research

Loneliness among emerging adults in rural reservation-based communities: longitudinal effects of 12th grade substance use and mental health symptoms.

Scientific reports, 15(1), 31935

Citation

Barry, Caroline M; Jagtiani, Ashna; Skinner, Juli R; Gassaway, Ashley N; Komro, Kelli A; Livingston, Melvin D. (2025). Loneliness among emerging adults in rural reservation-based communities: longitudinal effects of 12th grade substance use and mental health symptoms.. Scientific reports, 15(1), 31935. https://doi.org/10.1038/s41598-025-18008-8

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