Personality-Targeted Prevention Slowed Cannabis Use Escalation in At-Risk Teens Over 4 Years

Students receiving PreVenture, a brief personality-targeted cognitive-behavioral intervention, showed slower increases in cannabis use (OR=0.75), tobacco smoking (OR=0.79), alcohol use (OR=0.92), and illicit polysubstance use (OR=0.56) over 4 years compared to controls. Effects did not differ by sex. The cannabis reduction was among the strongest effects observed.

Pre-specified secondary analysis of a cluster-randomized clinical trial. 1,669 at-risk grade 7 students from 31 Montreal-area secondary schools were randomized by school to receive PreVenture (15 schools, 705 students) or control (16 schools, 964 students). At-risk status was defined by elevated anxiety sensitivity, hopelessness, impulsivity, or sensation seeking. Published in JAMA Network Open.

Most substance prevention programs are universal and have modest effects. This study shows that targeting the specific personality traits that drive substance use in at-risk teens can produce meaningful reductions across multiple substances, including cannabis, with just two sessions.

PreVenture has been tested in multiple countries and this secondary analysis extends its evidence base to cannabis specifically. The finding that a 2-session intervention can reduce cannabis use escalation by 25% over 4 years makes it one of the most efficient prevention tools available.

Secondary analysis of a trial not primarily designed for cannabis outcomes. Montreal-area sample may not generalize to all populations. Cluster randomization by school introduces potential confounding. Self-reported substance use. Bayesian analysis framework differs from traditional frequentist approaches.