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Background: An important life‐course event with respect to alcohol and cannabis use is turning 21 years of age, which may be associated with increases in use of these substances due to celebrations during the month and easier access to them on and following this birthday. We examined the trajectories of alcohol and cannabis use behaviors in the months leading up to, during, and following the 21st birthday month. We also examined whether the use trajectories vary by college status and baseline levels of use. Methods: We used data from 203 young adults recruited from the Greater Seattle region who turned 21 during the course of the study. Surveys were administered each month for 24 consecutive months. Measures included the typical number of drinks per week for the past month, the frequency of heavy episodic drinking, the number of cannabis use days, and any simultaneous alcohol and cannabis use. Multilevel spline models were run that estimated linear slopes over time at four intervals: (1) up to 1 month before the 21st birthday month; (2) from 1 month before to the month of the 21st birthday; (3) from the 21st birthday month to 1 month following; and (4) from 1 month following the 21st birthday month through all following months. Results: Alcohol use, generally, and simultaneous alcohol and cannabis use showed sharp increases from the month before the 21st birthday month to the 21st birthday month and decreases following the 21st birthday month. For cannabis use, there were significant increases in the months leading up to the 21st birthday and no other significant changes during other time intervals. Patterns differed by baseline substance use and college status. Conclusions: Findings from the current study have implications for the timing and personalization of prevention and intervention efforts. Event‐specific 21st birthday interventions may benefit from incorporating content targeting specific hazardous drinking behaviors in the month prior to the 21st birthday. [ABSTRACT FROM AUTHOR]

Background: Simultaneous alcohol and marijuana (SAM) use has been associated with greater alcohol use and consequences at the daily level, but limited research has examined SAM use in relation to marijuana use and its consequences. This study tested daily associations between SAM use and four outcomes: alcohol use (number of drinks), marijuana use (hours high), negative alcohol consequences, and negative marijuana consequences. Methods: A community sample of young adults [ages 18–25, mean (SD) = 21.61 (2.17) years] with recent alcohol and SAM use was recruited (N = 409; 50.9% female; 48.2% non‐Hispanic/Latinx White). Participants completed a baseline survey and six 2‐week bursts of daily surveys (81.1% of morning surveys completed) and reported on substance use and negative substance‐related consequences. Multilevel modeling was used to test the main aims and to explore each specific consequence. Results: Among days with any alcohol use, SAM use days were associated with consuming more drinks and experiencing more total negative alcohol‐related consequences than non‐SAM use days. Among days with any marijuana use, SAM use days were associated with more hours being high than non‐SAM use days. Exploratory models showed that SAM use was related to five specific alcohol‐related consequences and two specific marijuana‐related consequences. Conclusions: These findings build upon prior research by showing that SAM use days are linked to consuming more drinks, reporting more hours being high from marijuana, and experiencing more total alcohol‐related consequences even after controlling for the number of drinks, the number of hours high, any tobacco/nicotine use, and any other substance use. SAM use was also associated with a greater likelihood of experiencing some specific consequences related to alcohol and marijuana. The findings underscore the need for additional research on SAM use and marijuana‐related outcomes. The current study found that, among days with any alcohol use, SAM use days were associated with consuming more drinks and experiencing more total alcohol consequences and also experiencing some specific alcohol consequences. Among days with any marijuana use, SAM use days were associated with more hours high and experiencing some specific marijuana consequences. Findings build on prior research by showing effects of SAM use even after controlling for number of drinks, number of hours high, and other substance use. [ABSTRACT FROM AUTHOR]

Background: The contexts in which young adults drink alcohol play a salient role in alcohol‐related outcomes and negative consequences at an event‐level, but less is known about longitudinal risks. We collected longitudinal monthly data across 2 years on (a) daytime drinking, (b) pregaming/pre‐partying, and (c) playing drinking games. We then examined associations between drinking in these contexts and within‐person variability in alcohol consumption, consequences, and simultaneous alcohol and marijuana (SAM) use in a given month. We also examined the extent to which drinking in these contexts predicted hazardous drinking (using Alcohol Use Disorders Identification Test (AUDIT) scores) at a distal follow‐up timepoint, controlling for baseline AUDIT scores. Method: A community sample of 759 young adults (Mage = 21.1 years; 56.4% female) completed monthly surveys for 24 consecutive months and a distal 30‐month follow‐up. Multilevel models estimated within‐ and between‐person associations between drinking context frequencies (daytime drinking, pregaming, drinking games) and alcohol‐related outcomes (weekly consumption, consequences, SAM use). A single‐level negative binomial regression tested associations between drinking context frequency averages across a two‐year period and changes in AUDIT scores from baseline to a follow‐up 2.5 years later. Results: Over 75% of the sample of non‐abstaining young adults reported drinking in each of the three contexts at least once during the 24‐month period. Within‐persons, young adults reported greater consumption, more negative consequences, and increased likelihood of SAM use during months that they drank in these contexts more often than usual. Each context was associated with negative consequences, even when controlling for alcohol use frequency. More frequent daytime drinking and pregaming, but not drinking games, were associated with increases in AUDIT scores at the 30‐month follow‐up, suggesting that there are potential long‐term risks of drinking in these contexts. Conclusions: Findings suggest that daytime drinking, pregaming, and playing drinking games are high‐risk contexts in terms of month‐to‐month and long‐term risks. Additional research is needed on the various contexts in which young adults drink alcohol and the extent to which contextual factors interact with one another to amplify/reduce risks and harms. [ABSTRACT FROM AUTHOR]