The position that community norms supportive of marijuana use may be an underlying mechanism explaining the higher rates of marijuana use and abuse/dependence in states that legalized medical marijuana (either as a “common cause” of changes in legislation and marijuana use or as a mediator linking legislation to marijuana use) is supported by the broader literature on group norms, which has demonstrated that group norms shape individual behavior and mental health (Asch, 1951, 1952; Cullen, 1983; Durkheim, 1938) and that social pressures to conform to the group norms influence the decision to engage in behaviors once norms are internalized. In the area of substance use, parallels can be established with alcohol use and cigarette smoking. For example, “cultures” of drinking (Skog, 1985) in the neighborhood (Ahern et al., 2008) and workplace (Barrientos-Gutierrez et al., 2007) have been linked with risk for binge drinking. Further, perceived disapproval of adolescent alcohol use is associated with less prevalent underage drinking (Kumar et al., 2002; Lipperman-Kreda et al., 2010). Permissive neighborhood smoking norms have also been associated with increased prevalence of smoking (Ahern et al., 2009).
