# Cannabinoid Clinical Trials: Cannabis in At-Risk Teens > **Author:** Benjamin Caplan, MD (ABFM Board Certified, MA Lic. #240562, NPI: 1962722637) > **Publisher:** CED Clinic (https://cedclinic.com) > **Canonical URL:** https://cedclinic.com/sequential-messaging-cannabis-prevention-at-risk-teens/ > **Published:** 2026-04-14T19:43:26-04:00 | **Last Modified / Clinically Audited:** 2026-09-28T11:56:14-04:00 > **Clinical Summary:** Explore sequential messaging cannabis prevention strategies tailored for at-risk teens to improve effectiveness over standard anti-cannabis campaigns. --- #### Clinical Takeaway Research suggests that standard anti-cannabis messages often fail because they don’t account for the wide range of attitudes adolescents already hold about cannabis. This study tested a sequential messaging approach that first challenged negative reactions to prevention messages before delivering a more targeted follow-up communication, specifically in middle and high school students who had not yet used cannabis. The findings point toward more personalized, rebuttal-based strategies as a potentially more effective framework for [adolescent cannabis](https://cedclinic.com/cannabis-use-disorder-psychiatric-risk/) prevention compared to one-size-fits-all campaigns. ### #28 A Rebuttal-Based Social Norms-Tailored Cannabis Intervention for At-Risk Adolescents. **Citation:** Donaldson Candice D et al. *A Rebuttal-Based Social Norms-Tailored Cannabis Intervention for At-Risk Adolescents.* Prevention science: the official journal of the Society for Prevention Research. 2021. PMID: 33791930. **Study type:** Journal Article, Randomized Controlled Trial, Research Support, N.I.H., Extramural  |  **Topic area:** Pediatrics  |  **CED Score:** 10 Design: 5 Journal: 0 N: 3 Recency: 0 Pop: 3 Human: 1 Risk: -2 **Quality Gate Alerts:** - Preclinical only **Abstract:** Many past cannabis prevention campaigns have proven largely ineffective due in part to the diversity of adolescents’ cannabis-relevant beliefs. The current studies evaluated the impact of a sequential multiple message approach tailored to the usage norms of adolescents expressing negative attitudes toward a cannabis prevention appeal. A multiple-message strategy was implemented-initial unfavorable message evaluations were invalidated using attitudinal rebuttal feedback prior to presenting a third tailored communication. Participants were cannabis-abstinent middle and high school students (ages 11 to 16). Study 1 (N = 808) compared effects of gain- and loss-framed messages tailored to each student’s normative usage perceptions. In Study 2 (N = 391), students were randomly assigned to receive a tailored or non-tailored message after receiving feedback meant to destabilize anti-message attitudes. For at-risk adolescents in Study 1 who perceived [cannabis use](https://cedclinic.com/cannabis-cardiovascular-health-insights-2024/) as normative, a tailored gain-framed message resulted in the lowest usage intentions (p < .05). In Study 2, a conditional multiple-moderated mediation model showed that for high-risk teens with normative beliefs and pro-cannabis attitudes, exposure to a tailored gain-framed communication was associated with decreased cannabis attitude certainty, and lower usage intentions 2 months later (p < .05). Findings have implications for sequential messaging utilization in mass media campaigns and support the efficacy of tailored messages over a one-size-fits-all media approach. Further, results suggest that systematically weakening resistance to persuasive communications and tailoring messages consistent with individually perceived peer norms is an effective prevention strategy.  |   |  [View on PubMed ↗](https://pubmed.ncbi.nlm.nih.gov/33791930/)[Full Text ↗](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8257086/)[DOI ↗](https://doi.org/10.1007/s11121-021-01224-9) [https://cedclinic.com/contact/](https://cedclinic.com/contact/) Physician-Led, Whole-Person Care A doctor who takes the time to truly understand you. Personal care that starts with listening and is guided by experience and ingenuity. 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[Read More](https://cedclinic.com/sequential-cannabis-prevention-messaging-teens/) [Endocannabinoid System Research: Teen Cannabis Intervention](https://cedclinic.com/sequential-cannabis-prevention-messaging-teens/) Explore research on the [endocannabinoid system](https://cedclinic.com/endocannabinoid-system-fear-extinction/) and its role in cannabis interventions among teens. [Explore Research](https://cedclinic.com/sequential-cannabis-prevention-messaging-teens/) [Cannabinoid Clinical Trials: Cannabis Interventions for Teens](https://cedclinic.com/cannabis-interventions-for-teens/) Review clinical trials evaluating various cannabis intervention methods tailored for adolescent users. [Learn More](https://cedclinic.com/cannabis-interventions-for-teens/) Have thoughts on this? 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