Medical Students’ Views on Cannabis Use in Recreational Contexts Are Related to Their Own Consumption Intention

Round 1

Reviewer 1 Report

The manuscript entitled “Medical Students' Views on Cannabis Use in Recreational Contexts are Related to Their Own Consumption Intention” investigated whether medical students in Romania support cannabis legalization and the various influences that shape that opinion. The data are of potential interest, but several issues should be addressed. Admittedly, this is a bit outside my research expertise, but the manuscript needs additional explanation of most concepts if the authors desire broad readership.

1.         Abstract:

            Define DSO (it can be general).

            It is not clear what is meant by the statement that ends with “…efficacy to abstinence      (higher among female respondents) and DSO (perceived as less intense in male      respondents).” This sentence does not accurately describe the results. It is not clear until             the discussion that this presumably means that female respondents, despite reporting           more likelihood of having experiences causing DSO, also did not turn to cannabis as a coping mechanism.

This sentence is a bit confusing: “In a logistic regression analysis with the positive opinion of cannabis legalization as the outcome, the respondents' own consumption intention (on a Likert-type scale from 1 to 5) led to OR=2.918, 95%CI (1.893−4.497), when controlling for gender, age, smoking, drinking, onset age of smoking, and DSO.” What defines the OR should be stated more clearly.

2.         Introduction:

            Line 33 need “of” after regardless.

            Line 38-39; it is not clear why poly-substance abuse is mentioned since the first part of    the sentence focuses on cannabis.

3.         Methods:

            Where does ITEM come into the method? It is not part of Figure 1.

4.         Results:

            The four latent factor terms are not clearly defined: attitude, subjective norm (SN),          self-efficacy to abstinence (SEA), and intention and therefore the results (both the tables     and the figures) are very difficult to follow.

            Figures 2 and 3 are not described well in the results or figure legends. What do the          numbers mean? What do the arrows mean?

            Should zeros be included before numbers with decimal points?

5.         Discussion:

            Could the authors expand on this statement:

            “Medical knowledge and education are not deterrent factors concerning recreational       cannabis or cannabis in general, and our results confirmed these literature findings.” Was this simply because most of these soon-to-be doctors were in favor of legalization? This statement makes it sound like the authors compared individuals with higher   education and those that do not have additional education.

            Although there is no doubt that the time frame of the study, which included students      that started during the COVID pandemic, is important, the authors should be careful not            to leave the reader with the impression that their data show that the COVID pandemic             caused more cannabis use, or they should discuss other studies, if they exist (which I       think they do) showing that cannabis use did increase during/after the COVID pandemic. 

            Line 343 the word “data” is plural so “is” should be “are”.

            Line 355 no s needed on pandemic.

            Line 367 should be is (referring to population).

            Line 382 citations are needed for the gateway concept, as well as re-citing the papers       regarding the cyclical influence between tobacco and cannabis.

            The extensive discussion of limitations of the study is appreciated.

Minor grammatical issues throughout.

Author Response

Thank You very much for your appreciation of the manuscript, and the time and effort spent on reviewing it and giving us feed-back..

Please see the answers in the attached file.

We welcome any further comments and appreciate your time.

The Authors

Author Response File: Author Response.pdf

Reviewer 2 Report

The authors describe a cross-sectional study of advanced medical students to assess their attitude toward recreational cannabis consumption, their intention to use it, and their opinion of its legal status. Gender differences concerned individuals' efficacy to abstinence (higher among female respondents) and DSO (perceived as less intense in male respondents). In a logistic regression analysis with the favorable opinion of cannabis legalization as the outcome, the respondents' own consumption intention led to a more favorable opinion of cannabis legalization when controlling for gender, age, smoking, drinking, onset 16 age of smoking, and DSO. Overall, the manuscript is well written, the rationale for the study is justified, and the methods are transparent. The findings were as expected. Easy to read and follow. 

Author Response

Thank You very much for your appreciation of the manuscript, and the time and effort spent on reviewing it and giving us feed-back.

We welcome any further comments and appreciate your time.

The Authors

Round 2

Reviewer 1 Report

The authors were responsive to the concerns of the reviewers.

Author Response

Thank you very much for your appreciation.

The authors.