Perspectives of young cannabis users within the Nigerian policy context: The paradox of criminalization as a deterrence strategy

Background: The use of cannabis is criminalized in Nigeria and punitive law enforcement is the primary drug control strategy. Young cannabis users conceal use because of stigma, criminal identity and social ostracism. This qualitative study explored young people's perspectives about how criminalization affects the use of cannabis in Lagos, Nigeria. Methods: Focus groups and interviews were conducted among 39 cannabis users aged 16-21 years recruited using snowball sampling. Interviews were audio-recorded, transcribed verbatim and analyzed using thematic analysis. Results: Most interviewees did not view the criminal identity associated with cannabis use as a deterrent to use; they considered it a risk that could be mitigated by concealment of use. Reinforcement from social networks, personal meanings and dependence on cannabis for daily functioning sustained the decision to continue cannabis use despite associated risks. Female cannabis users who faced additional vulnerabilities addressed the risk of assault by clandestinely obtaining cannabis through third parties. The "criminal" stereotype from the negative societal perception about users as criminals which often resulted in stigma and lost opportunities paradoxically appeared to reinforce cannabis use among male users. Conclusion: A non-judgmental participatory approach is needed to contextualize their needs, inform health promotion and empower them to seek help.