The aim of this study was to identify profiles of cannabis consumers based on their motives for use and their stage of change readiness and treatment eagerness. Both statistically significant and clinically relevant consumer groups were identified: ICU, SCU, and ESU.

Both ICU and SCU clusters disclosed largely using cannabis as a coping mechanism, which in cannabis users has been linked with poorer mental health, significant psychopathological symptoms, and increased psychological stress compared with noncannabis users [35]. Both groups also reported high ASSIST scores, indicating a high risk of problematic cannabis use, but with relatively high levels of problem recognition. This recognition, combined with high willingness to act scores and great importance given to change, offers opportunities for targeted health interventions.

Within this perspective, understanding the underlying coping motives may play a critical role. For instance, in this study, coping motives are positively associated with problematic use—as measured by the ASSIST—and this overlap was reflected in our clustering results. The assessment of motives provides, however, conceptually and clinically distinct information. The ASSIST captures the severity and consequences of substance use, whereas coping motives reflect why individuals engage in cannabis use in the first place. This distinction is critical because motives can serve as predictive and explanatory variables, informing not just current use severity but also potential relapse risk, underlying psychological vulnerabilities (eg, emotion regulation difficulties), and targets for intervention. In particular, coping motives have consistently emerged as one of the strongest and most reliable psychological predictors of both cannabis use frequency and cannabis-related problems [1118]. Importantly, 2 individuals with similar ASSIST scores might differ in their underlying motives—one using cannabis primarily to cope with distress, and another for social or enhancement reasons—which may call for different intervention strategies. Thus, including motivational profiles allows for a more personalized and mechanism-based understanding of users, which is particularly relevant in the context of digital health tools aiming to offer tailored, scalable intervention.

As it stands, “taking steps” scores, according to the SOCRATES scores, remained moderate in ICU and SCU clusters, probably hampered by high ambivalence and low self-confidence to change. These last 2 factors may reflect pre-existing psychopathological symptoms or psychosocial distress, with cannabis being used to cope with and alleviate these symptoms [35-40]. This dimension should probably be specifically addressed for better therapeutic efficacy. In that respect, research has shown that reducing coping as a motive for cannabis use is a consistently positive predictive factor for a decrease in cannabis-related problems over the next months during treatment [13].

The ESU cluster reported the lowest ASSIST scores, which still translate into a moderate risk of problematic cannabis use. While low coping scores hint at a lower prevalence or burden of psychological comorbidity, individuals are still at risk for the negative physical consequences of smoking cannabis [3]. In other studies, enhancement motives remained predictive of psychosocial problems associated with cannabis use [41]. While enhancement was a highly endorsed motive across all clusters, it still holds discriminative value, as the clusters differed significantly on this dimension—cluster 2 scored highest, cluster 1 lowest, and cluster 3 intermediate. Notably, in cluster 3, enhancement was the most prominent motive relative to other MMM dimensions, justifying its label as the “enhancement-seeking” cluster.

Recognition of the problem was the lowest in the ESU cluster among the 3 groups, and in regard to this, low ambivalence scores should be interpreted as reflecting low awareness of the problem. These results could suggest that such individuals might be more likely to return to the pre-contemplation stage of change despite having downloaded an app aimed at reducing or stopping their use of cannabis. In this case, motivational dialogue might help increase problem recognition and the overcoming of resistance to change. ESU individuals have higher self-confidence in changing their cannabis use, which may be related to lower reliance on cannabis as a coping mechanism for psychological distress.

The SCU cluster was the most intricate, with several salient motives for cannabis use, rendering prognosis analyses and planning treatment interventions more complex. In another study, young adults with social motives for use reported similar levels of distress to nonusers [35]. Notwithstanding these results, evidence suggests that multiplicity of motives for use correlates with increased consumption and a higher likelihood of experiencing adverse consequences of cannabis [42]. SCU also exhibited high rates of use for expansion motives. A decrease in expansion as a reason for cannabis use following treatment is surprisingly associated with poorer treatment outcomes [12].

The distinct features of the 3 main clusters clearly illustrate the multifaceted nature of cannabis use, highlighting diverse motives for use and hence the need for tailored targets of intervention. Targeted therapeutic interventions rely on such multidimensional phenotypic assessments [43] to enhance their efficiency. Motives of use offer a good treatment target, as different motives are associated with either favorable or unfavorable treatment outcomes [12]. As an example, cognitive behavioral therapy, which is sometimes dispensed through computer-based training, could be enhanced by the adjunction of specific modules designed to change motives of cannabis use [44].

Treatment strategies may be effectively tailored according to user profiles identified through clustering. For example, individuals in the ICU cluster appear to use cannabis primarily to cope with psychological distress. They show high recognition of the problem and a strong willingness to change, but report low self-confidence and only moderate levels of action-taking. For this group, tailored interventions could focus on emotion regulation, stress management, and the development of alternative coping strategies. In addition, motivational enhancement techniques may be used to strengthen self-efficacy and support-maintained behavior change.

Individuals in the ESU cluster tend to use cannabis for excitement, exhibit low recognition of the problem, low ambivalence, but express high confidence in their ability to change. In this case, brief interventions—such as personalized assessments and normative feedback—may be appropriate. These should help participants explore the discrepancy between their current behavior and personal goals. Harm reduction strategies (eg, promoting safer cannabis use) should also be offered to support goal-congruent outcomes.

Members of the SCU cluster demonstrate multiple motivations for use (coping, social, and expansion), combined with a high willingness to change but low self-confidence. A multicomponent treatment plan should be considered, including social skills training (to address socially motivated use) and emotion regulation techniques. Motivational interviewing, harm reduction strategies, and interventions aimed at enhancing self-confidence are also recommended. Peer support groups may further provide meaningful sources of social validation and connection.

These cluster-specific considerations could inform the development of future app-based interventions, enabling more precise and multimodal tailoring of treatment. Such proposals merit empirical evaluation in future studies.