Alcohol-related cognitions: Implications for concurrent alcohol and marijuana use and concurrent alcohol and prescription stimulant misuse among young adults

•A large number of young adults age 18–20 engage in concurrent substance use.•Certain alcohol-related cognitions are associated with concurrent substance use.•Reducing alcohol-related cognitions may help reduce concurrent substance use. This study examined the associations between alcohol-related cognitions within the social reaction pathway of the Prototype Willingness Model and concurrent (use of two or more substances within a specified time period) use of 1) alcohol and marijuana and 2) alcohol and prescription stimulant misuse. A convenience sample of 1,062 emerging adults in the U.S. (18–20 years old; 54.5% female) who reported past 3-month alcohol use completed a baseline survey as part of a larger randomized controlled trial. Results indicate that controlling for age, biological sex, race, ethnicity, and college enrollment, perceived descriptive norms and willingness to drink were associated with past 3-month concurrent alcohol and marijuana use and concurrent alcohol and prescription stimulant misuse. However, alcohol prototype similarity and alcohol-related perceived vulnerability were not associated with either concurrent use outcome examined. These findings suggest that alcohol-related perceived descriptive norms and willingness to drink are associated with concurrent substance use among young adults. Thus, it is possible that existing efficacious alcohol interventions that target descriptive norms and willingness to drink may have the added benefit of also reducing concurrent substance cognitions and ultimately use.