Gender-Sensitive Coping–Well-Being Profiles Associated with Alcohol and Cannabis Co-Use Among Young Adult Women

BACKGROUND: Coping strategies and health-related quality of life (HRQoL) are critical psychosocial determinants of substance use risk during emerging adulthood. These factors may be particularly salient among young women due to gendered emotional and interpersonal stressors. However, much substance use research remains gender-neutral, often failing to account for unique developmental factors influencing women. OBJECTIVE: This study aims to identify gender-sensitive coping-well-being profiles associated with alcohol and cannabis co-use among young adult women and examine whether specific coping strategies and HRQoL domains predict hazardous involvement. METHODS: = 21.3). Validated self-report measures included the Alcohol Use Disorders Identification Test (AUDIT), Cannabis Abuse Screening Test (CAST), Coping Strategies Inventory (CSI), and the 36-Item Short Form Health Survey (SF-36). Analyses utilized ANOVA/MANCOVA, regression models, and two-step cluster analysis. RESULTS: Alcohol use was prevalent (92.5%), with 25% reporting alcohol and cannabis co-use. Greater cannabis-related risk was associated with higher alcohol involvement, increased self-critical coping, and higher scores on SF-36 Bodily Pain. Three distinct profiles emerged: High-Risk (co-use, elevated self-criticism, low general health, and reduced social support), Protective (strong problem-solving, social support, and higher HRQoL in key psychosocial domains), and Latent Vulnerability (low substance use despite poor coping resources, high self-criticism, and reduced mental well-being). CONCLUSIONS: Coping strategies and perceived well-being differentiate women's substance involvement beyond usage frequency. Gender-sensitive prevention should address self-critical coping and HRQoL, even among women with low current use but high psychosocial vulnerability. Psychosocial profiling may improve early identification for co-use risk.