Association for Public Policy Analysis & Management

Background: In October 2018, Canada became the second country in the world to legalize the recreational use of cannabis at the federal level. We sought to characterize the geographic- and individual-level patterns of cannabis use to provide a “baseline” in the years preceding legalization. We compared these patterns with tobacco use, given its longstanding legal and regulated status.

Methods: We analyzed the 2013, 2015, and 2017 cycles of the Canadian Tobacco, Alcohol and Drugs Survey, a nationwide population-based household survey. Descriptive statistics were used to summarize the distribution of cannabis use across provinces. Weighted logistic regression was performed to estimate the effects of individual-level characteristics on the likelihood of recent cannabis use (past 3 months).

Results: There was significant variation in the prevalence of cannabis use between the provinces. A secular increase in the prevalence of cannabis use was observed from 2013 to 2017 across most provinces. Mean age at first cannabis use was 16 years. Being a young adult, male, and actively employed was significantly associated with cannabis use. Being middle-aged and not actively employed was significantly associated with tobacco use. The likelihood of tobacco use was nearly seven times higher in individuals that have recently used cannabis, compared to those that have not.

Conclusion: While the short- and long-term impacts of cannabis legalization remain to be seen, our findings suggest that cannabis use in youth and cannabis and tobacco co-use may be important targets for future regulatory and health promotion efforts.