Canadian Journal of Public Health

, Volume 108, Issue 2, pp e110–e116 | Cite as

Patterns and factors of problematic marijuana use in the Canadian population: Evidence from three cross-sectional surveys

  • W. I. Andrew Bonner
  • Mustafa Andkhoie
  • Charlene Thompson
  • Marwa Farag
  • Michael SzafronEmail author
Quantitative Research


OBJECTIVES: The objectives of this study are to describe marijuana use in Canada and explore factors associated with problematic use.

METHODS: Data from the 2010–2012 circulations of the Canadian Alcohol and Drug Use Monitoring Survey were used to create three logistic regression models for the purposes of identifying and comparing factors associated with the degree of marijuana use, as determined via the WHO Alcohol, Smoking and Substance Abuse Involvement Screening Test (non-problematic, problematic) and European Monitoring Centre for Drugs and Drug Addiction (experiential, recent, current) methods.

RESULTS: Canadians aged 15–24 years are 15 times (p < 0.001) more likely to be current users than Canadians aged 65 or older, with the odds of exhibiting problematic marijuana use being 10 times (p < 0.001) greater. The odds of a male exhibiting problematic marijuana use are 2.46 times (p < 0.001) greater than for females. The odds of exhibiting problematic marijuana use are 41.0% (p = 0.031) and 53.0% (p = 0.008) greater for marijuana users with household incomes $40,000–$80,000 and less than $40,000 respectively compared to those with household income over $80,000. An earlier age of first marijuana use is associated with problematic use but not necessarily with being a current user.

CONCLUSION: The majority of our findings are consistent with the literature, showing that Canadians who are: male, adolescent or young adult, smokers, heavy drinkers, other illicit drug users, and who have poorer mental health status are more likely to engage in any marijuana use, particularly higher levels of marijuana use. These findings can be used to inform the development of policy in Canada to address problematic marijuana use and prepare for its possible legalization.

Key Words

Cannabis health policy smoking mental health substance-related disorders 


OBJECTIFS: Décrire la consommation de marijuana au Canada et explorer les facteurs associés à sa consommation abusive.

MÉTHODE: À l’aide des données des tirages 2010–2012 de l’Enquête de surveillance canadienne de la consommation d’alcool et de drogues, nous avons créé trois modèles de régression logistique afin d’identifier et de comparer les facteurs associés au degré de consommation de marijuana, déterminé selon le questionnaire ASSIST (Alcohol, Smoking and Substance Abuse Involvement Screening Test) de l’OMS (consommation non abusive, consommation abusive) et selon les méthodes de l’Observatoire européen des drogues et des toxicomanies (consommation expérimentale, récente, actuelle).

RÉSULTATS: Les Canadiens de 15 à 24 ans sont 15 fois (p < 0,001) plus susceptibles d’être des consommateurs actuels que les Canadiens de 65 ans et plus, et leur probabilité d’avoir une consommation abusive de marijuana est 10 fois plus élevée (p < 0,001). La probabilité qu’un homme ait une consommation abusive de marijuana est 2,46 fois supérieure (p < 0,001) à celle d’une femme. Les probabilités de consommation abusive de marijuana sont 41 % (p = 0,031) plus élevées chez les consommateurs de marijuana dont le revenu du ménage si situe entre 40 000 $ et 80000 $, et 53 % (p = 0,008) plus élevées chez ceux dont le revenu est inférieur à 40 000 $, comparativement à ceux dont le revenu du ménage est supérieur à 80000 $. L’âge précoce de la première consommation de marijuana est associé à la consommation abusive, mais pas nécessairement au fait d’être consommateur actuel.

CONCLUSION: La majorité de nos constatations sont conformes aux documents publiés; elles indiquent que les Canadiens qui sont de sexe masculin, adolescents ou jeunes adultes, fumeurs, buveurs excessifs, consommateurs d’autres drogues illicites et dont l’état de santé mentale est moins bon sont plus susceptibles de consommer de la marijuana, et en particulier d’avoir des niveaux de consommation élevés. Ces constatations peuvent servir à éclairer l’élaboration de politiques au Canada pour aborder la consommation abusive de marijuana et nous préparer à sa légalisation possible.

Mots Clés

cannabis politique de santé tabagisme santé mentale troubles liés à une substance 


  1. 1.
    Rotermann M, Langlois K. Prevalence and correlates of marijuana use in Canada, 2012. Health Rep 2015;26(4):10–15. PMID: 25875158.PubMedGoogle Scholar
  2. 2.
    United Nations Office on Drugs and Crime. Recent Statistics and Trend Analysis of Illicit Drug Markets - Cannabis Overview. UNODC, World Drug Report. Sales No. E.14.XI.7. Vienna, Austria: Research and Trend Analysis Branch, Division for Policy Analysis and Public Affairs, 2014; 39 p. Available at: (Accessed April 30, 2015).Google Scholar
  3. 3.
    Hall W, Degenhardt L. Adverse health effects of non-medical cannabis use. Lancet 2009;374(9698):1383–91. PMID: 19837255. doi: 10.1016/S0140-6736 (09)61037-0.CrossRefGoogle Scholar
  4. 4.
    Estoup AC, Moise-Campbell C, Varma M, Stewart DG. The impact of marijuana legalization on adolescent use, consequences, and perceived risk. Subst Use Misuse 2016;51(14):1881–87. PMID: 27612596. doi: 10.1080/10826084.2016.1200623.CrossRefGoogle Scholar
  5. 5.
    Degenhardt L, Ferrari A, Calabria B, Hall W, Norman R, Mcgrath J, et al. The global epidemiology and contribution of cannabis use and dependence to the global burden of disease: Results from the GBD 2010 Study. PLoS ONE 2013; 8(10):e76635. PMID: 24204649. doi: 10.1371/journal.pone.0076635.CrossRefGoogle Scholar
  6. 6.
    Government of Canada. A Framework for the Legalization and Regulation of Cannabis in Canada: The Final Report of the Task Force on Cannabis Legalization and Regulation. Ottawa, ON: Health Canada, 2016; 112 p. Available at: index-eng.php (Accessed May 10, 2017).Google Scholar
  7. 7.
    Asbridge M, Duff C, Marsh DC, Erickson PG. Problems with the identification of ‘problematic’ cannabis use: Examining the issues of frequency, quantity, and drug use environment. Eur Addict Res 2014;20(5):254–67. PMID: 25196945. doi: 10.1159/000360697.CrossRefGoogle Scholar
  8. 8.
    Chen K, Kandel DB, Davies M. Relationships between frequency and quantity of marijuana use and last year proxy dependence among adolescents and adults in the United States. Drug Alcohol Depend 1997;46(1):53–67. PMID: 9246553. doi: 10.1016/S0376-8716(97)00047-1.CrossRefGoogle Scholar
  9. 9.
    Humeniuk R, Ali R, Babor TF, Farrel M, Formigoni ML, Jittiwutikarn J, et al. Validation of the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST). Addiction 2008;103(6):1039–47. PMID: 18373724. doi: 10.1111/ j.1360-0443.2007.02114.x.CrossRefGoogle Scholar
  10. 10.
    Degenhardt L, Lynskey M, Coffey C, Patton G. ‘Diagnostic orphans’ among young adult cannabis users: Persons who report dependence symptoms but do not meet diagnostic criteria. Drug Alcohol Depend 2002;67(2):205–12. PMID: 12095670. doi: 10.1016/S0376-8716(02)00064-9.CrossRefGoogle Scholar
  11. 11.
    Elton-Marshall T, Leatherdale ST, Burkhalter R. Tobacco, alcohol and illicit drug use among Aboriginal youth living off-reserve: Results from the Youth Smoking Survey. Can Med Assoc J 2011;183(8):E480–86. PMID: 21555383. doi: 10.1503/cmaj.101913.CrossRefGoogle Scholar
  12. 12.
    European Monitoring Centre for Drugs and Drug Addiction. Methods and Definitions, 2012. Available at: methods (Accessed September 9, 2015).Google Scholar
  13. 13.
    Wagner F, Anthony J. From first drug use to drug dependence developmental periods of risk for dependence upon marijuana, cocaine, and alcohol. Neuropsychopharmacology 2002;26(4):479–88. PMID: 11927172. doi: 10.1016/ S0893-133X(01)00367-0.CrossRefGoogle Scholar
  14. 14.
    Wagner F, Anthony J. Male-female differences in the risk of progression from first use to dependence upon cannabis, cocaine, and alcohol. Drug Alcohol Depend 2007;86(2–3):191–98. PMID: 17029825. doi: 10.1016/j.drugalcdep. 2006.06.003.CrossRefGoogle Scholar
  15. 15.
    Staff J, Schulenberg J, Maslowsky J, Bachman J, O’Malley P, Maggs J, et al. Substance use changes and social role transitions: Proximal developmental effects on ongoing trajectories from late adolescence through early adulthood. Dev Psychopathol 2010;22(4):917–32. PMID: 20883590. doi: 10.1017/S0954579410000544.CrossRefGoogle Scholar
  16. 16.
    Galea S, Ahern J, Tracy M, Vlahov D. Neighborhood income and income distribution and the use of cigarettes, alcohol, and marijuana. Am J Prev Med 2007;32(6):S195–202. PMID: 17543711. doi: 10.1016/j.amepre.2007.04.003.CrossRefGoogle Scholar
  17. 17.
    Chen K, Kandel D. Predictors of cessation of marijuana use: An event history analysis. Drug Alcohol Depend 1998;50(2):109–21. PMID: 9649962. doi: 10.1016/S0376-8716(98)00021-0.CrossRefGoogle Scholar
  18. 18.
    Galea S, Ahern J, Vlahov D. Neighborhood education inequality and use of cigarettes, alcohol, and marijuana. Ann Epidemiol 2004;14(8):623. doi: 10. 1016/j.annepidem.2004.07.086.CrossRefGoogle Scholar
  19. 19.
    Lynskey MT, Heath AC, Bucholz KK, Slutske WS, Madden PA, Nelson EC, et al. Escalation of drug use in early-onset cannabis users vs co-twin controls. JAMA 2003;289(4):427–33. PMID: 12533121. doi: 10.1001/jama.289.4.427.CrossRefGoogle Scholar
  20. 20.
    Health Canada. Canadian Alcohol and Drug Use Monitoring Survey. Ottawa, ON: Health Canada, 2009. Available at: stat/_2008/summary-sommaire-eng.php (Accessed January 20, 2017).Google Scholar
  21. 21.
    Lyvers M. “Loss of control” in alcoholism and drug addiction: A neuroscientific interpretation. Exp Clin Psychopharmacol 2000;8(2):225–49. PMID: 10843306. doi: 10.1037/1064-1297.8.2.225.CrossRefGoogle Scholar
  22. 22.
    Williams J, Skeels C. The impact of cannabis use on health. Economist (Leiden) 2006;154(4):517–46. doi: 10.1007/s10645-006-9028-8.CrossRefGoogle Scholar
  23. 23.
    Byrnes JP, Miller DC, Schafer WD. Gender differences in risk taking: A meta-analysis. Psychol Bull 1999;125(3):367–83. doi: 10.1037/0033-2909. 125.3.367.CrossRefGoogle Scholar
  24. 24.
    Brook JS, Brook DW, De La Rosa M, Duque LF, Rodriguez E, Montoya ID, et al. Pathways to marijuana use among adolescents: Cultural/ecological, family, peer, and personality influences. J Am Acad Child Adolesc Psychiatry 1998; 37(7):759–66. PMID: 9666632. doi: 10.1097/00004583-199807000-00016.CrossRefGoogle Scholar
  25. 25.
    Peretti-Watel P. Cognitive dissonance and risk denial: The case of cannabis use in adolescents. J Socio Econ 2006;35(6):1032–49. doi: 10.1016/j.socec.2005.11.023.CrossRefGoogle Scholar
  26. 26.
    Hatterer L. The addictive process. Psychiatr Q 1982;54(3):149–56. PMID: 7182854. doi: 10.1007/BF01064756.CrossRefGoogle Scholar
  27. 27.
    Millson P, Challacombe L, Villeneuve P, Fischer B, Strike C, Myers T, et al. Self-perceived health among Canadian opiate users: A comparison to the general population and to other chronic disease populations. Can J Public Health 2004;95(2):99–103. PMID: 15074898.PubMedGoogle Scholar
  28. 28.
    Casswell S, Pledger M, Hooper R. Socioeconomic status and drinking patterns in young adults. Addiction 2003;98(5):601–10. PMID: 12751977. doi: 10.1046/j.1360-0443.2003.00331.x.CrossRefGoogle Scholar
  29. 29.
    Cerda M, Wall M, Keyes KM, Galea S, Hasin D. Medical marijuana laws in 50 states: Investigating the relationship between state legalization of medical marijuana and marijuana use, abuse and dependence. Drug Alcohol Depend 2012;120:22–27. doi: 10.1016/j.drugalcdep.2011.06.011.CrossRefGoogle Scholar
  30. 30.
    Harrison E, Haaga J, Richards T. Self-reported drug use data: What do they reveal? Am J Drug Alcohol Abuse 1993;19(4):423–41. PMID: 8273764. doi: 10.3109/00952999309001632.CrossRefGoogle Scholar

Copyright information

© The Canadian Public Health Association 2017

Authors and Affiliations

  • W. I. Andrew Bonner
    • 1
  • Mustafa Andkhoie
    • 1
  • Charlene Thompson
    • 1
  • Marwa Farag
    • 1
  • Michael Szafron
    • 1
    Email author
  1. 1.School of Public HealthUniversity of SaskatchewanSaskatoonCanada

Personalised recommendations