Higher risk cannabis use indicators among people living in Canada: a cross-sectional study examining the association with socio-demographic and socio-economic factors

Abstract Background In 2018, the Cannabis Act regulated the production and sale of cannabis for non-medical purposes in Canada. With the aim of continuing to protect the public health and safety of Canadians as the legal cannabis market matures, we conducted a thorough data disaggregation to identify segments of the cannabis consumer base in Canada who are more likely to engage in ‘higher risk’ cannabis use behaviours. The analysis also aligned with the Canadian federal department of health’s Sex- and Gender-Based Analysis Plus Action Plan. Methods Participants were respondents from the 2023 and 2024 cycles of the Canadian Cannabis Survey who reported consuming cannabis in the previous 12 months (n = 7,238). Sixteen higher risk cannabis use outcomes were identified, along with 11 socio-demographic/socio-economic characteristics (herein ‘covariates’). Outcomes were arranged in four categories: heavy cannabis consumption; use of higher risk cannabis products; negative effects of cannabis use on one’s life; and threats to personal or public safety. Prevalence of each outcome was estimated among past 12-month consumers. For each outcome, adjusted logistic regression models tested differences between subgroups for each covariate. After Bonferroni correction for multiple comparisons, a threshold of p < 0.003 was used. Results Over three-quarters (78%) of consumers engaged in at least one higher risk outcome (mean = 2.9, SD = 2.8). After adjustment, models revealed that several subgroups tended to engage in higher risk outcomes. These included younger people, males, those reporting lower education and household income levels, and those who reported having poor/fair mental health. There were also higher rates of certain higher risk outcomes among specific ethnic groups and sexual and gender minorities, but these differences became non-significant in adjusted models. Conclusions Study results may be used to identify subgroups of cannabis consumers in Canada who are more likely to engage in higher risk cannabis behaviours and who may benefit from more targeted public education or harm reduction initiatives.