Driving under the influence of cannabis risk perceptions and behaviour: A population-based study in Ontario, Canada

Factors related to the low-risk perception of driving after cannabis use

INTRODUCTION

Modifying risk perceptions related to driving after cannabis use (DACU) could deter individuals from enacting this behavior, as low-risk perception is associated with DACU engagement. This study identified sociodemographic characteristics, substance use, other driving behaviors, peer norms, and psychological characteristics that are associated with lower risk perception regarding DACU.

METHODS

Canadian drivers aged 17-35 who have used cannabis in the past year (n = 1,467) completed an online questionnaire. A multivariate linear regression model allowed for identifying variables associated with the low-risk perception of DACU (i.e. believing it to be safe as one's driving ability is not impaired by cannabis or by being high).

RESULTS

Lower risk perception of DACU was associated with identifying as male, weekly to daily cannabis use, engagement in DACU, general risky driving behaviors, being a passenger of a driver who engages in DACU, number of friends who engage in DACU, and peer approval of DACU. Having driven under the influence of alcohol, living in urban areas, having received traffic tickets in the past three years, and declaring past-week irritability and cognitive problems were associated with holding a higher risk perception related to DACU.

DISCUSSION

Road education and prevention programs should target attitudes and perceptions regarding risks shaped by sociocultural norms and past risky driving experiences. They need to reach out more specifically to drivers with the identified characteristics associated with the low-risk perception of DACU. These interventions can potentially help reduce the rate of individuals who engage in this behavior.

How have cannabis use and related indicators changed since legalization of cannabis for non-medical purposes? Results of the Canadian Cannabis Survey 2018-2022

BACKGROUND

Cannabis use for non-medical purposes was legalized and regulated in Canada through the Cannabis Act in October 2018. This paper examined trends in use of cannabis for non-medical purposes and related indicators from pre- to post-legalization in Canada (2018-2022).

METHODS

Data from 5 years of the Canadian Cannabis Survey, an annual web-based survey administered to Canadians 16 years of age or older, were used in the analysis (n2018=12,952; n2019=11,922; n2020=10,821; n2021=10,733; n2022=10,048). Cannabis measures include questions about use, types of products, sources, risk perceptions and beliefs, and exposure to public education campaigns and health warnings. Adjusted logistic regression models tested differences in outcomes over time.

RESULTS

Past 12-month cannabis consumption increased among Canadians from 22 % in 2018 to 27 % in 2022 (AOR=1.41;99 % CI:1.28-1.54). Similarly, daily/almost daily (DAD) consumption increased from 5 % in 2018 to 7 % in 2022 (AOR=1.36;99 % CI:1.16-1.59). Consumption of dried flower, hash/kief, and concentrates/extracts (e.g., wax, shatter, budder) decreased since 2018, whereas consumption of edibles, beverages and vape pens/cartridges increased (p < 0.001). Legal purchasing increased from 4 % in 2018 to 69 % in 2022, while accessing cannabis through social and illegal sources decreased over time (p < 0.001).

CONCLUSION

More Canadians are reporting cannabis consumption since legalization and regulation of cannabis for non-medical purposes, continuing a pre-existing trend despite an increase in awareness of the risks of consuming cannabis. Trends in product use indicate a transition from dried flower and concentrates/extracts towards consumption of cannabis foods, drinks and vape pens/cartridges. The legal market is increasingly displacing the illicit cannabis market in Canada.

Recreational Cannabis Legislation: substance use and impaired driving among Canadian rural and urban postsecondary students

BACKGROUND

Investigation of cannabis use trends among emerging adults (EA, aged between 18 and 24 years) following 2018 Canadian Recreational Cannabis Legislation (RCL) is critical. EAs report the heaviest cannabis use in Canada and are particularly vulnerable to the onset of problematic substance use.

OBJECTIVES

To describe and compare post-RCL use of cannabis and other state-altering substances, as well as the prevalence of impaired driving, among EA postsecondary students in both rural and urban settings, studying on one of five campuses in either Manitoba, Ontario, or Quebec.

METHODS

For this quantitative cross-sectional study, a self-report survey was administered to 1496 EA postsecondary students in the months following RCL (2018-2019). Multiple logistic regression analyses were conducted to explore the influence of provincial and urban/rural living contexts on recreational cannabis use, other state-altering substance use and impaired driving behaviours, adjusting for sociodemographic variables.

RESULTS

Statistically significant differences were observed between cohorts in almost all measures. Quebec students were more likely to have consumed cannabis during their lifetime (AOR = 1.41, 95% CI [1.05, 1.90]) than all other cohorts. Rural cohorts all had greater odds of reporting consumption of cannabis during the previous year compared to urban cohorts (AOR = 1.32, 95% CI [1.04, 1.67]). However, the relation between cannabis use in the last month and operating a motor vehicle after using cannabis (lifetime and past month) and living context differed between subjects in Quebec and those in the two other provinces. Quebec's students having lived mostly in urban contexts had greater odds of using cannabis in the past month and operating a motor vehicle after using cannabis (lifetime and past month) than those in rural contexts; the opposite was observed in Manitoba and Ontario. Differing interprovincial prohibitive/permissive legislation and licit cannabis infrastructure appeared to have little impact on post-RCL substance use.

CONCLUSIONS

In Manitoba and in Ontario, rural/urban living context seems to better predict substance use and related road-safety practices, suggesting these trends supersede permissive/prohibitive provincial legislation and licit cannabis-related infrastructures. Further investigation into sociodemographic factors influencing state-altering substance use and impaired driving, and maintaining tailored cannabis misuse prevention campaigns, is warranted on Canadian campuses.

Impacts of recreational cannabis legalization on use and harms: A narrative review of sex/gender differences

Legalization of cannabis use for non-medical (recreational) purposes is changing the global cannabis landscape. As attitudes toward cannabis use become more positive and prevalence of use increases in complex ways, concerns emerge about the potential for increased cannabis-attributable harms. Understanding the who, why, and when of this likely increase in cannabis-attributable harms is thus an important public health priority. Both sex and gender contribute to variability in the use, effects, and harms of cannabis and thus sex/gender considerations are important when evaluating the impacts of cannabis legalization. The goal of this narrative review is to broadly discuss sex/gender differences in attitudes toward and prevalence of cannabis use, whether there are sex/gender differences in the impacts of cannabis legalization, and why these sex/gender differences might exist. One of our strongest conclusions is that men have always been more likely to use cannabis than women, yet the sex/gender gap in prevalence of cannabis use has narrowed over time, and this might be partly due to cannabis legalization. The existing evidence suggests that there have also been sex/gender differences in the impacts of legalization on cannabis-attributable harms such as cannabis-involved motor vehicle collisions and hospitalizations, though these results are more variable. The body of literature reviewed has focused almost exclusively on samples of cisgender research participants, and thus future research should encourage inclusion of transgender and gender-diverse participants. More consideration of sex- and gender-based analysis in research evaluating long-term impacts of cannabis legalization is a clear research priority.

Cannabis-Legalisierung in Deutschland

Zusammenfassung: Zielsetzung: Die deutsche Bundesregierung hat beschlossen, den nicht-medizinischen Cannabis-Gebrauch und -Vertrieb zu legalisieren, und Kernpunkte des vorgesehenen Regelwerks vorgelegt. Einige dieser Kernpunkte werden aus der Sicht internationaler Erfahrungen und wissenschaftlicher Evidenz zur Legalisierung – insbesondere mit Blick auf Massnahmen und Ziele öffentlicher Gesundheit – eingeschätzt und kommentiert. Methodik: Selektive Zusammenfassung und policy-analytische Anwendung wissenschaftlicher Evidenz. Ergebnisse: Ein erheblicher Anteil von Cannabis-bezogenen Gesundheitsproblemen hängt mit dem Konsum von Hochpotenz- (THC) Produkten zusammen; allerdings würden kategorische THC-Grenzwerte für legal verfügbares Cannabis diese im Gesamten wahrscheinlich nicht reduzieren sondern primär Hochrisiko-Konsumenten weiter in der Illegalität belassen. Die Mindestalter-Grenze von 18 Jahren für legales Cannabis macht primär politischen Sinn und repräsentiert nicht unbedingt optimalen Gesundheits- oder sozialen Schutz für junge Konsumenten; allerdings wird der Cannabis-Konsum bei Minderjährigen wahrscheinlich weiter hoch blieben. Eine substanz-übergreifende, gesundheits-orientierte Angleichung mit den Gesetzesregelungen für andere Substanzen (z. B. Alkohol) wäre sinnvoll. Das Fahren unter Cannabis-Einfluss ist relativ häufig, und kann zu Verletzungs- und Todesfällen, und damit erheblicher Gesundheitsbelastung führen; seine Kontrolle braucht gezielte Aufklärungs- und Abschreckungs-Maßnahmen. Cannabis-Legalisierung ist mit einschlägigen internationalen (z. B. UN) Konventionen generell schwierig zu vereinbaren, sollte aber dazu genutzt werden, diese grundsätzlich auf der Basis von Prinzipien des Gesundheitsschutzes zu erneuern. Schlussfolgerungen: Für die Cannabis-Legalisierung in Deutschland gibt es kein perfektes Regelwerk; einige Kern-Ziele werden nur über Kompromiss-Ansätze zu erreichen sein, die im Zweifelsfall angepasst werden müssen. Wenn implementiert, wird Deutschland wichtige Daten zur Cannabis-Legalisierung als Politik-Option bieten können, wozu ein systematisches und umfassendes Prozess- und Ergebnis-Monitoring durchgeführt werden muss.

Driving under the influence of cannabis: perceptions from Canadian youth

BACKGROUND

Cannabis legalization is intended to protect the public from potential harm by restricting access and promoting greater awareness of cannabis-related risks. Youth are at a greater risk for experiencing road-related harms due to their own or others' use of cannabis. This qualitative research explored youths' perceptions about cannabis and road safety.

METHODS

A qualitative study using focus groups (FG) was conducted with youth (age 13-18) and young adults (age 19-25) who resided in Newfoundland and Labrador. Using semi-structured interview questions, the facilitator asked participants to share their opinions about cannabis and road safety. All sessions were hosted virtually using Zoom with recruitment until saturation was met. All sessions were audio recorded, de-identified, and transcribed. Analysis utilized an inductive thematic approach informed by Braun and Clarke's (2006) method and inductive coding was facilitated using NVivo.

RESULTS

Six youth (n = 38) and five young adult (n = 53) FG were conducted. Five prominent themes emerged throughout discussions across both age groups including: a) normalization of driving under the influence of cannabis, b) knowledge and awareness, c) perceptions of risk, d) modes of transportation, and e) detection. Variation in perceptions appeared to be influenced by lack of awareness of the impact of cannabis on driving ability, residence in urban versus rural locations, type of vehicle driven (e.g., car vs. off-road vehicles), and gender.

CONCLUSION

The themes uncovered from this research will help inform future enhancement of cannabis policy to ensure the safety of all citizens. These findings will also support the inclusion of youth-focused education that will equip youth with informed decision-making strategies regarding road safety. Furthermore, these findings can be utilized to inform the refinement of cannabis driving policies to ensure the safety of all citizens on or off the road.