After controlling for demographics and pre-pandemic use, Canadians living in health regions with higher COVID-19 infection rates were more likely to use cannabis and to use it more frequently.
People interested in how the COVID-19 pandemic affected cannabis use patterns.
Higher COVID-19 rates independently predicted more cannabis use
What the researchers found
Higher regional COVID-19 infection rates were independently associated with both greater likelihood of cannabis use and higher frequency of use, even after controlling for age, gender, SES, mental health, cannabis store density, and pre-pandemic use prevalence. The relationship persisted across all 10 Canadian provinces.
Why it matters
Understanding how pandemic stress affected substance use can inform future public health responses. The finding that areas hit hardest by COVID also had more cannabis use supports investing in harm reduction where pandemic impacts were greatest.
The numbers in context
Data from end of 2020, 2 years post-legalization. All 10 Canadian provinces included. Higher infection rates predicted both cannabis use likelihood and frequency after controlling for confounders including pre-pandemic use.
How the study worked
Analysis linking the National Cannabis Survey data with COVID-19 case rates and legal retail cannabis availability across health regions at end of 2020. Hierarchical generalized linear models controlled for individual and regional confounders.
What this study cannot tell us
Cross-sectional design cannot determine if higher infection rates caused increased cannabis use or if the relationship is driven by shared underlying factors. Self-reported cannabis use. Cannot distinguish medical from recreational use reasons.
How to read the evidence
National survey data linked with regional infection rates and cannabis availability. Hierarchical modeling with multiple controls is methodologically strong, but cross-sectional design limits causal claims.
When this study was published
Published in 2024 using data from end of 2020.
The bigger picture
The pandemic created a natural experiment for studying how widespread stress affects cannabis use at a population level. The geographic link between infection burden and cannabis use suggests that collective stress, not just individual decisions, drives substance use patterns.
Questions still open
- Was the increased cannabis use driven by stress coping, boredom, or reduced social constraints? Did the relationship persist after pandemic restrictions eased? Would targeted harm reduction in high-infection areas have reduced cannabis-related harms?
Common questions
Did the pandemic increase cannabis use?
Was this just because more cannabis stores were nearby?
Read the original research
The Relationship Between Rates of Cannabis Use and Covid-19 Infection Rates During the Pandemic: An Analysis of Canada's National Cannabis Survey.
Substance use & misuse, 59(14), 2094-2102
Citation
Cullen, Greggory; Cristiano, Nick; Walters, David; Hathaway, Andrew; Wrathall, Meghan; Wadsworth, Elle. (2024). The Relationship Between Rates of Cannabis Use and Covid-19 Infection Rates During the Pandemic: An Analysis of Canada's National Cannabis Survey.. Substance use & misuse, 59(14), 2094-2102. https://doi.org/10.1080/10826084.2024.2392562