Canadians in areas with higher COVID-19 rates were more likely to use cannabis during the pandemic

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.

Cullen, Greggory et al.·Substance use & misuse·2024·Moderate EvidenceCross-Sectional
RTHC-05239Cross SectionalModerate Evidence2024RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Cross-Sectional
Evidence
Moderate Evidence
Sample
Not reported

What This Study 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.

Key Numbers

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 They Did This

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.

Why This Research 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 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.

What This Study Doesn't 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.

Questions This Raises

  • ?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?

Trust & Context

Key Stat:
Higher COVID-19 rates independently predicted more cannabis use
Evidence Grade:
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.
Study Age:
Published in 2024 using data from end of 2020.
Original Title:
The Relationship Between Rates of Cannabis Use and Covid-19 Infection Rates During the Pandemic: An Analysis of Canada's National Cannabis Survey.
Published In:
Substance use & misuse, 59(14), 2094-2102 (2024)
Database ID:
RTHC-05239

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / ObservationalSnapshot without intervening
This study
Case Report / Animal Study

A snapshot of a population at one point in time.

What do these levels mean? →

Frequently Asked Questions

Did the pandemic increase cannabis use?

In Canada, areas with higher COVID-19 infection rates had more cannabis use and higher frequency of use, even after controlling for pre-pandemic levels. This suggests pandemic-related factors drove increased consumption.

Was this just because more cannabis stores were nearby?

No. The association between infection rates and cannabis use remained significant after controlling for the density of legal cannabis stores in each region, suggesting factors beyond access drove the increase.

Read More on RethinkTHC

Cite This Study

RTHC-05239·https://rethinkthc.com/research/RTHC-05239

APA

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

MLA

Cullen, Greggory, et al. "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, 2024. https://doi.org/10.1080/10826084.2024.2392562

RethinkTHC

RethinkTHC Research Database. "The Relationship Between Rates of Cannabis Use and Covid-19 ..." RTHC-05239. Retrieved from https://rethinkthc.com/research/cullen-2024-the-relationship-between-rates

Access the Original Study

Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.