Cannabis Use Days Are Associated With More Physical Activity, More Drinking, and More Smoking

Daily cannabis use was positively associated with same-day physical activity (+3.31 minutes MVPA, p=0.04), alcohol consumption (+0.45 drinks, p=0.01), and cigarettes smoked (+0.63 cigarettes, p=0.01). All associations were within-person, comparing use vs. non-use days for the same individual.

Ecological momentary assessment (EMA) over 28 days in a nationwide sample. 98 participants who used cannabis at least once during the study. Generalized linear mixed models adjusted for race, sex, and age.

This is among the first EMA studies to capture real-time daily associations between cannabis use and other behaviors. The physical activity finding challenges stereotypes about cannabis and lethargy, while the substance co-use findings have implications for harm reduction.

The simultaneous increase in physical activity and substance co-use on cannabis days suggests cannabis does not simply promote sedentary behavior. The co-use patterns highlight that cannabis days are "more of everything" days, which has implications for understanding polysubstance behavior.

Observational within-person design cannot determine causation. Small sample (n=98). Effect sizes are modest. Cannabis use timing relative to activity/substance use not captured. Self-reported measures.