Cannabis Use Doesn't Reduce Physical Activity in Teens, Unlike Tobacco | Research

The takeaway

A massive 45-country study of 358,391 young people found that cannabis use was not associated with lower physical activity levels, while tobacco use was.

Youth health researchers, substance use prevention specialists, physical activity advocates

358,391 youth studied: tobacco reduced activity by 1 day/week, cannabis did not

What the researchers found

Among 358,391 children and adolescents across 45 countries, cannabis users did not differ significantly from non-users in physical activity levels. In contrast, tobacco use was consistently linked to about 1 fewer day per week of moderate-to-vigorous physical activity. Cannabis was linked to slightly higher activity in boys only.

Why it matters

The assumption that substance use universally reduces physical activity appears to be substance-specific. Understanding these differences helps target public health interventions more precisely.

The numbers in context

358,391 participants (51% girls) from 45 countries, ages 10-17. Tobacco users had 1.09 fewer days/week of MVPA (95% CI: 1.06-1.11). Cannabis showed no significant difference overall; slightly higher MVPA in boys only (p=0.035).

How the study worked

Cross-sectional analysis of the Health Behavior in School-Aged Children (HBSC) study data from 2013-2019, covering 358,391 participants aged 10-17 from 45 countries, using generalized linear mixed models.

What this study cannot tell us

Cross-sectional design cannot establish causation. Self-reported substance use and physical activity may be inaccurate. Cannabis use frequency details limited. Cultural differences across 45 countries may confound results.

How to read the evidence

Massive multinational sample with sophisticated statistical modeling, though cross-sectional design and self-report measures limit causal claims.

When this study was published

2025 analysis of HBSC data from 2013-2019 across 45 countries.

The bigger picture

This challenges the stereotype of the sedentary cannabis user, at least among adolescents. It suggests that tobacco, not cannabis, is the substance most consistently linked to physical inactivity in youth.

Questions still open

Why does tobacco but not cannabis reduce physical activity in youth? Could cannabis users be compensating with exercise? Do these patterns persist into adulthood?

Common questions

Does cannabis use make teenagers less active?

This massive study of over 358,000 youth across 45 countries found no significant difference in physical activity between cannabis users and non-users. Tobacco, not cannabis, was consistently linked to less exercise.

Are there sex differences in cannabis and physical activity?

Boys who used cannabis showed slightly higher physical activity than non-users, while no significant difference was found in girls. The reasons for this sex difference are unclear.

Read the original research

Exploring the link between recreational substances and physical activity in children and adolescents: insights from the Health Behavior in School-Aged Children study (2013-2019).

BMC public health, 26(1), 74

View on PubMed ↗Publisher’s paper ↗

Citation

Miño, Camila; Yañéz-Sepúlveda, Rodrigo; Gutiérrez-Espinoza, Héctor; Olivares-Arancibia, Jorge; Rúa-Alonso, María; Calatayud, Joaquín; López-Bueno, Rubén; López-Gil, José Francisco. (2025). Exploring the link between recreational substances and physical activity in children and adolescents: insights from the Health Behavior in School-Aged Children study (2013-2019).. BMC public health, 26(1), 74. https://doi.org/10.1186/s12889-025-25448-4