ArticleLancet regional health. Americas2026
The prevalence of cannabis use pre-versus post-cannabis legalization in Canada by mental health status: findings from national repeat cross-sectional surveys.
Article in Lancet regional health. Americas, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The bidirectional relationship between cannabis use and mental health is complex. With the liberalization of cannabis laws in many countries, it is increasingly important to understand the impacts of cannabis legalization on individuals with mental health conditions. This study aimed to examine changes in cannabis use by mental health status pre-versus 5-years post-legalization of recreational cannabis in Canada. Methods: Data were from the International Cannabis Policy Study's national repeat cross-sectional surveys, conducted annually in Canada between 2018 and 2023, one year before and five years after the legalization of cannabis. The current analysis includes 92,843 Canadians aged 16-65 years. Adjusted logistic regression models examined changes in daily and past 12-month cannabis use pre-versus post-legalization among individuals experiencing each of the five mental health problems in the last year: anxiety, bipolar, depression, post-traumatic stress disorder (PTSD), and schizophrenia. Findings: Past 12-month cannabis consumption increased from pre-legalization versus the year immediately following legalization (2019) among those with anxiety (adjusted odds ratio (AOR) = 1.33, 95% CI = 1.15, 1.53, Interpretation: Few changes in cannabis use were observed pre-versus post-cannabis legalization among Canadians who reported experiencing a mental health problem, whereas daily and past 12-month use increased among Canadians not reporting a mental health problem. Funding: Funding for the ICPS study was provided by a Canadian Institutes of Health Research Project Grant and Project Bridge Grant (PJT-153342).
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