ArticleCanadian journal of public health = Revue canadienne de sante publique2026
Trends before and after legalization and COVID-19 on cannabis use among gay, bisexual, and other men who have sex with men in Montreal, Toronto, and Vancouver, Canada: A prospective cohort study.
Article in Canadian journal of public health = Revue canadienne de sante publique, 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
objectivesWe examined how cannabis use was affected by the legalization of cannabis in Canada in October 2018 and the COVID-19 pandemic among urban gay, bisexual, and other men who have sex with men (GBM).
methodsSexually active GBM aged ≥ 16 years in Vancouver, Montreal, and Toronto, Canada, were recruited from February 2017 to August 2019. Participants completed surveys every 6-12 months until August 2022. We examined past 6-month (P6M) trends of any cannabis use, frequency of use, and high-risk use measured by the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) with observation periods stratified into February 2017-October 2018; November 2018-March 2020; and June 2020-August 2022. We modelled associations between high-risk use (ASSIST scores ≥ 27) using multivariable generalized linear mixed models.
resultsWe analysed data from 950 GBM in Montreal, 258 in Toronto, and 387 in Vancouver. No significant changes in P6M any cannabis use were noted from November 2018 to March 2020 but declines were noted after June 2020 (OR = 0.81; 95% CI 0.66-1.00). There were no significant trends in frequency of consumption in any time period. High-risk cannabis use was not associated with visits from November 2018-March 2020 (AOR = 1.23; 95% CI 0.7-2.13) or after COVID-19 (AOR = 0.66; 95% CI 0.36-1.20) but was associated with AUDIT-C scores ≥ 4 (AOR = 1.69; 95% CI 1.00-2.87); moderate/severe anxiety scores (AOR = 2.94; 95% CI 1.60-5.39), moderate/severe depression scores (AOR = 2.55; 95% CI 1.26-5.17), and diagnoses of depression (AOR = 2.42; 95% CI 1.29-4.57).
conclusionOur study found no changes in the proportion of GBM reporting any cannabis use after legalization and declines after COVID-19. High-risk cannabis use was not associated with study visits after legalization or after COVID-19.
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