Comparison of recreational marijuana users in three nations Monisha Jayakumar, MPH PhD Program in Maternal and Child Health Johns Hopkins Bloomberg School of Public Health Thomas Nicholson, PhD John White, PhD Dept. of Public Health Western Kentucky University David F. Duncan, DrPH, FAAHB Duncan & Associates Richard Wilson, DHSc, MPH Health Knowledge and Cognitive Sciences University of Louisville

Purpose of Study  Compare the association of drug polices of the U.S., the U.K., and Canada in the 1990s and recreational marijuana use patterns.  Compare demographic and lifestyle characteristics, legal history, and mental well-being of samples drawn from the DRUGNET study, from the three countries.

Use of Cannabis Source: UNODC, World drug report, 2004

Research Question Is there a difference in patterns of use among the convenience samples of recreational cannabis users from the three countries (viz., United States, United Kingdom, and Canada) with differing drug policies?

Limitations  Self-administered survey  No probability sampling technique in selection  Exclusion of individuals without internet access  Study results cannot be generalized to the entire population of recreational marijuana users in the three countries  Selection bias (better educated, above average socioeconomic class)  Delimitation:

Population  The study population involved adult recreational marijuana users in the United States, United Kingdom, and Canada.  DRUGNET survey was an internet based cross-sectional survey of adult recreational drug users.  Data collection:  Advertised on web and several mailing lists  Self-selected subjects  Taking the survey: informed consent  Anonymity assured

Sample Size  272  U.S.A: 83 (5% of 1,660 by simple random sampling)  U.K: 69  Canada: 120 Design  Epidemiological study: cross-sectional descriptive study  Data collection:  Drug policies of countries during 1990s compared

Instrumentation  Survey instrument included four primary sub-sections: Demographic and lifestyle indices Recreational marijuana use Past legal history and attitudes about drug issues General Well-being Schedule (GWBS)  GWBS: designed for the National Center for Health Statistic’s U.S Health and Nutrition Examination Survey (HANES I)  Scores: 0 to 110 with higher scores signifying greater well-being

Data Analysis  Independent Variable Nationality  Dependent Variables Recreational marijuana use (i.e., age of first use, past year use, frequency of use, current use and 1st year use, heavy use and 1st year use, health problems, problems with marijuana, quit use, level of intoxication, marijuana and other drugs.) Demographics and Lifestyle (i.e., race, gender, work status, education level, in college, household income, income needs, marital status, spouse working, happy with marital status, have child responsibility, child knows parent’s drug use behavior, registered to vote, self- perception of health, have hobbies, involved in church activities, involved in community activities) Legal history (i.e., legal problems because of drug use, convicted of drug-related felony) General well-being status

Variable U.S.A. n % Canada n % U.K. n % X2X2 dfp Total subjects Race White Other 77 (93.9%) 5 (6.1%) 101 (87.8%) 14 (12.2%) 62 (92.5%) 5 (7.5%) Gender: Male Female 65 (79.3%) 17 (20.7%) 88 (75.2%) 29 (24.8%) 61 (88.4%) 8 (11.6%) Work status Full-time Part-time Self-emp Unemp 51 (63.0%) 16 (19.8%) 10 (12.3%) 4 (4.9%) 62 (53.4%) 26 (22.4%) 16 (13.8%) 12 (10.3%) 48 (72.7%) 9 (13.6%) 4 (6.1%) 5 (7.6%) Demographic Indices

Demographic Characteristics No statistically significant difference  Race: white  Gender: male  Employment: employed full-time  Educational status: high school/bachelors  Income: upper/middle SES  Marital Status: single (never married / widowed / divorced / separated)

Lifestyle Characteristics No statistically significant difference  Happy with marital status: Yes  Child responsibility: No  Child knows of parent’s drug use: Yes  Registered to vote: Yes  Hobbies: Yes  Active in church: No

Recreational Marijuana Use No statistically Significant difference  Age of onset: years  Past year use: Yes  Frequency of use  Current use vs. 1 st year use  Heavy use vs. 1 st year use  Health/psych problems from use: No  Problems with use, cut down use: Yes  Quit use: No

Recreational Marijuana Use Possibly significant differences:  Level of intoxication (X 2 = , df = 4, N = 227, p < 0.05) Medium intoxication: most frequent (in all 3 samples)  Marijuana with other drugs (X 2 = , df = 8, N = 222, p < 0.01) U.K.: most common among highly frequent users and least common among rare users U.S. & Canada: most common among medium frequency users (once a month, once a year users) Frequency of use consistent among samples

Legal History  U.S: more legal problems consequent to drug use (X 2 = 7.485, df = 2, N = 225, p < 0.05)  Drug-related felony (ns)  Non-drug related felony (ns)

General Well-Being Schedule VariableU.S.A.CanadaU.K. Total number of subjects Mean SD Scale = points p >.05

Summary  Samples from countries with differing drug policies maintained similar marijuana consumption patterns  Similar demographic and lifestyle characteristics  Significant difference in legal histories

Impact of US Laws  Punitive laws of the U.S have little impact on marijuana use (i.e., postponing age of experimentation, attitude towards use, quitting use)  U.S. sample had more legal problems but not for drug-related felony

Major Finding  The criminalization centered drug policy of the U.S. and the more lenient policies of Canada and the U.K. seem to explain the difference in legal histories among the samples. American drug laws seem to have no impact on reducing marijuana use.

Recommendation  Possession of marijuana for personal use should not be a considered a felony or misdemeanor  Drug abuse should be considered as a public health problem  Allocation of equal funds and resources for drug abuse prevention and treatment as law enforcement, if not more  Further studies comparing major cities in the U.S, Canada, U.K, Netherlands, & Sweden on recreational marijuana use may provide in depth information & better contrast.  Trends in marijuana use in Canada & U.K following the introduction of decriminalization-based drug policies should be studied and compared with that of the pre- decriminalization era.