The widening gender gap in marijuana use prevalence in the U.S. during a period of economic change, 2002-2014

Abstract

Aim: Concurrently with increasingly permissive attitudes towards marijuana use and its legalization, the prevalence of marijuana use has increased in recent years in the U.S. Substance use is generally more prevalent in men than women, although for alcohol, the gender gap is narrowing. However, information is lacking on whether time trends in marijuana use differ by gender, or whether socioeconomic status in the context of the Great Recession may affect these changes.

Methods: Using repeated cross-sectional data from the National Survey on Drug Use and Health (2002-2014), we examined changes over time in prevalence of past-year marijuana use by gender, and whether gender differences varied across income levels. After empirically determining a change point in use in 2007, we used logistic regression to test interaction terms including time, gender, and income level.

Results: Prevalence of marijuana use increased for both men (+4.0%) and women (+2.7%) from 2002 to 2014, with all of the increase occurring from 2007 to 2014. Increases were greater for men, leading to a widening of the gender gap over time (p<0.001). This divergence occurred primarily due to increased prevalence among men in the lowest income level (+6.2%) from 2007 to 2014.

Conclusion: Our findings are consistent with other studies documenting increased substance use during times of economic insecurity, especially among men. Corresponding with the Great Recession and lower employment rate beginning in 2007, low-income men showed the greatest increases in marijuana use during this period, leading to a widening of the gender gap in prevalence of marijuana use over time.

Keywords: Cannabis; Drug users; Economic recession; Men’s health; Socioeconomic factors.

Fig. 1

Change point model of prevalence of past-year marijuana use, NSDUH years 2002–2014 (N = 492,831). Predicted prevalence is from the piecewise regression model allowing for one slope from 2002 until 2007, and a second slope from 2007 to 2014

Fig. 2

Change in prevalence of past-year marijuana use overall and by gender, for 2002–2007 and 2007–2014. In the figure, the dotted lines indicate weighted prevalence estimates for each year. The solid lines indicate the model-based change over time on the prevalence scale, generated from logistic regression models adjusted for sociodemographics (age, race/ethnicity, marital status, education, and income), by calculating the predicted marginals (prevalence estimates back-transformed from the log odds scale) for each year. Separate regressions were carried out overall (also adjusting for gender), and for men and women.