Research paper
Is there a cannabis epidemic model? Evidence from France, Germany and USA

https://doi.org/10.1016/j.drugpo.2014.07.002Get rights and content
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Highlights

  • We studied the diffusion of cannabis in France, Germany and the USA.

  • The diffusion of cannabis experimentation is similar to the tobacco epidemic.

  • It begins in the most educated groups and among men first.

  • France is at an earlier stage compared to Germany and the USA.

  • The contribution of this process to social and health inequalities is questioned.

Abstract

Background

Cannabis is the most popular illicit drug in the world, but the process of its diffusion through the population has rarely been studied. The unfolding of the tobacco epidemic was accompanied by a shift in the educational gradient of users across generations. As a consequence, cannabis may show the same pattern of widening social inequalities. We test the diffusion hypotheses that a positive value in older cohorts – the more educated experimenting more – shifts to a negative one in younger cohorts – the more educated experimenting less, first for males and then females.

Methods

Three nationwide subsamples (18–64 years old) of representative surveys conducted in France (n = 21,818), Germany (n = 7887) and USA (n = 37,115) in 2009–2010 recorded age at cannabis experimentation (i.e., first use), educational level, gender, and age. Cumulative prevalence of experimentation was plotted for three retrospective cohorts (50–64, 35–49, 18–34 years old at data collection) and multivariate time-discrete logistic regression was computed by gender and generation to model age at experimentation adjusted on age at data collection and educational level. This latter was measured according to four categories derived from the International Standard Classification of Education (ISCED) and a relative (rather than absolute) index of education.

Results

The findings demonstrate a consistent pattern of evolution of the prevalence, gender ratio and educational gradient across generations and countries that support the hypothesis of an “epidemic” of cannabis experimentation that mimics the epidemic of tobacco.

Conclusion

We provide evidence for a cannabis epidemic model similar to the tobacco epidemic model. In the absence of clues regarding the future of cannabis use, our findings demonstrate that the gender gap is decreasing and, based on the epidemic model, suggest that we may expect widening social inequalities in cannabis experimentation if cannabis use decreases in the future.

Keywords

Cannabis experimentation
Cannabis epidemic
Cross-national comparison
Educational inequalities
Gender inequalities

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