Gender by Ethnicity Differences in Trajectory of Cannabis Use Among Cannabis-Using Young Adults during Pre- and Post-Recreational Cannabis Legalization (RCL) in Los Angeles
Authors: Wong C F , Odejimi O , Conn B M , Davis J , Ataiants J , Fedorova E V , Suen M , Lee S J , Osornio A , Lankenau S E 
Published: September 2022

Introduction: By the end of 2022, most states across the US except for three would have enacted some form of legalized cannabis policy. Support for the legalization of cannabis for recreational purposes are particularly high among young adults. Given the rapidly changing policy landscape, understanding how these policies may have impacted cannabis use among different groups of young people can help inform current and future policy decisions and programs/intervention to curb problematic use. There is evidence to suggest significant and meaningful differences in use behaviors among individuals from different racial/ethnic backgrounds and gender identities. However, limited research has examined how these groups based on the intersection of these identities might differ in their cannabis use prior to and after recreational cannabis legalization (RCL). Method: 366 cannabis-using young adults (aged 18-26) comprising 210 medical cannabis patients and 156 non-patients were surveyed annually between 2014-2020 in Los Angeles culminating into 6 waves of data. Bilinear spline growth curve models examined changes in cannabis use trajectory, with three waves pre-RCL and three waves post-RCL after accounting for patient status and age. Multi-group analyses investigated differences between six genderXrace/ethnicity subgroups: 1) African American Females (AAF); 2) Caucasian/White Females (WF); 3) Hispanic Females/Latina (HF); 4) African American Males (AAM); 5) Caucasian/White Males (WM); and 6) Hispanic Males/Latino (HM). Omnibus tests investigated homogeneity in the latent growth constructs across the 6 groups. We tested equality of covariances (correlations) and means across groups (p < .05). If inequality was shown, further tests were conducted. Results: Overall, significant group differences were observed in cannabis use trajectories and the correlations between intercepts and growth factors. Specifically, HF, HM, AAM and WM reported moderate level of cannabis use (between 50 to 56 days of use) compared to AAF and WF at baseline, whereby AAF reported significantly higher use (70.72 days) relative to all other groups. In contrast, WF reported significantly lower use (35.42 days). There were different patterns in pre-RCL growth parameters. Whereas AAF and HF had relatively flat rate of change, WF, WM, and HM had relatively similar significant decrease in use pre-RCL. Interestingly, during the period post-RCL, AAF, WM, and HM all showed significant decline in use, but WF was the only group with a significant increase in use while HF and AAM had modest increases in use. While baseline use generally predicted pre-RCL use within each subgroup (for some, baseline use led to more rapid increase while for others, it led to more rapid decrease in use), this is less true for post-RCL use. Significant effects associated with age and patient status were also observed. Conclusions: These are among the first findings to show how cannabis policy has differentially impacted cannabis use behaviors prior to and after RCL among a diverse population of cannabis-using young adults. Additional research should investigate potential mechanisms of these difference and longer-term health impacts.