JMIR Publications

ABSTRACT

Background:

Opponents of cannabis legalization have been vocal about increased risks of cannabis-impaired driving due to legalization. With the mixed evidence about the relationship between legalization and increased driving risks, youth advocacy organizations need guidance for targeting educational resources focused on responsible cannabis use. However, a paucity of data exists on cannabis consumption patterns associated risky behaviors. As a result, advocates, policy makers, and industry stakeholders have limited quantitative evidence to assess how best to allocates scarce educational resources to mitigate the risk of cannabis-impaired driving.

Objective:

The objective of this study was to demonstrate how low-cost brief interventions can be broadly implemented to educate young people about responsible cannabis use. This study also quantifies the relationship between cannabis consumption and driving behaviors from users of a digital health educational intervention for cannabis use, which can be used to better understand attitudes and behaviors toward cannabis. Finally, this paper can contribute to the development of programs to reduce cannabis-impaired driving by quantifying relationships between cannabis user’s willingness to drive impaired and self-reported demographic and behavioral factors.

Methods:

Data were analyzed from 1,110 participants who completed the “Check Your Cannabis” (CYC) brief intervention between March 2019 and October 2020. The CYC asks a brief set of questions about an individual’s cannabis use, as well as questions about personal beliefs and behaviors. An ordered probit model was used to test relationships between cannabis use, demographics and driving behaviors.

Results:

While gender and age were not statistically significant factors in respondents reporting cannabis-impaired driving, ASSIST risk scores were significant determinants of the probability of cannabis-impaired driving. Every 10-point increase in the ASSIST score increased the probability of sometimes driving after cannabis use by 7.3 percent (P<.001). Polysubstance use was also a statistically significant determinant of cannabis-impaired driving. Compared to the base group of participants who reported never drinking alcohol or using other substances with cannabis, those who sometimes drink or use other substances with cannabis were 13 percent (P<.001) more likely to sometimes or always drive after using cannabis.

Conclusions:

To our knowledge this is the first study to examine associations between cannabis use and driving behaviors from the user’s perspective. Our analysis indicates that contrary to current research and public perceptions, age and gender were not factors, after controlling for risk factors. However, the largest amount spent on any given day, higher ASSIST scores, and polysubstance use was positively and significantly associated with driving under the influence of cannabis. Based on these results, public health campaigns and other interventions may have greater impact if they focus resources on problematic cannabis users rather than youth or the general population. Future research may investigate if spending patterns may give insight on those who purchase cannabis from informal sources.