Navigating the Shift: Understanding the Dynamics of Cannabis Use in Germany Amidst Legalization Prospects
Background: With Germany potentially legalizing cannabis use in 2024, there is a strong need to better understand its cannabis users. In this presentation, we will examine the profile of a typical German cannabis user, how their cannabis use is tied to tobacco use, and to what extent their cannabis use is related to the use of other illegal substances. Additionally, with the prevalence of cannabis consumers steadily increasing, we will also examine trends in these relations over the previous two decades.
Methods: Data are from the 10 waves of the Epidemiological Survey on Substance Abuse (ESA), a 32-page survey administered every 2 to 3 years on the use of alcohol, tobacco, illegal drugs including cannabis, and medication. Data analyzed are from years 1995, 1997, 2000, 2003, 2006, 2009, 2012, 2015, 2018, and 2021 with a total sample size of 78,678 persons aged 18 to 59 years. For each survey wave, a representative sample was ensured by using a multi-level random sample of population registers in Germany and post-stratification weights. Sample and design weights are then applied to adapt the sample distribution to match that of the German population on certain characteristics including age, gender, education, federal state, and municipality size class. Cannabis user was defined as having consumed cannabis in the past 12 months and the illegal drugs examined included ecstasy, methamphetamines, amphetamines, crack/cocaine, LSD/other hallucinogens, new psychoactive substances, and heroin.
Results: Data were preprocessed to ensure a harmonized treatment of all variables across all waves. Characteristics of cannabis users and relations to tobacco and illegal drug use were assessed with linear, logistic, and multinomial regression. Preliminary results indicate the profile of a typical cannabis user has changed over time, with persons in 2021, relative to 1995, more likely to be female, older, and with higher education. Additionally, most cannabis users do not regularly smoke cigarettes or use alternative tobacco products. However, a prevalent practice among cannabis consumers involves the concurrent use of tobacco, frequently consumed through inhalation. Finally, cannabis use is still correlated to the use of other illegal drugs, but the strength of this relation has decreased since 1995.
Discussion: Overall, the typical cannabis user in Germany has changed since 1995. Additionally, we found cannabis is frequently consumed with tobacco and, as tobacco is a highly addictive substance, its co-use with cannabis could increase the frequency by which individuals consume cannabis. Finally, the relation between using cannabis and using another illegal drug is decreasing. Overall, the results suggest shifting dynamics of cannabis use over the past two decades.
