Canadian Cannabis Survey 2019 - Summary

Introduction

The Cannabis Act is a new national legal framework designed to control the production, distribution, sale and possession of cannabis in Canada. Health Canada has been collecting additional data to better understand how Canadians view and use cannabis. These data will be used to evaluate the impact of the legislation, which was brought into force on October 17, 2018, and to support development of policy and program initiatives, including public education and awareness activities.

Health Canada estimates the prevalence of cannabis use in the general population through two surveys: the Canadian Tobacco, Alcohol and Drugs Survey (CTADS) and the Canadian Student Tobacco, Alcohol and Drugs Survey (CSTADS). CTADS 2017 indicates that 15% of Canadians age 15 and older (or 4.4 million) have used cannabis in the past 12 months (19% among age 15 to 19 years; 33% among age 20 to 24 years; and 13% among age 25 years and older). CSTADS 2016/17 indicates that 17% of students in grades 7 to 12 (approximately 340,000) have used cannabis in the past 12 months. However, these surveys are not designed to collect detailed information on cannabis use in Canada. In order to obtain more information, Health Canada has developed and implemented the Canadian Cannabis Survey (CCS).

The Canadian Cannabis Survey has been conducted annually since 2017. It examines in more depth, patterns of use, such as the quantities of cannabis consumed and the use of cannabis for medical purposes; the cannabis market, such as sources of cannabis and pricing; and issues of public safety, such as impaired driving. In 2018, additional questions were asked, such as changes to willingness to publicly report cannabis use if legal; perceived risk of using cannabis in various ways; expected source of cannabis once it is legal; absenteeism from school and work as a result of cannabis use; and receiving treatment or counselling for cannabis use; maternal use during pregnancy and while breastfeeding. The 2019 Canadian Cannabis Survey included additional questions, such as exposure to education campaigns, public health or safety messages; and the respondents' usual source of cannabis products since the Cannabis Act came into effect. Data for the 2019 Canadian Cannabis Survey was collected after the Cannabis Act came into effect and the data will be compared to the 2018 data that were collected prior to the Cannabis Act coming into effect.

The CCS was designed to use a two-step recruitment process where respondents were first recruited by phone (land-line or mobile) from lists of random telephone numbers. Respondents who passed a set of screening questions were then deemed eligible and were sent a link to an online survey, either by email or short message service (SMS) to their mobile phones. The average time to complete the 2019 CCS was 24 minutes for respondents who reported using cannabis within the past 12 months and 12 minutes for respondents who reported that they had not used cannabis.

The following summary presents survey findings from the third data collection cycle, which commenced April 4, 2019 and ended June 17, 2019. Survey findings were weighted by province, age groups, and sex at birth. For the 220 people who were missing a response for sex at birth, gender was used in place of sex at birth for 117 cases, and no weights were attributed to the 103 other cases (no sex or gender identified). The cases where a weight could not be attributed were excluded from the analyses. The results for 2019 are based on online responses from approximately 12,000 respondents aged 16 years and older across all provinces and territories. The CCS was designed to obtain a sufficient number of respondents from key sub-populations, and minimum sample sizes were determined and met in order to ensure statistical relevance of results and representativeness. Of the responses that were received, 3,968 responses were from people who indicated that they had used cannabis in the past 12 months for either non-medical or medical purposes. Sex and age breakdowns included 5,983 females, 5,937 males, 820 respondents aged 16 to 19 years, 1,765 respondents aged 20 to 24 years, and 9,438 respondents aged 25 years and older. The number of respondents from the provinces and territories consisted of 1,503 respondents from Alberta, 1,790 from British Columbia, 446 from Manitoba, 416 from New Brunswick, 429 from Newfoundland and Labrador, 483 from Nova Scotia, 3,541 from Ontario, 444 from Prince Edward Island, 2,203 from Québec, 555 from Saskatchewan, and 213 from the three territories combined.

Data were collected on four thematic areas: knowledge, attitudes and behaviours; cannabis use and products used; driving and cannabis; and cannabis for medical purposes. A summary of the key results is provided below and the detailed results tables have been published on the Library and Archives website.

Comparisons to the 2018 CCS data were made where applicable, i.e., some questions were changed between 2018 and 2019 cycles. All reported increases and decreases in the text below are statistically significant changes (i.e., not likely to have occurred by chance alone). To improve readability, the words "statistically significant" will not be repeated. Similarly, at times the text will state that the proportion is "unchanged" or not different between groups, even though the numbers are not identical. This occurs when the difference between numbers is not statistically significant.

Definitions

Theme 1: Knowledge, attitudes and behaviours

All respondents were asked questions about their opinions and knowledge related to cannabis. Topics included social acceptability of cannabis and other substance use, perceived risk of using cannabis and other substances, observation of cannabis use in public, exposure to health warning messages and public health messaging, and cannabis use in the home.

Social acceptability

Respondents were asked about the social acceptability of using various products occasionally and regularly. Of the proposed substances (alcohol, tobacco and cannabis), the most socially acceptable product to use, whether occasionally or regularly, was alcohol, followed by cannabis and tobacco. For example, the regular use of alcohol was considered completely or somewhat socially acceptable by 55% of respondents, compared to 44% for smoking cannabis for non-medical purposes, followed by 43% for eating cannabis for non-medical purposes, 42% for vaping cannabis for non-medical purposes, 41% for the use of e-cigarettes containing nicotine, and 35% for tobacco (including cigarettes, cigars or smokeless tobacco). The social acceptability of the occasional use of smoking, eating or vaping cannabis increased slightly compared to 2018.

A greater proportion of people who indicated using cannabis in the past 12 months reported that the occasional or regular use of alcohol, tobacco and cannabis were socially acceptable than those who did not report cannabis use. This pattern was also seen in 2018.

Willingness to disclose cannabis use

Thirty-four percent (34%) reported they would be more willing to publicly disclose whether they use cannabis now that it is legal. Twenty-one percent (21%) said they were already willing to disclose whether they use cannabis and 23% said they would not be more willing to say if they use cannabis.

Perceived risks of using various substances

Respondents were asked, how much they thought a person risked harming themselves by using various products once in a while and on a regular basis. Perceived risk was determined using a 4-point Likert scale, which had the following categories: no risk, slight risk, moderate risk, great risk and "don't know".

In general, the majority of people felt that occasional use of alcohol or cannabis had no risk or slight risk, whereas smoking tobacco or using an e-cigarette with nicotine once in a while was seen as having moderate or great risk by the majority of people.

When asked about the use of these substances on a regular basis, the majority of people overall perceived either moderate or great risk for smoking tobacco (94%, a decrease from 95% in 2018), followed by using an e-cigarette with nicotine (84%, an increase from 82% in 2018), drinking alcohol (79%, unchanged from 2018), smoking cannabis (74%, an increase from 72% in 2018), vaping cannabis (72%, an increase from 70% in 2018), and eating cannabis (68%, an increase from 66% in 2018).

Those who used cannabis in the past 12 months had a lower percentage reporting moderate or great risk from regular use of the aforementioned products than those who had not used cannabis. The difference in the percentage reporting moderate or great perceived risk was much smaller for the regular use of alcohol, tobacco, and e-cigarettes with nicotine compared to smoking, eating or vaporizing cannabis. For example, 92% of those who use cannabis report moderate or great risk from regular use of tobacco compared to 95% of those who do not use cannabis, whereas less than half (46%) of those who had used cannabis in the past 12 months perceived moderate or great risk with smoking cannabis compared to 83% of people who had not used cannabis in the past 12 months.

Exposure to health warning messages

Respondents were asked if they had seen the health warning messages on cannabis products/packages or on Health Canada's website. Thirty-four percent (34%) of people reported they had seen the warnings and a further 15% reported they were not sure. Among those who used cannabis in the past 12 months, the percentage who reported having seen the warnings increased to 58%. Of those who had seen the warnings, over half (53%) reported the warning increased their knowledge of the harms related to cannabis use at least somewhat.

Exposure to education campaigns, public health or safety messages

Respondents were asked if they had seen or heard education campaigns, public health or safety messages about cannabis in various locations since the coming into force of the Cannabis Act. Respondents could select more than one location if they had seen or heard these messages in multiple locations. The most common location for people to have seen or heard these messages was on television or radio (51%), followed by social media (31%), publicly displayed posters or billboards (28%), a health care setting (21%), and in newspapers or magazines (20%). Twenty-four percent (24%) of people reported that they had not noticed any education campaigns or public health messages. For all locations, those who used cannabis in the past 12 months were more likely to report having seen these messages.

Increases in knowledge of harms related to cannabis and access to trustworthy information

Respondents were asked if their knowledge of the harms related to cannabis increased since the coming into force of the Cannabis Act. Just over a third (36%) of people reported that their knowledge of harms related to cannabis increased at least somewhat. Those who had not used cannabis in the past 12 months had a higher percentage reporting at least some increase in knowledge than those who had used cannabis (38% and 32%, respectively).

People were also asked if they felt they had access to enough trustworthy information about the health risks of cannabis use to make informed decisions. Most people (71%) reported agreeing strongly or somewhat that they had enough trustworthy information. This was more common among those who used cannabis in the past 12 months (87%) than among those who had not used cannabis (66%).

Knowledge/beliefs about harms related to cannabis

Respondents were asked about if they know or believe cannabis smoke can be harmful, whether cannabis use during pregnancy or breastfeeding can be harmful, if frequent cannabis use can increase the risk of mental health problems, and whether teenagers are at greater risk of harm from cannabis use than adults. For all of these harms, the majority of people reported they believe these risks to be true. Those who did not use cannabis in the past 12 months had higher percentages of agreement than those who had used cannabis. Seventy-six percent (76%) of people reported cannabis smoke can be harmful; 69% among those who used cannabis and 79% among those who did not use cannabis. For use during pregnancy or breastfeeding, 87% believe this can be harmful; 82% among those who used cannabis and 89% among those who did not use cannabis. Seventy-five (75%) reported they believe frequent cannabis use can increase the risk of mental health problems; 65% among those who used cannabis and 78% among those who did not use cannabis. Finally, eighty-four percent (84%) agreed that teenagers are at greater risk of harm from cannabis use than adults; 82% among those who used cannabis and 85% among those who did not use cannabis.

Opinions on whether cannabis use can be habit forming

Overall, 90% of people thought that using cannabis could be habit forming, an increase from 82% in 2018. The majority of people who reported using cannabis in the past 12 months (87%) and those who did not use (91%) also thought cannabis could be habit forming, both increases from 2018 (71% and 85%, respectively).

Changes in observations of use in public places

Respondents were asked if they had observed a change in the number of people using cannabis in public places since the coming into force of the Cannabis Act. Overall, 55% of people reported they had not noticed any change in the number of people using cannabis in public. A further 42% reported noticing an increase in the number of people using cannabis in public, while 2% reported noticing fewer people using cannabis in public places.

Cannabis use inside the home

All respondents were asked about cannabis consumption methods in the home over the past 12 months. Among those who did not use cannabis in the past 12 months, 9% indicated cannabis was smoked in the home, 5% indicated someone ate or drank cannabis, and 4% indicated that someone vaporized cannabis inside the home. Compared to estimates among those who did not use cannabis in the past 12 months, responses from those who had used cannabis in the past 12 months were noticeably different with 66% responding that someone smoked cannabis inside their home, a decrease from 2018 (72%), followed by eating or drinking cannabis (44%), an increase from 2018 (39%) and vaporizing cannabis (32%), unchanged from 2018.

Theme 2: Cannabis use and products used

The results presented under Theme 2 refer specifically to people who reported using cannabis for non-medical purposes in their lifetime (n=7,188), in the 12 months prior to completing the survey (n=3,454), and the past 30 days prior to completing the survey (n=2,426).

Respondents who reported using cannabis for non-medical purposes were asked detailed questions about their use of cannabis for non-medical purposes. Topics included frequency of cannabis use, age of initiation of use, methods of consumption, types of cannabis products used, typical THC to CBD ratio of products, average amount spent on these products, usual source of cannabis, and where people store cannabis inside the home.

Cannabis use

Respondents were asked about their cannabis use for non-medical purposes within the past 12 months. Twenty-five percent (25%) of people reported having used cannabis in the past 12 months, an increase from 22% in the previous cycle. Provincial/territorial estimates ranged from 19% to 33%. When recruited, respondents were informed that the survey was about cannabis. This information may have created a participation bias in that those who use cannabis may have been more likely to complete the survey. For this and other methodological reasons, the CCS may provide estimates for cannabis use that are higher than other population level surveys such as CTADS that are designed specifically to measure the prevalence of cannabis use. However, the aim of the CCS is to obtain detailed information about the habits of people who use cannabis and behaviours relative to cannabis use.

Past 12-month use in respondents of various demographic groups

People between the ages of 16 to 24 years reported cannabis use in the past year at a percentage that was more than double that of those 25 years and older. Specifically, past 12-month use of cannabis among people aged 16 to 19 years and those aged 20 to 24 was 44% and 51%, respectively, compared to 21% for people aged 25 years and older, all increases from 2018 (36%, 44%, and 19%, respectively). More males (29%) reported past 12-month use compared to females (21%), both increases from the previous cycle (26% and 18%, respectively).

New to this cycle, people were asked about their sexual orientation and whether they were born in Canada. The proportion of people reporting cannabis use in the past 12 months was higher among people who identified as bisexual (54%), homosexual (39%), or another sexuality (35%), than among people who identified as heterosexual (23%). The proportion of people using cannabis in the past 12 months was double among people who were born in Canada (28%) compared to people who were not born in Canada (14%).

People who reported they were currently attending a school, college, CEGEP, or university reported cannabis use during the past 12 months (40%) at a higher proportion compared to who were not currently students (22%). People who reported working at a job or business in the past week or have a job or business they were absent from reported cannabis use during the past 12 months (27%) at a higher proportion compared to those who did not work at a job or business (18%). The questions asking about student and employment status changed from 2018 to 2019 and do not allow for comparisons.

Those who reported having less than high school or a high school diploma as their highest level of education had the highest proportion reporting cannabis use in the past 12 months (31% each), almost twice that of those with a post-graduate degree/diploma (17%). This is similar to the pattern seen in 2018.

In 2019, two new questions were added that asked respondents to self-report on their physical and mental health using a 5-point Likert scale, which had the following categories: excellent, very good, good, fair, and poor. For physical health, the group with the highest proportion reporting past 12-month cannabis use was those who report fair physical health (29%). The groups with the lowest proportions reporting cannabis use were excellent and poor physical health (22% each). For self-reported mental health the percentage reporting past 12-month cannabis use increases as mental health ratings decrease. Seventeen percent (17%) of those reporting excellent mental health, 22% of those reporting very good mental health, 31% of those reporting good mental health, 49% of those reporting fair mental health, and 49% of those reporting poor mental health indicated they had used cannabis for non-medical purposes in the past 12 months.

Age of initiation

People who reported ever using cannabis were asked about the age at which they first tried or started using cannabis for non-medical purposes. The average age of initiating cannabis use was 19.2 years, a small increase from 18.9 years in 2018, which is comparable to the average age of 18.6 years reported in CTADS 2017. Females were slightly older than males when they first tried cannabis (19.7 and 18.8 years, respectively). CSTADS 2016/17, which asked questions of students in grades 7 to 12, reported an average age of initiation of 14.2 years. Average age of initiation is highly dependent on the age range of the respondents in a survey, as well as the distribution of respondents within predetermined age groups. For the CCS, the age of initiation is higher among the largest age group of adults age 25 and older, resulting in a higher average age of initiation overall.

Provincial/territorial estimates of average age of initiating cannabis use ranged from 18.1 years to 20.4 years.

Frequency of cannabis use

Respondents who reported using cannabis over the past 12 months were asked how frequently they used the substance. Over half of these respondents reported using cannabis three days per month or less (55%), and 18% reported daily cannabis use, both unchanged from 2018. The most common response was less than one day per month (35%), followed by daily (18%), two to three days per month (14%), one to two days per week (12%, an increase from 10% in 2018), three to four days per week (9%), one day per month (6%), and five to six days per week (6%). These were unchanged from the previous cycle.

A greater percentage of males (26%) reported daily or almost daily use compared to females (21%), whereas a greater percentage of females (40%) reported less than monthly use compared to males (30%). A higher proportion of people aged 20 to 24 and 25 years and older reported daily or almost daily use (23% and 25%, respectively) than those aged 16 to19 (16%). There were no significant differences in percentages reporting less than monthly use among age groups examined. Provincial/territorial estimates for daily or almost daily use ranged from 21% to 29% and estimates of less than monthly use ranged from 22% to 40%.

People who had reported using cannabis in the past 30 days were asked how often they used cannabis in the past 30 days. The most common response was daily (23%), followed by one or two days per week (19%), one day per month (18%), 2 or 3 days per month (18%), three or four days per week (13%), and five or six days per week (9%). This was the first time that frequency of use in the past 30 days was asked. This question was added to examine the frequency of use among people who had used cannabis recently. Also, the past 30-day timeframe provided information about frequency of use over a period that was entirely after the coming into force of the Cannabis Act.

Number of hours "stoned" or "high" on a typical use day

People who had reported using cannabis in the past 30 days were asked about the number of hours they would spend "stoned" or "high" on a typical use day. Thirty-seven percent (37%, unchanged from 2018) reported they would be "stoned" or "high" on a typical use day for one or two hours, followed by three or four hours (30%, unchanged from 2018), less than one hour (16%, a decrease from 19% in 2018), five or six hours (8%, unchanged from 2018), and seven or more hours (9%, an increase from 6% in 2018).

Methods of consumption

People who had reported using cannabis in the past 12 months were asked about their methods of consumption for non-medical purposes. Smoking (84%) was the most common method of cannabis consumption reported by people who used cannabis in the past 12 months, a decrease from 2018 (89%). Other methods of consumption were: eating it in food (46%), an increase from 42% in 2018; vaporizing using a vape pen or e-cigarette (27%), and vaporizing using a vaporizer (15%), both unchanged from 2018.

When examining methods of consumption by province and the territories, the most common method of consumption in all regions was smoking (estimates ranged from 81% to 92%). This was followed by eating it in food (estimates ranged from 27% to 57%) and vaporization using a vape pen (estimates ranged from 17% to 33%).

Types of cannabis products used and frequency

People who used cannabis in the past 12 months were asked about the types of cannabis products they had used in the past 12 months. The six most common products used were dried flower/leaf (77%), a decrease from 82% in 2018; edible food products (44%), an increase from 41%; vape pens/cartridges (26%), not comparable to 2018; hashish/kief (23%), a decrease from 26% in 2018; cannabis oil for oral use (23%); and concentrates/extracts (17%). Cannabis oil for oral use and concentrates/extracts are new categories and are not directly comparable to 2018. Respondents were also asked about the frequency at which they used these cannabis products. The most commonly reported frequency for these six products was less than one day a month, ranging from 29% for dried flower to 57% for beverages. Daily/almost daily use was highest for dried flower (27%), followed by edible food products (15%). For all other products, daily/almost daily use was report by less than 10% of people who used the product.

A higher of percentage of males reported using dried flower (81%), hash (26%), and concentrates/extracts (19%) compared to females (73%, 18%, and 14%, respectively). A higher percentage of females reported using edible food products (48%) and topicals (11%) when compared to males (42% and 6%, respectively). The least used cannabis products for both males and females were beverages (4% and 5%, respectively).  

In all provinces and the territories, the most common product used was dried flower/leaf, ranging from 74% to 83%. Edibles were the second most commonly reported products (estimates ranged from 24% to 60%), except in Québec. In Québec, the second most commonly reported product was hashish/kief (28%), followed by edibles (24%).  

Relative levels of THC and CBD in cannabis products used for non-medical purposes

New in the 2019 cycle of the Canadian Cannabis Survey, people who used cannabis in the past 12 months were asked about the relative levels of THC and CBD in the cannabis products they typically use. Thirty-seven percent (37%) indicated higher THC and lower CBD, 16% selected equal levels of THC and CBD, 13% indicated higher CBD and lower THC, and 2% selected other. Most of the other responses indicated the use of products with different levels of THC and CBD depending on the purpose of use or the time of day. Thirty-two percent (32%) indicated they did not know the relative levels of THC and CBD.

Average amount used on a typical use day

People who had used cannabis in the past 12 months were asked to report on the average amount of cannabis used on a typical use day. Of those who had used dried flower/leaf, the average amount used on a typical use day was just under one gram (0.9 grams); this is a slight decrease from 2018 (1.1 grams). Those who used edible cannabis products consumed approximately 1.1 serving; those who used hashish/kief used an average of 0.4 grams; those who used vape pens used an average of 0.1 cartridges; those who used beverages used approximately 336 millilitres on a typical use day, all unchanged from 2018. For cannabis oil for oral use, the average amount used was 0.9 millilitres. The average amount of concentrate or extract used was 0.2 grams. These two products are not directly comparable to the previous cycle.

Sources used to obtain the cannabis product

People who reported using cannabis in the past 12 months were asked about who they usually obtained cannabis from in the past 12 months. The top sources to obtain cannabis were from a legal storefront (24%), from a friend (22%), from a legal online source (13%), shared among friends (10%), from an illegal storefront (7%), grown by or for them (6%), and from a dealer (6%).

New in this cycle, those who used cannabis were also asked if they had purchased any cannabis from a legal source. Fifty-two percent (52%) reported they had made a purchase from a legal source. Those who used cannabis were also asked what their usual source has been since the coming into force of the Cannabis Act. Twenty-nine percent (29%) reported their usual source as a legal storefront, 14% indicated a legal online retailer, 4% reported growing at home, 34% reported it came from someone sharing, and 19% acknowledged their usual source was an illegal source.  

People were also asked which factor most influences who they usually obtain cannabis from. The three most common factors indicated were quality/safe supply (39%), followed by price (22%), and convenience (11%).

Average amount spent on cannabis each month

People who had used cannabis in the past 12 months indicated typically spending close to $64 on cannabis products for non-medical use each month, a decrease from $73 in 2018. People who had used cannabis within the past 30 days reported spending approximately $74 in the past 30 days to obtain cannabis for non-medical use, a decrease from $85 in 2018. On average, females reported spending less on cannabis than males.

When looking at spending by province and territories, those who used cannabis in the past 12 months indicated typically spending as little as $51 on cannabis products for non-medical use each month to as much as $81. People who used cannabis in the past 30 days reported spending between $62 and $113 in the past 30 days depending on where they lived.

Cannabis products bought or received, and at what frequency

People who had used cannabis in the past 30 days were asked about the cannabis products they bought or received in the past 30 days and the frequency of these two occurrences. The most common response options selected were buying or receiving dried flower/leaf (83%), a decrease from 87% in 2018, followed by edibles (20%, unchanged from 2018), cannabis oil for oral use (11%), hashish/kief (10%, unchanged from 2018), vape pens (10%, an increase from 8% in 2018) and concentrates/extracts (9%). Cannabis oil for oral use and concentrates/extracts are not comparable to 2018 data due to changes in product categories. For all products, the most common frequency of obtaining them was one day per month.

The average amount purchased in the past 30 days varied by product type. On average, people who used cannabis in the past 30 days purchased or received 14 grams of dried flower/leaf, 6 servings of edibles, 9 grams of hashish/kief, and 1.5 cartridges or vape pens, all unchanged from 2018. For cannabis oil for oral use, people purchased an average of 19 millilitres and for concentrates and extracts the average purchase was 4 grams.

Average price per unit of purchases, by product type

People who had purchased cannabis in the past 30 days reported the average price per unit by product type. Over the past 30 days, people spent the most per unit on cartridges or vape pens ($45.95/cartridge), concentrates and extracts ($29.57/gram). The average price per unit for the more frequently used product types was $9.83 per gram of dried flower/leaf, unchanged from 2018; $6.24 per serving for edibles, a decrease from $8.94 per serving in 2018; and $14.06 per gram of hashish/kief, unchanged from 2018.

Proportion of people who use cannabis and receive cannabis products for free

Of the respondents who had obtained cannabis in the past 30 days, some reported receiving cannabis products for free. Overall, 21% of respondents obtained free edibles, unchanged from 24% in 2018, and 10% obtained free dried flower/leaf, a decrease from 14% in 2018. When looking specifically at dried flower/leaf, more females (16%) reported obtaining these products for free compared to males (7%).

Frequency of cannabis use to get "high" before school or work

Students who had used cannabis in the past 12 months were asked about the frequency of cannabis use to get "high" within two hours before or at school. Overall, 59% reported they had not used cannabis to get "high" before or at school in the past 12 months, an increase from 53% in 2018. Twenty-six percent (26%) of past 12-month students who use cannabis reported rarely using cannabis before or at school (less than once a month), unchanged from 27% in 2018, and 9% used cannabis before or at school weekly or more often, also unchanged from 2018. Most students (93%, unchanged from 2018) reported never being absent from school because of their cannabis use.

The majority of people who reported using cannabis in the past 12 months had not used cannabis to get "high" within two hours before or at work in the past 12 months (67%, unchanged from 64% in 2018), and a further 12% reported they had not been employed in the past 12 months. Twelve percent (a decrease from 15% in 2018) reported using cannabis before or at work rarely (less than once a month), and 5% (a decrease from 8% in 2018) used cannabis before or at work weekly or more often. Most people (87%, a decrease from 90% in 2018) indicated they had not been absent from work as a result of their cannabis use and a further 11% (an increase from 9% in 2018) stated they were not employed.

Professional help for non-medical cannabis use

Most people (96%) who had used cannabis more than once in their lifetime reported they never felt they needed professional help (e.g., treatment or counselling) for their non-medical use of cannabis. Only 3% reported ever having received professional help for non-medical cannabis use.

Where cannabis is stored inside the home

People who had used cannabis in the past 12 months were asked about where they store cannabis inside the home. Among those who currently had cannabis stored at home, storage locations included unlocked cabinets or drawers (35%), an increase from 31% in 2018; locked containers (20%), a decrease from 26%; childproof containers (32%), an increase from 24%; and open shelves or tables (17%), an increase from 14% in 2018.

Theme 3: Driving and cannabis

People who had used cannabis in the past 12 months were asked about their driving habits relative to cannabis use and cannabis use in combination with alcohol or other drugs. All respondents were asked if they had ever been a passenger in a vehicle driven by someone within two hours of using cannabis, and all respondents were also asked for their opinions on cannabis and driving.

People who operated a vehicle after using cannabis

The CCS specifically looked at driving after using cannabis. New for this cycle of the survey respondents were asked about both driving within two hours of smoking or vaporizing cannabis or a cannabis product and about driving within four hours of ingesting a cannabis product. They were also asked to indicate the type(s) of vehicle(s) they had driven after using cannabis.

Among people who had used cannabis in the past 12 months, 26% reported that they had ever driven within two hours of smoking or vaporizing cannabis, and of those who had driven after smoking or vaporizing cannabis, 43% did so within the past 30 days, 31% within the past 12 months, and 25% more than 12 months ago. By far the most common type of vehicle driven was a car (93%), followed by all-terrain vehicles (16%), boats (9%), and snowmobiles (8%). A higher proportion of males (32%) reported ever driven within two hours of smoking or vaporizing cannabis than females (19%). This behaviour was also more prevalent among those 25 years of age or older (29%) compared to 20 to 24 year olds (23%) and 16 to 19 year olds (16%). Provincial and territorial estimates of ever driven within two hours of smoking or vaporizing cannabis ranged from 22% to 35%. Estimates on how recently this occurred are suppressed for most regions due to the small sample size.

Among people who had used cannabis in the past 12 months, 16% reported that they had ever driven within four hours of ingesting a cannabis product, and of those who had driven after ingesting cannabis, 37% did so within the past 30 days, 39% within the past 12 months, and 24% more than 12 months ago. By far the most common type of vehicle driven was a car (93%), followed by all-terrain vehicles (16%), boats (7%), and snowmobiles (7%). A higher proportion of males (19%) than females (12%) reported ever driven within four hours of ingesting a cannabis product. This behaviour was also more prevalent among those 25 years of age or older (17%) compared to 20 to 24 year olds (13%) and 16 to 19 year olds (11%).

People who operated a vehicle within two hours of using cannabis in combination with alcohol or other drugs

People who indicated they had ever driven within two hours of smoking/vaporizing cannabis or within four hours of ingesting cannabis were also asked if they drove a vehicle within two hours of using cannabis in combination with alcohol. Twenty percent (20%) of these people reported that they had driven a vehicle within two hours of using cannabis in combination with alcohol. Of those who had driven after using cannabis in combination with alcohol, 38% did so within the past 30 days, 34% within the past 12 months, and 28% more than 12 months ago. Males (24%) had a higher prevalence of driving within two hours of cannabis use in combination with alcohol than females (13%).

The same people were also asked if they drove a vehicle within two hours of using cannabis in combination with other drugs. Eight percent (8%) of these people reported that they had driven a vehicle within two hours of using cannabis in combination with other drugs.

Reasons people operated a vehicle after recent use of cannabis

New in the 2019 cycle, people who indicated they had ever driven within two hours of smoking/vaporizing cannabis or within four hours of ingesting cannabis were asked why they drove after using cannabis. Respondents were allowed to select all reasons that applied so percentages sum to more than 100%. By far the most common reason indicated was because the person did not feel impaired (80%), followed by they thought they could drive carefully (20%), didn't have far to drive (19%), other reasons (10%), no alternative transportation (9%), and didn't think they would be caught by law enforcement (7%).

People who were passengers in a vehicle driven by someone within two hours of using cannabis

All respondents were asked if they had ever been a passenger in a vehicle driven by someone who had used cannabis within the previous two hours. Overall, 28% of people reported having ever been a passenger in a vehicle driven by someone who had recently used cannabis; this is a decrease from 31% in 2018. This behaviour was more common among those who used cannabis in the past 12 months (60%), a decrease from 70%, compared to those who did not use (17%), also a decrease from 20% in 2018. The immediacy of this behaviour, among people who indicated using cannabis in the past 12 months, ranged from within the past 30 days (27%, a decrease from 32% 2018), within the past 12 months (31%, unchanged), to more than 12 months ago (41%, an increase from 37% in 2018). For those who did not use cannabis in the past 12 months, 8% reported being a passenger in a vehicle driven by someone who had recently used cannabis in the past 30 days, 13% report this in the past year, and 79% reported this happening more than 12 months ago, all unchanged from 2018.

Provincial and territorial estimates of ever being a passenger in a vehicle driven by someone who had used cannabis within two hours of driving ranged from 23% to 37%.

Interaction with law enforcement related to driving

Two percent (2%) of people who had used cannabis in the past 12 months reported having an interaction with law enforcement related to driving under the influence while they were the driver of a vehicle, a decrease from 3% in 2018.

Opinions on cannabis use and driving

People were asked for their opinions on how cannabis use affects driving. More than eight in ten (85%) people reported that they think that cannabis use affects driving; this is an increase from 81% in 2018. This dropped to 69% when looking at responses from those who reported using cannabis in the past 12 months, an increase from 61% in 2018, while less than one quarter of them responded that it depends (19%, a decrease from 22%), or that it did not affect driving (9%), a decrease from 13%.

People were asked for their opinion on the time it takes until it is safe to drive after cannabis use. The majority of people did not specify the time it takes before it is safe to drive after cannabis use; 32% reported it depends on the person's tolerance, weight, and quantity, unchanged from 33% in 2018. A further 20% of people said that they did not know when it was safe to drive, a slight decrease from 21% in 2018.

Opinions on likelihood of being caught driving under the influence

All respondents were asked how likely they thought it was that a person would be caught by police if they drove under the influence of alcohol or under the influence of cannabis. Likelihood was determined using a 5-point Likert scale, which had the following categories: not at all likely, not likely, somewhat likely, likely, and extremely likely.

Among all people, the most common response for both being caught driving under the influence of alcohol and driving under the influence of cannabis was 'somewhat likely' (40% and 41%, respectively). However, 48% of people indicated likely, or extremely likely when asked about a driver being caught driving under the influence of alcohol, unchanged from 49% in 2018. This is higher than the 25% of people indicating likely, or extremely likely when asked about a driver being caught driving under the influence of cannabis, a small increase from 23% in 2018.

Theme 4: Cannabis for medical purposes

Respondents were asked about their use of cannabis for medical purposes and those who indicated they had used cannabis in the past 12 months were asked if they would complete an additional section related to this use. Of the 1,842 respondents who indicated they had used cannabis for medical purposes in the past 12 months, 1,067 agreed to complete the medical use section of the survey. Questions were on the source of the product, type of product, frequency of use, type of strain, how much was used in a typical day, diseases and symptoms addressed by cannabis use, and changes in respondents' use of other medications as a result of cannabis use.

Medical use

People were asked about their cannabis use for medical purposes in the past 12 months. Fourteen percent (14%) of all respondents aged 16 years and older indicated that they used cannabis for medical purposes, an increase from 13% in 2018; provincial and territorial estimates ranged from 7% to 24%.

Possession of medical documents

When we asked people if they used cannabis for medical purposes in the past 12 months they were asked to specify whether this use was with or without documentation from a healthcare professional. Four percent (4%) of people, or 27% of those who used cannabis for medical purposes, said they did so with a document from a healthcare professional. The majority (73%) who reported cannabis use for medical purposes did not have a document from a healthcare professional.

Changes in use of other medications

Respondents who completed the medical section of the survey were asked if cannabis use for medical purposes allowed them to decrease their use of other medications. The majority of people who used cannabis for medical purposes reported that cannabis use helped decrease their use of other medications (61%, a decrease from 68% in 2018). Twenty-two percent (22%, unchanged from 19% in 2018) reported that this question was not applicable.

Frequency of cannabis use for medical purposes

People who completed the medical section of the survey and had used cannabis for medical purposes in the past 12 months were asked about the frequency they used cannabis for medical purposes in the past 12 months. The most common frequency reported was daily (35%), followed by less than one day per month (15%), two or three days per month (15%), one or two days per week (11%), three or four days per week (11%), five or six days per week (7%), and one day per month (6%). These were all unchanged from 2018.

Seventy-eight percent (78%) of people who used cannabis for medical purposes in the past 12 months and who completed the medical section of the survey reported using cannabis in the past 30 days for medical purposes, unchanged from 2018.

Types of cannabis products used for medical purposes

People who used cannabis for medical purposes in the past 12 months and who completed the medical section were asked about the types of cannabis products they used within the last year. Some product categories were modified between 2018 and 2019 and cannot be directly compared. The three main products used were dried flower/leaf (60%, a decrease from 71% in 2018), cannabis oil for oral use (46%, not comparable to previous cycle) and edibles (28%, a decrease from 34% in 2018). Other products reported by these respondents for medical purposes included cannabis cartridges/vape pens (17%, not comparable to 2018); topical ointments (17%, unchanged from 2018); concentrates and extracts (13%, not comparable to previous cycle); hashish/kief (9%, unchanged from 2018); and beverages (5%, unchanged from 2018).

Those who were 20 to 24 years old (79%) had a higher prevalence of using dried flower/leaf than those 25 years and older (58%). Males also had a higher percentage of using dried flower/leaf than females (66% and 55%, respectively).

Respondents who used cannabis for medical purposes and who completed the medical section were also asked about the frequency at which they used these cannabis products. Dried flower/leaf had a variety of responses, which ranged from daily/almost daily use (43%), weekly use (25%), monthly use (19%), and less than one day a month (14%), all unchanged from 2018. Cannabis oil for oral use also had a variety of responses, which ranged from less than one day a month (17%), monthly use (22%), weekly use (22%), and daily/almost daily use (39%). This product category is not comparable to 2018.

Relative levels of THC and CBD in cannabis products used for medical purposes

New in the 2019 cycle of the Canadian Cannabis Survey, people who used cannabis in the past 12 months for medical purposes and who completed the medical section of the survey were asked about the relative levels of THC and CBD in the cannabis products they typically use. Forty-one percent (41%) indicated higher CBD and lower THC, 18% selected higher THC and lower CBD, 14% indicated equal levels of THC and CBD, 14% indicated they used a mix of different products, and 4% selected other. Many of the other responses indicated the use of products with only CBD and no THC. Nine percent (9%) indicated they did not know the relative levels of THC and CBD.

Average amount used on a typical use day for medical purposes

People who used cannabis for medical purposes in the past 12 months were also asked to report the average amount of cannabis used on a typical use day. Of those who had used dried flower/leaf, the average amount used on a typical use day was 1.5 grams whereas those who used edible cannabis products consumed approximately 1.1 servings; cartridges/vape pens, 0.1 cartridges; hashish, 0.4 grams; and beverages, 400 millilitres, all unchanged from 2018. Among those who used cannabis oil for oral use, the average amount used was 1.5 millilitres and for concentrates/extracts, the average amount was 0.3 grams. These two product categories are not comparable to 2018.

Sources used to obtain cannabis products for medical purposes

People who used cannabis for medical purposes in the past 12 months and who completed the medical section of the survey were asked where they obtained cannabis for medical purposes. In addition to the sources asked about in 2018, the options of a legal storefront and a legal website other than a Health Canada licensed producer were added in 2019. Other options were also modified to better reflect the possible sources after the coming into force of the Cannabis Act. This means that not all sources can be compared to previous cycles. Respondents could select multiple sources. In 2019, the top five sources to obtain cannabis for medical purposes were from a legal storefront (27%), a Health Canada licensed producer (23%, unchanged from 2018), a friend (21%, a decrease from 30% in 2018), a legal website other than a Health Canada licensed producer (20%), and an illegal storefront (12%). Of those who obtained cannabis from a Health Canada licensed producer, 76% reported they will continue to access cannabis from a licensed producer now that legal retail sales of cannabis for non-medical purposes are available.

Average amount spent on cannabis for medical purposes in a typical month

People who used cannabis for medical purposes in the past 12 months and who completed the medical section of the survey spent approximately $108 on cannabis for medical purposes in a typical month. When people who used cannabis for medical purposes in the past 30 days were asked how much they actually spent on cannabis in the past 30 days, they reported spending about $115. These amounts were unchanged from 2018.

New in 2019, we also asked if people currently had insurance coverage for cannabis for medical purposes. Most people (94%) did not have any insurance coverage. Three percent (3%) indicated they had partial insurance coverage and a further 3% said they were fully covered.

Cannabis products for medical purposes bought or received

People who used cannabis for medical purposes in the past 30 days were asked about the cannabis products they bought or received in the past 30 days and the frequency of these occurrences. The most common response options selected were buying or receiving dried flower/leaf (61%, a decrease from 72% in 2018) followed by cannabis oil for oral use (37%, not comparable to the previous cycle), and edibles (17%, a decrease from 21% in 2018). For all products, the most common frequency of obtaining them was one day per month.

The average amount purchased for medical use in the past 30 days varied by product type. On average, people who used cannabis purchased or received 24.6 grams of dried flower/leaf, 6.1 servings of edibles, and 1.4 cartridges/vape pens, all unchanged from 2018. For cannabis oil for oral use, the average quantity obtained was 26.8 millilitres and for concentrates/extracts, the average quantity obtained was 4.3 grams. These two product categories are not directly comparable to the previous cycle.

Average price per unit of cannabis purchases for medical purposes, by product type

People who purchased cannabis for medical purposes in the past 30 days also reported the average price per unit by product type. Over the past 30 days, people who used cannabis for medical purposes spent the most per unit on cannabis cartridges/vape pens ($45.65/cartridge, unchanged from 2018) and concentrates/extracts ($30.91/gram, not comparable to 2018). For the more commonly purchased products the average price per unit were $10.79 per gram for dried flower and $13.70 per serving for edibles, both unchanged from 2018. The average price paid for cannabis oil for oral use was $18.62 per millilitre.

Opinions on cannabis use for medical purposes and driving

People who used cannabis for medical purposes and completed the medical section of the survey were asked if they believed that cannabis use for medical purposes impairs one's ability to drive. More of these people reported that 'yes' cannabis use for medical purposes impairs one's ability to drive (43%, unchanged from 2018) compared to those who reported 'no' (20%, a decrease from 27% in 2018) and 'it depends' (32%, unchanged from 2018). The same people were also asked for their opinion on the time until it was safe to drive after using cannabis for medical purposes. The most common responses were that 'it depends' (32%, unchanged from 2018), followed by three to five hours (18%, unchanged from 2018), and one to three hours (13%, a decrease from 17% in 2018). Six percent (6%, a decrease from 9% in 2018) of these people indicated that it was safe to drive immediately after cannabis use for medical purposes.

Driving a vehicle after using cannabis for medical purposes

Driving after using cannabis for medical purposes was studied among people who used cannabis for medical purposes and completed the medical section of the survey. New in 2019, the questions about driving after recent cannabis use were split based on the method of cannabis use. People were asked if they had ever driven within two hours of smoking of vaporizing cannabis and also if they had ever driven within four hours of orally ingesting cannabis. Overall, 26% reported they had ever driven within two hours of smoking or vaporizing cannabis. Of those who had driven after smoking or vaporizing cannabis, 49% did so within the past 30 days, 30% within the past 12 months, and 21% more than 12 months ago. When asked about driving within four hours of ingesting cannabis, 20% reported doing so in their lifetime. For those who had driven after ingesting cannabis, 46% reported doing so within the past 30 days, 39% within the past 12 months, and 15% more than 12 months ago.

A greater proportion of males (35%) reported driving within two hours of smoking or vaporizing cannabis for medical purposes compared to females (18%). This pattern persisted for driving within four hours of ingesting cannabis (26% and 16%, respectively).

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