Trends in Post Legalization Cannabis Use Among Ethnic Groups in California: 2018-2023

Objective: To examine trends in past 30-day cannabis use from 2018 to 2023 among Hispanic, White non-Hispanic, Black non-Hispanic, American Indian/Alaskan Native non-Hispanic, Asian non-Hispanic, Other/Two or more races adults (18 and over) in California. Methods: Data are from the California Health Interview Survey (CHIS), which each year interviews a representative household sample of the non-institutionalized population in California. Data were analyzed using crosstabulations and logistic regression to assess trends in cannabis use over time. Results: Multivariable analysis, controlling for sociodemographic factors, revealed an overall flat trend in past 30-day cannabis use in California from 2018 to 2023. Results for the main effect of race/ethnicity on past 30 day cannabis use indicated that the overall odds of using cannabis were lower among Asians compared to Whites (AOR = 0.60; 95% CI = 0.43,0.85; p < 0.01). Results for interactions between race/ethnicity and survey years indicated diverging cannabis use trends between Whites and Hispanics: Among Whites, the odds of past 30-d cannabis use increased (AOR = 1.04; 95%CI = 1.02,1.06; p < 0.001). Among Hispanics, past 30 day cannabis use had a statistically significant declining trend (AOR = 0.96; 95%CI = 0.92,0.99; p < 0.01). Conclusion: Legalization of recreational cannabis use in California does not seem connected with an increase in past 30 day cannabis use among adults. However, trends are different across different race/ethnic groups, possibly influenced by cross-group differences in factors such as level of access to cannabis, risk perception, socioeconomic status, and cultural and population-level norms about substance use. These findings highlight the importance of disaggregated analyses in revealing subgroup-specific trajectories that may be obscured in aggregate models.