Prevalence of Cannabis Use Among Indigenous Populations - A Systematic Review

Monitoring the prevalence of cannabis use is essential for a more complete understanding of the impacts and influence of a country's policies regarding its use. This systematic review aimed to synthesize the evidence and compare the prevalence of cannabis use among Indigenous populations globally.

PubMed/Medline, ProQuest, and Scopus databases were systematically searched for relevant articles published between January 1, 2010, and July 31, 2024. Relevant articles that reported prevalence or proportion of Indigenous peoples using cannabis were assessed for risk of bias using the Joanna Briggs Institute Critical Appraisal Tool, and evidence from included studies was synthesized.

Of the identified 1,347 potentially eligible studies, 40 studies met the inclusion criteria. Included studies were from Canada (n = 20), the USA (n = 3), the USA and Canada (n = 2), Australia (n = 13), New Zealand (n = 1), and Greenland (n = 1). Among young people (12-19 years), prevalence of reported lifetime cannabis use was the highest among Indigenous Canadians (91.1%), followed by Indigenous Americans in the USA (76%), and the lowest among Māori people in New Zealand (15.9%). Among adults, Aboriginal and Torres Strait Islander peoples in Australia reported lower prevalence of cannabis use (43%) than Indigenous people in Canada (53.2%). Daily use reported across these populations was the highest in Australia (50.4%). These findings reflect data from diverse Indigenous populations, each with distinct cultural, historical, and social contexts.

Indigenous young people and adults worldwide report varying prevalence of lifetime and current cannabis use. Indigenous people in Canada and the USA reported higher prevalence than Aboriginal and Torres Strait Islander peoples in Australia and Māori people in New Zealand. These findings highlight the need to strengthen culturally safe and informed health-care delivery across diverse populations, with future approaches benefiting from partnership with Indigenous communities to ensure relevance to community priorities.