Cannabis Use and Diet Quality Among University Students: The Role of Meal Skipping and Health Behaviours

Background/Objectives: Diet quality among university students is influenced by multiple behavioural and lifestyle factors, yet limited research has examined how cannabis use relates to overall diet quality within this population. This study examined the association between cannabis use and diet quality among university students and assessed whether this relationship was explained by behavioural, contextual, and psychological factors. Methods: A cross-sectional online survey was distributed to all registered students at a large Canadian university in January 2026. Diet quality was assessed using the Canadian Food Intake Screener (CFIS), and past 30-day cannabis use was examined as the primary exposure. Hierarchical multiple linear regression models were conducted sequentially, adjusting for demographic characteristics, health behaviours, mental health variables, living arrangements, meal skipping, and other substance use. Results: Among 1581 survey respondents, 1467 participants were included in the fully adjusted regression analyses. Past 30-day cannabis use was reported by 33.7% of participants. In demographic-adjusted analyses, cannabis use was associated with lower diet quality scores (B = -0.81, p < 0.01). This association remained statistically significant following adjustment for health behaviours, mental health variables, and living arrangements. However, after adjustment for meal skipping, the association between cannabis use and diet quality was attenuated and no longer statistically significant (B = -0.44, p = 0.09). Meal skipping emerged as one of the strongest behavioural correlates of lower diet quality. Additional adjustment for other substance use did not materially alter findings. Conclusions: Cannabis use was initially associated with lower diet quality among university students; however, this association was attenuated after accounting for broader behavioural factors, particularly meal skipping. Given the cross-sectional design, these findings do not establish whether cannabis use influences dietary behaviours or whether meal skipping represents a pathway linking cannabis use and diet quality. These findings highlight the importance of considering diet quality within a broader behavioural framework and suggest that eating patterns represent an important correlate of diet quality among university students.