Sex differences in factors associated with cannabis use among emerging adults

Cannabis use is prevalent among young adults and is influenced by a range of psychological, behavioral, and environmental factors. Although some individuals report using cannabis to manage stress or trauma-related symptoms, the relative contribution of early adversity and concurrent psychosocial factors to cannabis use-and whether these associations differ by sex-remains unclear. This study examined the extent to which adverse childhood experiences (ACEs), depressive and anxiety symptoms, alcohol use, and dissociative experiences are associated with cannabis use in men and women. A total of 1,210 undergraduates (84% female) completed surveys assessing these domains. R-squared decomposition analyses were used to quantify each factor's contribution to variance in cannabis use by sex. Alcohol use was the strongest predictor across both sexes. ACEs explained a greater proportion of variance among men (14.8%) than women (5.7%), with household incarceration most influential for men and household substance use most influential for women. Dissociative symptoms were uniquely associated with cannabis use among women. These findings suggest that cannabis use in emerging adults reflects multiple, sex-specific pathways involving both early life experiences and current psychosocial factors, underscoring the need for tailored prevention and intervention strategies.