By Jewel Bailey, MPH
Knowledge Broker, Health Promotion Resource Centre
Provincial System Support Program
Centre for Addiction and Mental Health (CAMH)
With cannabis legalization swiftly approaching, the burning question in the minds of many is: will more young people start using cannabis once legalized? Findings from the 2017 Ontario Student Drug Use and Health Survey (OSDUHS) provide some insights into this question, along with rich information on a broad range of substance use issues facing students. The OSDUHS, which is conducted with Ontario students in grades 7-12 every two years, celebrated its 40th anniversary in 2017. This long standing survey among students in Canada is conducted by the Centre for Addiction and Mental Health. 11,435 students, from 52 school boards and 214 schools participated in the 2017 survey.
One key finding: the majority of students (62%) report that they don’t plan to use cannabis after legalization. However, 8% intends to start, while 4% say they will increase their use. The OSDUHS also found that younger students were more likely to say they won’t use cannabis when legalized, and felt regular use posed the biggest risk of harm.
As someone involved in mental health promotion and the prevention of substance use problems, I’ve been thinking about what messages should be shared with students about cannabis. I’ve also been thinking about the role of attitudes and intentions in health behaviors. Overall, all students should receive information on the immediate and long-term risks of cannabis use so they can make informed decisions. Those who plan to increase their use require more targeted attention since cannabis-related harms increase with frequency of use. Some of the health problems found among those who use cannabis daily or near daily are: mental health problems, dependence, and issues with cognitive, psychomotor, and respiratory functioning.
Students were also asked about their position on the federal government’s decision to legalize cannabis. There were no stark differences in how they felt, since one third support this move, another third don’t agree with legalization, and another third are undecided. Students in the older grades were more likely to support legalizing cannabis for adults.
Because the OSDUHS captures a broad range of information on substance use, you might be interested in findings for other substances of significant public health concern such as, alcohol, smoking, and illicit fentanyl use.
For instance, the 2017 survey shows some encouraging results for student alcohol use. Hazardous and harmful drinking significantly decreased since the 2015 survey, reaching an all-time low in 2017! But given the expansion of alcohol into grocery stores, how do students feel about where they buy their beer? 35% of students think it will be harder to purchase beer in the LCBO or beer store than a grocery store, and 30% felt there was no difference in difficulty in purchasing alcohol in any of these locations. These percentages highlight the importance of controlling the availability of alcohol to minimize alcohol-related harms.
What about cigarette smoking and illicit fentanyl use? The OSDUHS shows we have made significant progress in reducing the prevalence of smoking. Still, if you work in the area of tobacco control and smoking cessation, you might find it concerning that 43% of past year student smokers smoked contraband cigarettes. Meanwhile, 40% of students who use electronic cigarettes used e-cigarettes without nicotine. The latter is particularly important as researchers and practitioners seek to determine if e-cigarettes can serve as a cessation device and reduce the harms from cigarette smoking. 2017 is the first year the survey started tracking illicit fentanyl use, and the results reveal that about 1% of high school students used this drug in the past year. That sounds like a small number—but in fact it represents about 5,800 students.
Other significant 2017 findings are: the increase in the non-medical use of over-the-counter cough or cold medication when compared to the 2015 findings. Males show a significant increase in past year use, because of the euphoria produced by a certain drug found in some medications. Their use jumped from 7% in 2015 to 11% in 2017. In addition, the non-medical use of Attention Deficit Hyperactivity Disorder drugs has shown a significant increase over the last 10 years – from 1% in 2007 to 2.3% in 2017.
As the OSDUHS turns 40 years, there’s much to celebrate when it comes to the reduction of student drug use in the last four decades. Most past year drug use has shown a significant decline. There have been decreases in the use of substances such as alcohol (binge drinking), tobacco cigarettes, inhalants, and non-medical use of opioids. In addition, students are delaying their initiation of drug use; their first use of cigarette, alcohol, and cannabis is beginning at older ages.
This is encouraging news for those of us who work in health promotion. We know that positive shifts in population health can take years to achieve; progress might appear elusive when we’re immersed in the day-to-day activities, but the OSDUHS shows that progress is being made, and is possible.
In measuring long-term health impacts and outcomes, change cannot be attributed to any one program or policy; it’s the combination and culmination of multiple interventions and the collective efforts over time that make the difference. What will be the story about students’ use of cannabis and other substances when the OSDUHS celebrates its next 40th anniversary? We don’t know.
What we do know is health promotion, public health policy, regulation, and supportive environments have worked to reduce the prevalence of cigarette smoking and alcohol consumption, and are still relevant in addressing current substance use problems.
Want to learn more about the 2017 OSDUHS drug use results, and low risk guidelines for cannabis and alcohol? Why not check out the links below:
1 Harmful/hazardous use is based on the Alcohol Use Disorders Identification Test. This is a 10-item screener which identifies problematic alcohol use. A score of eight or higher is considered