Recent Trends and Key Correlates of Marijuana Use Among Individuals with a Heart Disease in the United States: Evidence from a National Sample

Background/Purpose: In the United States (U.S.), marijuana is the most commonly used illicit drug and is becoming more prevalent due to its legalization for medical and recreational purposes and more lenient attitudes. Despite the potentials for therapeutic benefits, evidence suggests that marijuana use is likely to increase the risk of adverse cardiovascular events and pathologies. The recent study reporting that two million Americans with cardiovascular diseases have used or currently using marijuana raises major public health concerns. However, studies are limited to elicit the recent marijuana use trends among individuals with heart diseases and key correlates associated with the recent trends in marijuana use. We examine the latest trends of current marijuana use since 2015 and the effects of marijuana-specific factors on the trends among adults with a heart condition using a nationally representative sample in the U.S.

Methods: We obtained data on 7,339 adults who reported having a heart condition or disease in the past year from the 2015-2019 National Survey of Drug Use and Health, a cross-sectional study of a nationally representative US sample of non-institutionalized individuals. We examined self-reports of past-month marijuana use and three marijuana-specific factors (i.e., difficult access to obtain marijuana, perception of greater risk, disapproval of marijuana use). The marijuana use trends were tested by including survey year as a continuous variable in multivariate logistic regression models. Then, marijuana-specific factors were added to the multivariate logistic regression models to assess the roles of those factors in understanding the recent marijuana use trends. Lastly, the interaction term between survey year and race/ethnicity on marijuana use examined to test racial/ethnic differences in the trends.

Results: The rates of past-month marijuana use among individuals with a heart condition or disease has increased significantly from 5.0% in 2015 to 7.8% in 2019, indicating a 56% increase during the past 5 years (AOR=1.13, 95% CI=1.02-1.25). In the racial/ethnic subgroup analysis, Whites reported significant increases in marijuana use from 4.3% in 2015 to 8.1% in 2019 (AOR=1.17, 95% CI=1.05-1.32) while Blacks (AOR=1.01, 95% CI=0.75-1.37) and Hispanics (AOR=0.84, 95% CI=0.63-0.11) did not report notable increases. When either of the marijuana-specific factors were included in the models, the magnitude of the increasing trends was reduced and became insignificant. For Whites, addition of all three marijuana-specific factors led to insignificant increases (AOR=1.10, 95% CI=0.98-1.23).

Conclusions/Implications: Disconcertingly, notable increases in current marijuana use have been found among U.S. adults with a heart condition or disease in the past five years, primarily driven by increases among Whites. The increases were significantly associated with the changes in accessibility, risk perception, and use disapproval of marijuana use. Thus, efforts to raise awareness of the risk and regulate easy access need to be considered to decelerate increasing involvement in marijuana use among U.S. adults with a heart condition, especially Whites.