title: The widening gender gap in marijuana use prevalence in the U.S. during a period of economic change, 2002-2014.
abstract: Concurrently with increasingly permissive attitudes towards marijuana use and its legalization, the prevalence of marijuana use has increased in recent years in the U.S. Substance use is generally more prevalent in men than women, although for alcohol, the gender gap is narrowing. However, information is lacking on whether time trends in marijuana use differ by gender, or whether socioeconomic status in the context of the Great Recession may affect these changes.
  
  
  
  Using repeated cross-sectional data from the National Survey on Drug Use and Health (2002-2014), we examined changes over time in prevalence of past-year marijuana use by gender, and whether gender differences varied across income levels. After empirically determining a change point in use in 2007, we used logistic regression to test interaction terms including time, gender, and income level.
  
  
  
  Prevalence of marijuana use increased for both men (+4.0%) and women (+2.7%) from 2002 to 2014, with all of the increase occurring from 2007 to 2014. Increases were greater for men, leading to a widening of the gender gap over time (p<0.001). This divergence occurred primarily due to increased prevalence among men in the lowest income level (+6.2%) from 2007 to 2014.
  
  
  
  Our findings are consistent with other studies documenting increased substance use during times of economic insecurity, especially among men. Corresponding with the Great Recession and lower employment rate beginning in 2007, low-income men showed the greatest increases in marijuana use during this period, leading to a widening of the gender gap in prevalence of marijuana use over time.
authors.affiliation: Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.
authors.forename: Hannah
authors.initials: H
authors.lastname: Carliner
authors.affiliation: Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.
authors.forename: Pia M
authors.initials: PM
authors.lastname: Mauro
authors.affiliation: Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.
authors.forename: Qiana L
authors.initials: QL
authors.lastname: Brown
authors.affiliation: New York State Psychiatric Institute, New York, NY, USA; Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
authors.forename: Dvora
authors.initials: D
authors.lastname: Shmulewitz
authors.affiliation: New York State Psychiatric Institute, New York, NY, USA.
authors.forename: Reanne
authors.initials: R
authors.lastname: Rahim-Juwel
authors.affiliation: New York State Psychiatric Institute, New York, NY, USA.
authors.forename: Aaron L
authors.initials: AL
authors.lastname: Sarvet
authors.affiliation: New York State Psychiatric Institute, New York, NY, USA; Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA; Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, USA.
authors.forename: Melanie M
authors.initials: MM
authors.lastname: Wall
authors.affiliation: Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.
authors.forename: Silvia S
authors.initials: SS
authors.lastname: Martins
authors.affiliation: Department of Economics, Boston University, Boston, MA, USA.
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Carliner
authors.affiliation: Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA; New York State Psychiatric Institute, New York, NY, USA; Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA. Electronic address: deborah.hasin@gmail.com.
authors.forename: Deborah S
authors.initials: DS
authors.lastname: Hasin
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D004651:Employment / Q000706:statistics & numerical data; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D002189:Marijuana Abuse / Q000453:epidemiology*; D008385:Marijuana Smoking / Q000453:epidemiology*; D008875:Middle Aged; D015995:Prevalence; D012737:Sex Factors; D012923:Social Class
keywords: Cannabis; Drug users; Economic recession; Men’s health; Socioeconomic factors