Co-Use of Alcohol and Cannabis During COVID-19: Associations Between Sociodemographic Factors and Self-Reported Mental Health Symptoms and Heavy Episodic Drinking in Canadian Adults
Abstract
1. Introduction
2. Material and Methods
2.1. Participants and Data Collection
2.2. Measures
2.3. Covariates
2.4. Statistical Analyses
3. Results
3.1. Description of Participants and Prevalence of Alcohol–Cannabis Co-Use
3.2. Associations of Sociodemographic Factors with Alcohol–Cannabis Co-Use
3.3. Associations with Heavy Episodic Drinking, Anxiety, Depression, and Loneliness
4. Discussion
4.1. Prevalence and Sociodemographic Risk Factors of Alcohol–Cannabis Co-Use
4.2. Co-Use Associations with HED, Anxiety, Depression and Loneliness
4.3. Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Statistics Canada. Alcohol and Cannabis Use During the Pandemic: Canadian Perspectives Survey Series 6. 2021. Available online: https://www150.statcan.gc.ca/n1/daily-quotidien/210304/dq210304a-eng.pdf (accessed on 16 July 2022).
- Michelle, R. Canadians who report lower self-perceived mental health during the COVID-19 pandemic more likely to report increased use of cannabis, alcohol and tobacco. In StatCan COVID-19: Data to Insights for a Better Canada; Statistics Canada: Ottawa, ON, Canada, 2020. [Google Scholar]
- Imtiaz, S.; Shield, K.D.; Roerecke, M.; Cheng, J.; Popova, S.; Kurdyak, P.; Fischer, B.; Rehm, J. The burden of disease attributable to cannabis use in Canada in 2012. Addiction 2016, 111, 653–662. [Google Scholar] [CrossRef]
- Canadian Substance Use Costs and Harms. Canadian Substance Use Costs and Harms (2015–2017); Canadian Substance Use Costs and Harms: Ottawa, ON, Canada, 2020. [Google Scholar]
- Bartel, S.J.; Sherry, S.B.; Stewart, S.H. Pandemic-Related Changes in Alcohol and Cannabis Use: Comparing Retrospective Reports and Prospective Data. Int. J. Ment. Health Addict. 2023, 21, 2077–2083. [Google Scholar] [CrossRef]
- Patrick, M.E.; Terry-McElrath, Y.M.; Miech, R.A.; Keyes, K.M.; Jager, J.; Schulenberg, J.E. Alcohol use and the COVID-19 pandemic: Historical trends in drinking, contexts, and reasons for use among U.S. adults. Soc. Sci. Med. 2022, 301, 114887. [Google Scholar] [CrossRef]
- Patrick, M.E.; Kloska, D.D.; Terry-McElrath, Y.M.; Lee, C.M.; O’Malley, P.M.; Johnston, L.D. Patterns of simultaneous and concurrent alcohol and marijuana use among adolescents. Am. J. Drug Alcohol Abus. 2018, 44, 441–451. [Google Scholar] [CrossRef] [PubMed]
- Leatherdale, S.T.; Burkhalter, R. The substance use profile of Canadian youth: Exploring the prevalence of alcohol, drug and tobacco use by gender and grade. Addict. Behav. 2012, 37, 318–322. [Google Scholar] [CrossRef]
- Metrik, J.; Gunn, R.L.; Jackson, K.M.; Sokolovsky, A.W.; Borsari, B. Daily Patterns of Marijuana and Alcohol Co-Use Among Individuals with Alcohol and Cannabis Use Disorders. Alcohol. Clin. Exp. Res. 2018, 42, 1096–1104. [Google Scholar] [CrossRef]
- Subbaraman, M.S.; Kerr, W.C. Simultaneous versus concurrent use of alcohol and cannabis in the National Alcohol Survey. Alcohol. Clin. Exp. Res. 2015, 39, 872–879. [Google Scholar] [CrossRef]
- Abuse, S. Mental Health Services Administration, Results from the 2013 National Survey on Drug Use and Health: Summary of National Findings, NSDUH Series H-48, HHS Publication No. (SMA) 14-4863; Substance Abuse and Mental Health Services Administration: Rockville, MD, USA, 2014. [Google Scholar]
- Roche, D.J.O.; Bujarski, S.; Green, R.; Hartwell, E.E.; Leventhal, A.M.; Ray, L.A. Alcohol, tobacco, and marijuana consumption is associated with increased odds of same-day substance co- and tri-use. Drug Alcohol Depend. 2019, 200, 40–49. [Google Scholar] [CrossRef]
- Schensul, J.J.; Convey, M.; Burkholder, G. Challenges in measuring concurrency, agency and intentionality in polydrug research. Addict. Behav. 2005, 30, 571–574. [Google Scholar] [CrossRef]
- Chait, L.D.; Perry, J.L. Acute and residual effects of alcohol and marijuana, alone and in combination, on mood and performance. Psychopharmacology 1994, 115, 340–349. [Google Scholar] [CrossRef]
- Ramaekers, J.G.; Robbe, H.W.J.; O’Hanlon, J.F. Marijuana, alcohol and actual driving performance. Hum. Psychopharmacol. Clin. Exp. 2000, 15, 551–558. [Google Scholar] [CrossRef]
- Yurasek, A.M.; Aston, E.R.; Metrik, J. Co-use of Alcohol and Cannabis: A Review. Curr. Addict. Rep. 2017, 4, 184–193. [Google Scholar] [CrossRef] [PubMed]
- Kepner, W.E.; Han, B.H.; Nguyen, D.; Han, S.S.; Lopez, F.A.; Palamar, J.J. Past-month binge drinking and cannabis use among middle-aged and older adults in the United States, 2015–2019. Alcohol 2023, 107, 32–37. [Google Scholar] [CrossRef] [PubMed]
- Center for Behavioral Health Statistics and Quality. Key Substance Use and Mental Health Indicators in the United States: Results from the 2015 National Survey on Drug Use and Health; HHS Publication No. SMA 16-4984, NSDUH Series H-51; Center for Behavioral Health Statistics and Quality: Rockville, MD, USA, 2016. [Google Scholar]
- Terry-McElrath, Y.M.; O’Malley, P.M.; Johnston, L.D. Alcohol and Marijuana Use Patterns Associated With Unsafe Driving Among U.S. High School Seniors: High Use Frequency, Concurrent Use, and Simultaneous Use. J. Stud. Alcohol Drugs 2014, 75, 378–389. [Google Scholar] [CrossRef] [PubMed]
- Thompson, K.; Holley, M.; Sturgess, C.; Leadbeater, B. Co-Use of Alcohol and Cannabis: Longitudinal Associations with Mental Health Outcomes in Young Adulthood. Int. J. Environ. Res. Public Health 2021, 18, 3652. [Google Scholar] [CrossRef]
- Sokolovsky, A.W.; Gunn, R.L.; Micalizzi, L.; White, H.R.; Jackson, K.M. Alcohol and marijuana co-use: Consequences, subjective intoxication, and the operationalization of simultaneous use. Drug Alcohol Depend. 2020, 212, 107986. [Google Scholar] [CrossRef]
- Gutkind, S.; Gorfinkel, L.R.; Hasin, D.S. Prospective effects of loneliness on frequency of alcohol and marijuana use. Addict. Behav. 2022, 124, 107115. [Google Scholar] [CrossRef]
- Boden, J.M.; Fergusson, D.M. Alcohol and depression. Addiction 2011, 106, 906–914. [Google Scholar] [CrossRef]
- Ontario Agency for Health Protection and Promotion (Public Health Ontario); Meyer, W.; Leece, P. Evidence Brief: Risk Factors for Simultaneous Use of Alcohol and Cannabis; Queen’s Printer for Ontario: Toronto, ON, Canada, 2018. [Google Scholar]
- Brière, F.N.; Fallu, J.S.; Descheneaux, A.; Janosz, M. Predictors and consequences of simultaneous alcohol and cannabis use in adolescents. Addict. Behav. 2011, 36, 785–788. [Google Scholar] [CrossRef]
- McCabe, S.E.; Cranford, J.A.; Morales, M.; Young, A. Simultaneous and Concurrent Polydrug Use of Alcohol and Prescription Drugs: Prevalence, Correlates, and Consequences. J. Stud. Alcohol 2006, 67, 529–537. [Google Scholar] [CrossRef]
- Terry-McElrath, Y.M.; O’Malley, P.M.; Johnston, L.D. Simultaneous alcohol and marijuana use among U.S. high school seniors from 1976 to 2011: Trends, reasons, and situations. Drug Alcohol Depend. 2013, 133, 71–79. [Google Scholar] [CrossRef] [PubMed]
- Collins, R.L.; Ellickson, P.L.; Bell, R.M. Simultaneous polydrug use among teens: Prevalence and predictors. J. Subst. Abus. 1998, 10, 233–253. [Google Scholar] [CrossRef] [PubMed]
- Midanik, L.T.; Tam, T.W.; Weisner, C. Concurrent and simultaneous drug and alcohol use: Results of the 2000 National Alcohol Survey. Drug Alcohol Depend. 2007, 90, 72–80. [Google Scholar] [CrossRef]
- Baker, K.E. The Future of Transgender Coverage. N. Engl. J. Med. 2017, 376, 1801–1804. [Google Scholar] [CrossRef]
- Goodwin, S.R.; Moskal, D.; Marks, R.M.; Clark, A.E.; Squeglia, L.M.; Roche, D.J.O. A Scoping Review of Gender, Sex and Sexuality Differences in Polysubstance Use in Adolescents and Adults. Alcohol Alcohol. 2022, 57, 292–321. [Google Scholar] [CrossRef]
- Day, J.K.; Fish, J.N.; Perez-Brumer, A.; Hatzenbuehler, M.L.; Russell, S.T. Transgender Youth Substance Use Disparities: Results From a Population-Based Sample. J. Adolesc. Health 2017, 61, 729–735. [Google Scholar] [CrossRef]
- Callegaro, M.; DiSogra, C. Computing Response Metrics for Online Panels. Public Opin. Q. 2008, 72, 1008–1032. [Google Scholar] [CrossRef]
- Spitzer, R.L.; Kroenke, K.; Williams, J.B.W.; Löwe, B. A Brief Measure for Assessing Generalized Anxiety Disorder: The GAD-7. Arch. Intern. Med. 2006, 166, 1092–1097. [Google Scholar] [CrossRef]
- Roy-Byrne, P.; Veitengruber, J.P.; Bystritsky, A.; Edlund, M.J.; Sullivan, G.; Craske, M.G.; Welch, S.S.; Rose, R.; Stein, M.B. Brief intervention for anxiety in primary care patients. J. Am. Board Fam. Med. 2009, 22, 175–186. [Google Scholar] [CrossRef]
- Ren, Z.; Zhou, Y.; Liu, Y. The psychological burden experienced by Chinese citizens during the COVID-19 outbreak: Prevalence and determinants. BMC Public Health 2020, 20, 1617. [Google Scholar] [CrossRef] [PubMed]
- Kroenke, K.; Spitzer, R.L.; Williams, J.B.W.; Löwe, B. The Patient Health Questionnaire Somatic, Anxiety, and Depressive Symptom Scales: A systematic review. Gen. Hosp. Psychiatry 2010, 32, 345–359. [Google Scholar] [CrossRef]
- Elton-Marshall, T.; Wells, S.; Jankowicz, D.; Nigatu, Y.T.; Wickens, C.M.; Rehm, J.; Hamilton, H.A. Multiple COVID-19 Risk Factors Increase the Likelihood of Experiencing Anxiety Symptoms in Canada. Can. J. Psychiatry 2020, 66, 56–58. [Google Scholar] [CrossRef]
- Radloff, L.S. The CES-D Scale:A Self-Report Depression Scale for Research in the General Population. Appl. Psychol. Meas. 1977, 1, 385–401. [Google Scholar] [CrossRef]
- Somé, N.H.; Shokoohi, M.; Shield, K.D.; Wells, S.; Hamilton, H.A.; Elton-Marshall, T.; Abramovich, A. Alcohol and cannabis use during the COVID-19 pandemic among transgender, gender-diverse, and cisgender adults in Canada. BMC Public Health 2022, 22, 452. [Google Scholar] [CrossRef] [PubMed]
- Flentje, A.; Barger, B.T.; Capriotti, M.R.; Lubensky, M.E.; Tierney, M.; Obedin-Maliver, J.; Lunn, M.R. Screening gender minority people for harmful alcohol use. PLoS ONE 2020, 15, e0231022. [Google Scholar] [CrossRef] [PubMed]
- Benotsch, E.G.; Zimmerman, R.; Cathers, L.; McNulty, S.; Pierce, J.; Heck, T.; Perrin, P.B.; Snipes, D. Non-medical use of prescription drugs, polysubstance use, and mental health in transgender adults. Drug Alcohol Depend. 2013, 132, 391–394. [Google Scholar] [CrossRef] [PubMed]
- Santos, G.M.; Rapues, J.; Wilson, E.C.; Macias, O.; Packer, T.; Colfax, G.; Raymond, H.F. Alcohol and substance use among transgender women in San Francisco: Prevalence and association with human immunodeficiency virus infection. Drug Alcohol Rev. 2014, 33, 287–295. [Google Scholar] [CrossRef]
- Hughto, J.M.W.; Quinn, E.K.; Dunbar, M.S.; Rose, A.J.; Shireman, T.I.; Jasuja, G.K. Prevalence and Co-occurrence of Alcohol, Nicotine, and Other Substance Use Disorder Diagnoses Among US Transgender and Cisgender Adults. JAMA Netw. Open 2021, 4, e2036512. [Google Scholar] [CrossRef]
- Connolly, D.; Gilchrist, G. Prevalence and correlates of substance use among transgender adults: A systematic review. Addict. Behav. 2020, 111, 106544. [Google Scholar] [CrossRef]
- Kidd, J.D.; Jackman, K.B.; Barucco, R.; Dworkin, J.D.; Dolezal, C.; Navalta, T.V.; Belloir, J.; Bockting, W.O. Understanding the Impact of the COVID-19 Pandemic on the Mental Health of Transgender and Gender Nonbinary Individuals Engaged in a Longitudinal Cohort Study. J. Homosex. 2021, 68, 592–611. [Google Scholar] [CrossRef]
- Restar, A.J.; Jin, H.; Jarrett, B.; Adamson, T.; Baral, S.D.; Howell, S.; Beckham, S.W. Characterising the impact of COVID-19 environment on mental health, gender affirming services and socioeconomic loss in a global sample of transgender and non-binary people: A structural equation modelling. BMJ Glob. Health 2021, 6, e004424. [Google Scholar] [CrossRef]
- Tucker, J.S.; Seelam, R.; Green, H.D.; Rodriguez, A.; Pollard, M.S. Alcohol and cannabis co-use in a national sample of U.S. adults ages 30–80. Addict. Behav. 2023, 142, 107663. [Google Scholar] [CrossRef]
- Höhne, B.; Pabst, A.; Hannemann, T.-V.; Kraus, L. Patterns of concurrent alcohol, tobacco, and cannabis use in Germany: Prevalence and correlates. Drugs Educ. Prev. Policy 2014, 21, 102–109. [Google Scholar] [CrossRef]
- O’Grady, K.E.; Arria, A.M.; Fitzelle, D.M.; Wish, E.D. Heavy Drinking and Polydrug Use among College Students. J. Drug Issues 2008, 38, 445–466. [Google Scholar] [CrossRef] [PubMed]
- Jones, S.E.; Oeltmann, J.; Wilson, T.W.; Brener, N.D.; Hill, C.V. Binge drinking among undergraduate college students in the United States: Implications for other substance use. J. Am. Coll. Health 2001, 50, 33–38. [Google Scholar] [CrossRef]
- Neddermann-Carrillo, S.; Abidi, L.; Gea, A.; Bes-Rastrollo, M.; de la Fuente-Arrillaga, C.; Lahortiga-Ramos, F.; Martínez-González, M.Á.; Pardavila-Belio, M.I.; Ruiz-Canela, M. Tobacco and alcohol co-use: Lifestyle and sociodemographic factors, and personality aspects as potential predictors in the “Seguimiento Universidad de Navarra” cohort. Res. Nurs. Health 2024, 47, 251–265. [Google Scholar] [CrossRef]
- Higgins, S.T.; Budney, A.J.; Bickel, W.K.; Foerg, F.E.; Badger, G.J. Alcohol dependence and simultaneous cocaine and alcohol use in cocaine-dependent patients. J. Addict. Dis. 1994, 13, 177–189. [Google Scholar] [CrossRef]
- Ogborne, A.C.; Kapur, B.M.; Newton-Taylor, B. Characteristics of drug users admitted to alcohol detoxication centers. Am. J. Drug Alcohol Abus. 1992, 18, 177–186. [Google Scholar] [CrossRef] [PubMed]
- Airagnes, G.; Lemogne, C.; Meneton, P.; Plessz, M.; Goldberg, M.; Hoertel, N.; Roquelaure, Y.; Limosin, F.; Zins, M. Alcohol, tobacco and cannabis use are associated with job loss at follow-up: Findings from the CONSTANCES cohort. PLoS ONE 2019, 14, e0222361. [Google Scholar] [CrossRef]
- Linden-Carmichael, A.N.; Mallett, K.A.; Sell, N.; Turrisi, R. Are Co-users of Alcohol and Marijuana More Willing to Experience Consequences From Drinking? A Longitudinal Examination Among First-Year College Students. Alcohol. Clin. Exp. Res. 2019, 43, 1567–1574. [Google Scholar] [CrossRef]
- Ingram, I.; Kelly, P.J.; Deane, F.P.; Baker, A.L.; Goh, M.C.W.; Raftery, D.K.; Dingle, G.A. Loneliness among people with substance use problems: A narrative systematic review. Drug Alcohol Rev. 2020, 39, 447–483. [Google Scholar] [CrossRef] [PubMed]
- Stanton, R.; To, Q.G.; Khalesi, S.; Williams, S.L.; Alley, S.J.; Thwaite, T.L.; Fenning, A.S.; Vandelanotte, C. Depression, Anxiety and Stress during COVID-19: Associations with Changes in Physical Activity, Sleep, Tobacco and Alcohol Use in Australian Adults. Int. J. Environ. Res. Public Health 2020, 17, 4065. [Google Scholar] [CrossRef] [PubMed]
- Mann, F.; Wang, J.; Pearce, E.; Ma, R.; Schlief, M.; Lloyd-Evans, B.; Ikhtabi, S.; Johnson, S. Loneliness and the onset of new mental health problems in the general population. Soc. Psychiatry Psychiatr. Epidemiol. 2022, 57, 2161–2178. [Google Scholar] [CrossRef]
- Forster, J.J. Sample Surveys: Nonprobability Sampling. In International Encyclopedia of the Social & Behavioral Sciences; Smelser, N.J., Baltes, P.B., Eds.; Pergamon: Oxford, UK, 2001; pp. 13467–13470. [Google Scholar] [CrossRef]
- Lagos, D.; Compton, D.L. Evaluating the Use of a Two-Step Gender Identity Measure in the 2018 General Social Survey. Demography 2021, 58, 763–772. [Google Scholar] [CrossRef]
- Reisner, S.L.; Biello, K.; Rosenberger, J.G.; Austin, S.B.; Haneuse, S.; Perez-Brumer, A.; Novak, D.S.; Mimiaga, M.J. Using a Two-Step Method to Measure Transgender Identity in Latin America/the Caribbean, Portugal, and Spain. Arch. Sex. Behav. 2014, 43, 1503–1514. [Google Scholar] [CrossRef]
- Gerlich, M.G.; Rehm, J. Recall bias in case-crossover designs studying the potential influence of alcohol consumption. J. Stud. Alcohol Drugs 2010, 71, 619. [Google Scholar] [CrossRef]
- Stockwell, T.; Zhao, J.; Giesbrecht, N.; Macdonald, S.; Thomas, G.; Wettlaufer, A. The raising of minimum alcohol prices in Saskatchewan, Canada: Impacts on consumption and implications for public health. Am. J. Public Health 2012, 102, e103–e110. [Google Scholar] [CrossRef]
Total Sample | Alcohol Only | Cannabis Only | Co-Use | No-Use | ||
---|---|---|---|---|---|---|
n | % | n (%) | n (%) | n (%) | n (%) | |
Total, n (%) | 9011 | 100 | 4353 (48.3) | 280 (3.1) | 907 (10.1) | 3471 (38.5) |
Gender | ||||||
Man | 4456 | 49.5 | 2247 (50.4) | 137 (3.1) | 529 (11.9) | 1543 (34.6) |
Woman | 4472 | 49.6 | 2087 (46.7) | 139 (3.1) | 356 (8.0) | 1890 (42.3) |
Transgender and gender-diverse | 62 | 0.7 | 15 (24.2) | 4 (6.4) | 22 (35.5) | 21 (33.9) |
Prefer not to answer | 21 | 0.2 | 4 (19.1) | 0 (0) | 0 (0.0) | 17 (80.9) |
Age | ||||||
Age 18–39 | 3467 | 38.5 | 1433 (41.3) | 162 (4.7) | 501 (14.5) | 1371 (39.5) |
Age 40–59 | 2846 | 31.6 | 1377 (48.4) | 82 (2.9) | 264 (9.3) | 1123 (39.5) |
Age 60+ | 2698 | 29.9 | 1543 (57.2) | 36 (1.3) | 142 (5.3) | 977 (36.2) |
Ethno-racial background | ||||||
White | 6209 | 68.9 | 3339 (53.8) | 197 (3.2) | 619 (10.0) | 2054 (33.1) |
Non-white | 2802 | 31.1 | 1014 (36.2) | 83 (3.0) | 288 (10.3) | 1417 (50.6) |
Marital status | ||||||
Separated/divorced/widowed | 1126 | 12.5 | 517 (45.9) | 30 (2.7) | 111 (9.9) | 468 (41.6) |
Married | 5631 | 62.5 | 2953 (52.4) | 147 (2.6) | 550 (9.8) | 1981 (35.2) |
Single | 2135 | 23.7 | 841 (39.4) | 100 (4.7) | 233 (10.9) | 961 (45.0) |
Marital status not stated | 119 | 1.3 | 42 (35.3) | 3 (2.5) | 13 (10.9) | 61 (51.3) |
Residential environment | ||||||
Urban | 4224 | 46.9 | 1955 (46.3) | 134 (3.2) | 466 (11.0) | 1669 (39.5 |
Suburban | 3356 | 37.2 | 1714 (51.1) | 93 (2.8) | 318 (9.5) | 1231 (36.7) |
Rural | 1431 | 15.9 | 684 (47.8) | 53 (3.7) | 123 (8.6) | 571 (39.9) |
Income | ||||||
Income less than $40,000 | 1080 | 12.0 | 346 (32.0) | 51 (4.7) | 108 (10.0) | 575 (53.2) |
Income of $40,000–$79,999 | 2216 | 24.6 | 980 (44.2) | 91 (4.1) | 255 (11.5) | 890 (40.2) |
Income of $80,000–$119,999 | 2031 | 22.5 | 1026 (50.5) | 55 (2.7) | 259 (12.8) | 691 (34.0) |
Income $120,000+ | 2238 | 24.8 | 1280 (57.2) | 45 (2.0) | 219 (9.8) | 694 (31.0) |
Income not stated | 1446 | 16.0 | 721 (49.9) | 38 (2.6) | 66 (4.6) | 621 (42.9) |
Employment status | ||||||
Employed | 7660 | 85.0 | 3764 (49.1) | 229 (3.0) | 737 (9.6) | 2930 (38.2) |
Unemployed | 867 | 9.6 | 384 (44.3) | 38 (4.4) | 115 (13.3) | 330 (38.1) |
Other impact on employment | 484 | 5.4 | 205 (42.4) | 13 (2.7) | 55 (11.4) | 211 (43.6) |
Educational attainment | ||||||
Post-secondary | 1362 | 15.1 | 610 (44.8) | 58 (4.3) | 155 (11.4) | 539 (39.6) |
High school | 1068 | 11.9 | 440 (41.2) | 48 (4.5) | 112 (10.5) | 468 (43.8) |
College | 1802 | 20.0 | 840 (46.6) | 71 (3.9) | 214 (11.9) | 677 (37.6) |
University | 4703 | 52.2 | 2438 (51.8) | 102 (2.2) | 420 (8.9) | 1743 (37.1) |
Education attainment not stated | 76 | 0.8 | 25 (32.9) | 1 (1.3) | 6 (7.9) | 44 (57.9) |
Co-Use vs. Non Co-Use | Co-Use vs. Alcohol Use Only | Co-Use vs. Cannabis Use Only | Co-Use vs. No-Use | |
---|---|---|---|---|
aOR (95% CI) | aOR (95% CI) | aOR (95% CI) | aOR (95% CI) | |
Gender | ||||
Women | 0.63 *** (0.55–0.73) | 0.71 *** (0.61–0.83) | 0.74 ** (0.55–0.99) | 0.54 *** (0.46–0.63) |
TGD | 3.61 *** (2.09–6.25) | 4.73 *** (2.36–9.49) | 1.72 (0.56–5.27) | 3.42 *** (1.81–6.46) |
Age | ||||
Age 40–59 | 0.53 *** (0.45–0.63) | 0.51 *** (0.42–0.61) | 1.10 (0.79–1.52) | 0.54 *** (0.45–0.65) |
Age 60+ | 0.27 *** (0.22–0.33) | 0.23 *** (0.18–0.29) | 1.44 (0.91–2.28) | 0.30 *** (0.24–0.37) |
Ethno-racial background | ||||
Non-White | 0.77 *** (0.66–0.91) | 1.10 (0.92–1.30) | 1.07 (0.78–1.47) | 0.48 *** (0.41–0.58) |
Marital status | ||||
Separated/divorced/widowed | 1.60 *** (1.23–2.07) | 1.46 *** (1.10–1.94) | 1.77 ** (1.07–2.95) | 1.59 *** (1.20–2.11) |
Married | 1.19 (1.00–1.42) | 1.08 (0.89–1.31) | 1.44 ** (1.04–1.99) | 1.34 *** (1.11–1.62) |
Marital status not stated | 1.85 (0.96–3.57) | 2.25 ** (1.07–4.74) | 2.21 (0.54–9.09) | 1.87 (0.91–3.84) |
Living area | ||||
Urban | 1.26 ** (1.01–1.56) | 1.11 (0.88–1.40) | 1.37 (0.91–2.06) | 1.40 *** (1.11–1.78) |
Suburban | 1.07 (0.85–1.34) | 0.92 (0.72–1.17) | 1.38 (0.91–2.10) | 1.21 (0.95–1.55) |
Income | ||||
Income: $40,000–$79,999 | 1.24 (0.97–1.59) | 0.91 (0.69–1.20) | 1.32 (0.86–2.03) | 1.51 *** (1.17–1.96) |
Income: $80,000–$119,999 | 1.41 *** (1.09–1.82) | 0.93 (0.70–1.23) | 2.06 *** (1.28–3.32) | 1.89 *** (1.44–2.48) |
Income: $120,000+ | 1.06 (0.81–1.38) | 0.65 *** (0.48–0.87) | 2.01 *** (1.20–3.37) | 1.59 *** (1.20–2.12) |
Income not stated | 0.51 *** (0.36–0.71) | 0.35 *** (0.25–0.51) | 0.78 (0.45–1.35) | 0.64 ** (0.45–0.90) |
Employment | ||||
Unemployed | 0.74 *** (0.59–0.92) | 0.79 ** (0.62–1.00) | 0.96 (0.63–1.46) | 0.69 *** (0.54–0.88) |
Other impacts on employment | 1.04 (0.73–1.49) | 1.15 (0.78–1.70) | 1.46 (0.70–3.03) | 0.90 (0.61–1.33) |
Educational attainment | ||||
High school | 0.96 (0.73–1.25) | 1.00 (0.75–1.33) | 0.95 (0.59–1.53) | 0.89 (0.67–1.18) |
College | 1.01 (0.81–1.27) | 0.97 (0.76–1.24) | 1.19 (0.78–1.81) | 1.06 (0.83–1.36) |
University | 0.67 *** (0.54–0.82) | 0.58 *** (0.46–0.72) | 1.48 (1.00–2.20) | 0.75 ** (0.60–0.95) |
Education attainment not stated | 0.85 (0.33–2.17) | 0.84 (0.30–2.36) | 2.73 (0.27–27.93) | 0.77 (0.28–2.1) |
Survey waves | ||||
Wave 2 | 1.14 (0.84–1.56) | 1.07 (0.77–1.49) | 1.02 (0.56–1.87) | 1.26 (0.90–1.76) |
Wave 3 | 1.27 (0.93–1.72) | 1.20 (0.86–1.65) | 1.74 (0.90–3.35) | 1.37 (0.98–1.91) |
Wave 4 | 1.28 (0.94–1.74) | 1.18 (0.85–1.63) | 1.25 (0.67–2.31) | 1.43 ** (1.02–1.99) |
Wave 5 | 1.17 (0.85–1.60) | 1.19 (0.85–1.67) | 1.36 (0.72–2.56) | 1.11 (0.79–1.56) |
Wave 6 | 1.43 ** (1.06–1.93) | 1.48 ** (1.07–2.04) | 0.82 (0.46–1.44) | 1.44 ** (1.04–2.00) |
Wave 7 | 1.31 (0.97–1.78) | 1.38 (0.99–1.91) | 1.06 (0.58–1.94) | 1.32 (0.95–1.84) |
Wave 8 | 1.09 (0.80–1.50) | 1.05 (0.75–1.46) | 1.01 (0.55–1.87) | 1.20 (0.86–1.69) |
Wave 9 | 1.32 (0.97–1.80) | 1.29 (0.93–1.79) | 0.82 (0.46–1.47) | 1.43 ** (1.02–1.99) |
Constant | 0.21 *** (0.14–0.33) | 0.65 (0.41–1.03) | 1.03 (0.46–2.31) | 0.39 *** (0.25–0.63) |
Observations | 8990 | 5256 | 1187 | 4361 |
Pseudo R-squared | 0.06 | 0.08 | 0.05 | 0.08 |
Goodness-of-fit (Hosmer–Lemeshow), Chi 2 (p value) | 7.10 (0.53) | 7.40 (0.50) | 11.66 (0.17) | 8.36 (0.40) |
Anxiety | Depression | Loneliness | Heavy Episodic Drinking | |
---|---|---|---|---|
Alcohol–cannabis co-use | 1.93 *** | 1.96 *** | 1.87 *** | 7.58 *** |
(1.65–2.25) | (1.67–2.29) | (1.60–2.19) | (6.50–8.84) | |
Gender | ||||
Women | 1.42 *** | 1.37 *** | 1.34 *** | 0.78 *** |
(1.28–1.59) | (1.23–1.53) | (1.20–1.49) | (0.70–0.87) | |
Transgender and gender-diverse | 2.06 *** | 2.72 *** | 2.31 *** | 0.87 |
(1.21–3.50) | (1.61–4.60) | (1.37–3.92) | (0.48–1.59) | |
Age | ||||
Age 40–59 | 0.78 *** | 1.00 | 0.83 *** | 1.03 |
(0.69–0.88) | (0.88–1.13) | (0.74–0.95) | (0.91–1.17) | |
Age 60+ | 0.34 *** | 0.45 *** | 0.45 *** | 0.71 *** |
(0.29–0.40) | (0.39–0.53) | (0.39–0.53) | (0.61–0.82) | |
Ethno-racial background | ||||
Non White | 1.15 ** | 1.01 | 1.04 | 0.93 |
(1.02–1.29) | (0.89–1.13) | (0.92–1.17) | (0.83–1.05) | |
Marital status | ||||
Separated/divorced/widowed | 1.12 | 1.07 | 1.21 ** | 1.22 ** |
(0.92–1.36) | (0.89–1.29) | (1.01–1.44) | (1.01–1.48) | |
Married | 1.04 | 0.86 ** | 0.50 *** | 1.07 |
(0.91–1.18) | (0.75–0.97) | (0.44–0.56) | (0.94–1.22) | |
Living area | ||||
Urban | 1.13 | 1.12 | 1.02 | 0.96 |
(0.96–1.33) | (0.95–1.32) | (0.87–1.19) | (0.83–1.12) | |
Suburban | 1.07 | 1.03 | 0.94 | 1.01 |
(0.91–1.26) | (0.87–1.22) | (0.80–1.11) | (0.87–1.18) | |
Income | ||||
Income: $40,000–$79,999 | 0.77 *** | 0.68 *** | 0.74 *** | 1.36 *** |
(0.64–0.91) | (0.58–0.81) | (0.62–0.87) | (1.13–1.63) | |
Income: $80,000–$119,999 | 0.63 *** | 0.56 *** | 0.75 *** | 1.34 *** |
(0.52–0.76) | (0.46–0.67) | (0.62–0.89) | (1.10–1.62) | |
Income: $120,000+ | 0.57 *** | 0.42 *** | 0.51 *** | 1.53 *** |
(0.47–0.69) | (0.34–0.51) | (0.42–0.62) | (1.25–1.86) | |
Income not stated | 0.57 *** | 0.58 *** | 0.58 *** | 1.01 |
(0.47–0.70) | (0.47–0.70) | (0.48–0.71) | (0.82–1.25) | |
Employment | ||||
Unemployed | 1.81 *** | 1.74 *** | 1.68 *** | 1.31 *** |
(1.55–2.13) | (1.48–2.05) | (1.43–1.97) | (1.11–1.55) | |
Other impacts on employment | 1.24 | 1.23 | 1.21 | 1.05 |
(0.99–1.55) | (0.98–1.55) | (0.96–1.51) | (0.84–1.32) | |
Educational attainment | ||||
Post-secondary | 1.29 ** | 1.21 | 1.06 | 0.97 |
(1.05–1.58) | (0.99–1.48) | (0.87–1.29) | (0.80–1.18) | |
College | 1.14 | 1.02 | 0.94 | 0.96 |
(0.94–1.38) | (0.84–1.24) | (0.78–1.13) | (0.80–1.16) | |
University | 1.10 | 1.04 | 0.97 | 0.89 |
(0.92–1.31) | (0.87–1.23) | (0.82–1.14) | (0.75–1.05) | |
Wave 2 | 0.81 | 1.08 | 1.05 | 1.03 |
(0.66–1.01) | (0.87–1.36) | (0.85–1.31) | (0.83–1.28) | |
Wave 3 | 0.72 *** | 0.90 | 0.90 | 1.15 |
(0.58–0.89) | (0.72–1.13) | (0.72–1.12) | (0.93–1.43) | |
Wave 4 | 0.72 *** | 0.95 | 1.06 | 1.19 |
(0.58–0.90) | (0.75–1.19) | (0.85–1.32) | (0.96–1.47) | |
Wave 5 | 0.84 | 1.14 | 0.90 | 1.13 |
(0.67–1.04) | (0.91–1.43) | (0.72–1.13) | (0.91–1.40) | |
Wave 6 | 0.99 | 1.16 | 1.09 | 1.06 |
(0.80–1.22) | (0.93–1.45) | (0.88–1.36) | (0.86–1.32) | |
Wave 7 | 0.82 | 1.05 | 0.95 | 1.07 |
(0.66–1.01) | (0.84–1.31) | (0.76–1.18) | (0.86–1.33) | |
Wave 8 | 0.73 *** | 0.95 | 0.80 * | 1.19 |
(0.58–0.91) | (0.76–1.20) | (0.64–1.00) | (0.96–1.48) | |
Wave 9 | 1.04 | 1.20 | 1.14 | 1.04 |
(0.84–1.28) | (0.96–1.49) | (0.91–1.41) | (0.83–1.29) | |
Constant | 0.36 *** | 0.34 *** | 0.59 *** | 0.23 *** |
(0.27–0.49) | (0.25–0.46) | (0.45–0.79) | (0.17–0.32) | |
Observations | 8990 | 8990 | 8990 | 8976 |
Pseudo R-squared | 0.06 | 0.06 | 0.08 | 0.09 |
Goodness-of-fit (Hosmer–Lemeshow), Chi 2 (p value) | 5.74 (0.68) | 13.06 (0.11) | 8.37 (0.40) | 9.69 (0.29) |
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Somé, N.H.; Imtiaz, S.; Nigatu, Y.T.; Wells, S.; de Oliveira, C.; Ali, S.; Elton-Marshall, T.; Rehm, J.; Shield, K.D.; Hamilton, H.A. Co-Use of Alcohol and Cannabis During COVID-19: Associations Between Sociodemographic Factors and Self-Reported Mental Health Symptoms and Heavy Episodic Drinking in Canadian Adults. Psychoactives 2025, 4, 27. https://doi.org/10.3390/psychoactives4030027
Somé NH, Imtiaz S, Nigatu YT, Wells S, de Oliveira C, Ali S, Elton-Marshall T, Rehm J, Shield KD, Hamilton HA. Co-Use of Alcohol and Cannabis During COVID-19: Associations Between Sociodemographic Factors and Self-Reported Mental Health Symptoms and Heavy Episodic Drinking in Canadian Adults. Psychoactives. 2025; 4(3):27. https://doi.org/10.3390/psychoactives4030027
Chicago/Turabian StyleSomé, Nibene H., Sameer Imtiaz, Yeshambel T. Nigatu, Samantha Wells, Claire de Oliveira, Shehzad Ali, Tara Elton-Marshall, Jürgen Rehm, Kevin D. Shield, and Hayley A. Hamilton. 2025. "Co-Use of Alcohol and Cannabis During COVID-19: Associations Between Sociodemographic Factors and Self-Reported Mental Health Symptoms and Heavy Episodic Drinking in Canadian Adults" Psychoactives 4, no. 3: 27. https://doi.org/10.3390/psychoactives4030027
APA StyleSomé, N. H., Imtiaz, S., Nigatu, Y. T., Wells, S., de Oliveira, C., Ali, S., Elton-Marshall, T., Rehm, J., Shield, K. D., & Hamilton, H. A. (2025). Co-Use of Alcohol and Cannabis During COVID-19: Associations Between Sociodemographic Factors and Self-Reported Mental Health Symptoms and Heavy Episodic Drinking in Canadian Adults. Psychoactives, 4(3), 27. https://doi.org/10.3390/psychoactives4030027