Impact of Medical Marijuana Laws on State-Level Marijuana Use by Age and Gender, 2004–2013

  • Christine M. Mauro
  • Paul Newswanger
  • Julian Santaella-Tenorio
  • Pia M. Mauro
  • Hannah Carliner
  • Silvia S. Martins


In states that have passed medical marijuana laws (MMLs), marijuana use (MU) increased after MML enactment among people ages 26 and older, but not among ages 12–25. We examined whether the age-specific impact of MMLs on MU varied by gender. Data were obtained from the 2004–2013 restricted-use National Survey on Drug Use and Health, aggregated at the state level. The exposure was a time-varying indicator of state-level MML (0 = No Law, 1 = Before Law, 2 = After Law). Outcomes included past-month MU prevalence, daily MU prevalence among past-year users (i.e., 300+ days/year), and past-year marijuana use disorder (MUD) prevalence. Linear models tested the state-level MML effect on outcomes by age (12–17, 18–25, 26+) and gender. Models included a state-level random intercept and controlled for time- and state-level covariates. Past-month MU did not increase after enactment of MML in men or women ages 12–25. Among people 26+, past-month MU increased for men from 7.0% before to 8.7% after enactment (+ 1.7%, p < 0.001) and for women from 3.1% before to 4.3% after enactment (+ 1.1%, p = 0.013). Among users 26+, daily MU also increased after enactment in both genders (men 16.3 to 19.1%, + 2.8%, p = 0.014; women 9.2 to 12.7%, + 3.4%, p = 0.003). There were no statistically significant increases in past-year MUD prevalence for any age or gender group after MML enactment. Given the statistically significant increase in daily use among past-year users aged 26+ following enactment, education campaigns should focus on informing the public of the risks associated with regular marijuana use.


Medical marijuana laws Cannabis Gender Marijuana use 



Medical marijuana laws


Marijuana use


Marijuana use disorder


Funding information

This work was supported by the National Institutes of Health, National Institute on Drug Abuse (grant R01 DA037866 to S. S. Martins). Santaella-Tenorio is funded by the J. William Fulbright and the Colciencias doctoral scholarships. P. Mauro is funded through training grant T32 DA031099 (PI: Hasin).

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent is not applicable as this was considered non-human subject research by Columbia University’s IRB.

Supplementary material

11121_2017_848_MOESM1_ESM.docx (16 kb)
ESM 1 (DOCX 16 kb)


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Copyright information

© Society for Prevention Research 2017

Authors and Affiliations

  1. 1.Department of BiostatisticsColumbia UniversityNew YorkUSA
  2. 2.Department of Sociomedical SciencesColumbia UniversityNew YorkUSA
  3. 3.Department of EpidemiologyColumbia UniversityNew YorkUSA
  4. 4.New York State Psychiatric InstituteNew YorkUSA

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