Abstract

Introduction: The associations between marijuana use and various health-related behaviors, including receipt of preventive health services, have not been widely examined. Hypothesis: Given the known adverse cognitive effects of tetrahydrocannabinol (THC), we hypothesized that current marijuana users were less likely than non-users to receive recommended preventive health services. Methods: The Behavioral Risk Factor Surveillance System (BRFSS) is an ongoing telephone survey that collects data on health-related risk behaviors, chronic health conditions, and use of preventive services by non-institutionalized U.S. adults ≥18 years of age from the 50 U.S. states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, Guam, American Samoa, and Palau. In 2017, there were 10 U.S. states that administered the BRFSS Marijuana Module. We identified survey respondents that were eligible for receipt of each recommended preventive health service. Using chi square statistics, we examined the rates of receipt of recommended preventive services among eligible users compared to non-users in these 10 states. Results: In 2017, among 45,655,241 participants, 10.7% used marijuana in the past 30 days, and 69.3% of those used it daily. The predominant method of marijuana use was smoking (90.4%). Compared to non-users, marijuana users were more likely to be 18-29 years of age (39.7% vs 17.4%, p<0.0001) and male (61.6% vs 46.4%, p<0.0001). Marijuana users were less likely to be Hispanic (18.2% vs 21.5%) or Asian, Native Hawaiian, or Pacific Islander (5.3% vs 9.5%) compared to non-users (p<0.0001). Participants who used marijuana were more likely to be employed (63.8% vs 56%) and to have graduated high school (28.8% vs 24.8%) compared to those who did not use marijuana (p<0.0001). Marijuana users were less likely than non-users to be married (27.9% vs 54%, p<0.0001). Among all participants, fewer marijuana users than non-users received an influenza vaccination within the past year (25.4% vs 41.5%, p<0.0001). Additionally, among age-eligible participants, those who used marijuana were less likely to have received serum cholesterol screenings in the past five years (79.5% vs 83%) and regularly take aspirin as a method of cardiovascular risk reduction (36.6% vs 44.9%) compared to non-users (p<0.0001). Among participants with diabetes, fewer marijuana users received an eye examination (48.8% vs 57.8%) or an influenza vaccination (35.9% vs 56.9%) within the last year compared to non-users (p<0.0001). Conclusion: Marijuana users were less likely to receive an influenza vaccination and preventive services recommended for cardiovascular risk reduction. Users may need more targeted interventions to receive needed care.

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