Global temporal and regional trends in cannabis use among medical students: a systematic review and meta-analysis

Abstract

Objective:  Given the interest in the potential effects of cannabis on medical students, this study aimed to establish the prevalence of recreational use in this population.

Methods:  We searched MEDLINE, LILACS, PubMed, Embase, PsycINFO/PsycArticles/APA Books, and SciELO for observational studies published before June 9, 2025 on the reported prevalence of cannabis use among medical students. We conducted subgroup analyses based on sex, study cycle, school type, decade of publication, and world region. Data were pooled using a random-effects model.

Results:  Our search identified 109 studies meeting the inclusion criteria, published between 1971 and 2025, encompassing data from 62,444 participants in 32 countries. The lifetime prevalence was 29.2%, 20.5% in the past year, 9.2% in the past month, and 5.1% in the past week. The global prevalence decreased from 38.4% in the 1970s (95%CI 19.2-57.7) to 18.1% in the 2000s (95%CI 13.6-23.8) and increased again to 30.4% in the 2020s (95%CI 19.2-41.6), driven by trends in Latin America, Asia, and Africa. The lowest prevalence was in Asia (11.5%, 95%CI 07.1-15.8) and the highest was in the U.S. and Canada (59.7%, 95%CI 53.1-66.3).

Conclusion:  Cannabis use is prevalent among medical students, with an increasing trend and regional variations. Targeted interventions are needed to raise awareness of the associated risks.

Systematic review registration:  PROSPERO, CRD42021272280

Keywords:
Cannabis; medical students; epidemiology; substance use