The burden of disease attributable to cannabis use in Canada in 2012

Addiction. 2016 Apr;111(4):653-62. doi: 10.1111/add.13237. Epub 2016 Jan 5.


Background and aims: Cannabis use is associated with several adverse health effects. However, little is known about the cannabis-attributable burden of disease. This study quantified the age-, sex- and adverse health effect-specific cannabis-attributable (1) mortality, (2) years of life lost due to premature mortality (YLLs), (3) years of life lost due to disability (YLDs) and (4) disability-adjusted life years (DALYs) in Canada in 2012.

Design: Epidemiological modeling.

Setting: Canada.

Participants: Canadians aged ≥ 15 years in 2012.

Measurements: Using comparative risk assessment methodology, cannabis-attributable fractions were computed using Canadian exposure data and risk relations from large studies or meta-analyses. Outcome data were obtained from Canadian databases and the World Health Organization. The 95% confidence intervals (CIs) were computed using Monte Carlo methodology.

Findings: Cannabis use was estimated to have caused 287 deaths (95% CI = 108, 609), 10,533 YLLs (95% CI = 4760, 20,833), 55,813 YLDs (95% CI = 38,175, 74,094) and 66,346 DALYs (95% CI = 47,785, 87,207), based on causal impacts on cannabis use disorders, schizophrenia, lung cancer and road traffic injuries. Cannabis-attributable burden of disease was highest among young people, and males accounted for twice the burden than females. Cannabis use disorders were the most important single cause of the cannabis-attributable burden of disease.

Conclusions: The cannabis-attributable burden of disease in Canada in 2012 included 55,813 years of life lost due to disability, caused mainly by cannabis use disorders. Although the cannabis-attributable burden of disease was substantial, it was much lower compared with other commonly used legal and illegal substances. Moreover, the evidence base for cannabis-attributable harms was smaller.

Keywords: Burden of disease; Canada; cannabis; comparative risk assessment; disability-adjusted life years; marijuana; mortality; years of life lost due to disability; years of life lost due to premature mortality.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Canada / epidemiology
  • Cannabis / adverse effects*
  • Cost of Illness*
  • Disabled Persons / statistics & numerical data
  • Female
  • Humans
  • Life Expectancy*
  • Male
  • Middle Aged
  • Quality-Adjusted Life Years*
  • Young Adult