Prevalence of and Factors Associated With Substance Use Among Canadian Medical Students

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the national prevalence of tobacco, alcohol, cannabis, and nonmedical prescription stimulant (NPS) use among Canadian medical students.Furthermore, we explored whether substance use varied by medical student demographics and was associated with psychological morbidity. MethodsThis cross-sectional study was conducted using an electronic survey of medical students across all 17 Canadian medical schools.Reporting followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) reporting guideline.The University of British Columbia institutional review board approved this study, and participants supplied written informed consent.Detailed methods have been previously published 5 and are included the eAppendix in the Supplement.We purposively sampled all Canadian medical students from all years of study: a target population of 11 469.We recruited participants during 2 preplanned waves: November 30 to December 14, 2015 (n = 2981), and February 14 to March 1, 2016 (n = 1457).We analyzed data for the current study between February and July 2021.Primary outcomes included the prevalence of alcohol, tobacco, cannabis, and NPS use.We conducted logistic regression models and computed odds ratios (ORs) using R statistical software version 3.5.3(R Project for Statistical Computing).Significance was set at P < .05,using 2-sided χ 2 tests to detect significant associations. ResultsWe analyzed 4438 valid surveys from the 11 469 students who received the survey, giving a participation rate of 40.2%.Participant characteristics have been previously described.5 Among 4438 respondents, 2857 (64.3%) were female; the mean (SD) age was 24.2 (3.5) years.The lifetime self-reported prevalence rates were 45.6% (95% CI, 44.0%-47.2%)for cannabis, 8.3% (95% CI, 7.4%-9.2%)for NPS, and 6.8% (95% CI, 5.9%-7.7%)for cigarettes; past-month excessive alcohol use was 46.4% (95% CI, 44.8%-48.1%)(Table 1).In multivariable logistic regression, we found that male sex was associated with greater self-reported prevalence rates of all 4 substances (excessive alcohol: OR, 1.66; 95% CI, 1.44-1.91;current cigarette use: OR, 2.31; 95% CI, 1.71-3.11;cannabis in past 12 months: OR, 1.41; 95% CI, 1.19-1.69;NPS in past 12 months: OR, 1.72; 95% CI, 1.22-2.42).Lower age was associated with self-reported cannabis use in the past 12 months (OR, 0.95; 95% CI, 0.93-0.97)and excessive alcohol use (OR, 0.96; 95% CI, 0.94-0.98),whereas older students were more likely to self-report cigarette use (OR, 1.17; 95% CI, 1.14-1.21)(Table 2).There was no significant association between self-reported substance use and mood or anxiety disorders.However, students with higher psychological distress were more likely to report excessive + Supplemental content

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