Exploring perceived gender norms about cannabis among treatment-seeking adults in the era of cannabis legalization in Canada: A qualitative analysis

Abstract

Introduction

Prevalence of cannabis use has historically been higher among men than among women, yet the past few decades have seen a significant narrowing of this gender gap. The narrowing gender gap is likely attributable to multiple factors, including global and regional shifts in gender norms related to cannabis, which may be influenced by legalization of recreational cannabis use in many countries, including in Canada where the present study took place. The goal of this study was to explore perceived gender norms about cannabis use and how these norms might influence behavior.

Methods

We conducted in-depth, one-to-one interviews with a sample of 23 adults in Toronto, Ontario, Canada who had been in treatment for cannabis-related harms. We used the Braun & Clarke method of reflexive thematic analysis and a theoretical framework grounded in Connell's masculinities science and more recent critical femininities scholarship to explore perceived gender norms about cannabis. In particular, we were interested in how perceived norms might influence behavior and how an understanding of changing norms can contribute to developing gender-responsive or gender-transformative interventions for cannabis use disorder (CUD).

Results

Our analysis generated three main themes. Masculine Dominance of Cannabis Use demonstrates the social construction of recreational cannabis use (especially smoking cannabis) as a dominant masculine behavior. Cannabis Use as Deviation from Femininity demonstrates how increased stigma and social harms experienced by women and gender-diverse people is accomplished by framing their cannabis use as inauthentic and deviant. Finally, Rejecting and Reconfiguring Gender Norms about Cannabis suggests challenges to masculine dominance of cannabis use and how cannabis legalization may have catalyzed this process (possibly by increasing visibility of women using cannabis).

Conclusions

Our results suggest that gender continues to play a meaningful role in determining social cannabis norms, though relationships between gender and cannabis norms are clearly changing, possibly in connection to legalization of non-medical cannabis use. We end by discussing implications for treatment (e.g., norm-based interventions to encourage treatment-seeking among men) and public health (e.g., normalizing women's and gender-diverse people's cannabis use may reduce sociocultural harms associated with cannabis use).