Attitudes Toward Marijuana Use Among Public University Students in Tehran

Background: Substance use is a global mental health issue and a significant challenge in many countries. As reported by the United Nations, marijuana had the highest production, trafficking, and consumption rates in 2022. Attitudes play a crucial role in influencing substance use, including marijuana. Examining attitudes can help predict individuals’ readiness for consumption, and established attitudes can shape their behavior. Objectives: This study aimed to investigate the prevalence of lifetime marijuana use and attitudes regarding perceived harms, benefits, addictiveness, and reasons for use among students from Tehran universities. Additionally, it seeks to explore gender differences in these attitudes. Methods: This cross-sectional survey was conducted between June 2021 and January 2022 among 538 students from Tehran universities, comprising 44% men and 55.6% women. The sample size of 538 individuals was selected using convenience sampling. Lifetime marijuana use was self-reported, and attitudes were assessed using a validated marijuana attitude questionnaire rated on a 4-point Likert scale. Gender differences were analyzed using descriptive statistics and chi-square tests. Results: Overall, 17.5% of participants reported lifetime marijuana use, with a significantly higher prevalence among males (25%) compared to females (10.37%; P < 0.05). Most students (86%) considered marijuana to be addictive, especially females (92%) compared to males (78%) (χ2 = 17.6; P < 0.05). A larger proportion of females (74%) than males (58%) believed that marijuana was difficult to control (χ2 = 10.08; P < 0.05). While 93.5% acknowledged the existence of side effects, more males (39%) perceived benefits from marijuana use compared to females (28%; P < 0.05). The reported benefits included feelings of happiness (53%), stress and anxiety reduction (50%), and improved concentration (38%). Conclusions: The study revealed that both female and male students perceived marijuana use as equally harmful. However, female students exhibited a more negative attitude toward marijuana use compared to their male counterparts. Specifically, female students considered marijuana to be more addictive (92% vs 78% in males; χ2 = 17.6; P = .001) and harder to control (74% vs 58% in males; χ2 = 10.08; P = .001) than male students. This more negative attitude among female students regarding marijuana’s addictiveness, side effects, and controllability corresponded to lower actual usage rates (10.37% vs 25% in males), suggesting that their negative attitudes may act as a deterrent. It seems the existence of a more negative attitude toward marijuana in females makes them less inclined to use it, potentially having a protective role. Conversely, male students reported higher usage rates alongside a more positive attitude toward marijuana.