What proportion of people who use cannabis in Germany have spoken with their general practitioner about their consumption? A repeated cross-sectional representative population survey.

Introduction: On April 1st, 2024, Germany's cannabis legalisation bill entered into force. It is unknown what effect the legal changes could have, if any, on the prevalence of cannabis use. Preventive measures of cannabis-related health impacts are best possible if harmful use is recognised and addressed at an early stage. Our aim was to estimate the proportion of people who used cannabis in Germany that discussed their cannabis consumption with their general practitioner (GP), on the initiative of either the GP or the patient, and how these varied according to person characteristics.

Methods: We used data from the German Study on Tobacco Use (DEBRA). This is a repeated ongoing representative cross-sectional household survey on the use of tobacco and alternative nicotine delivery systems in Germany in people aged 14 years and older. In bi-monthly study waves we asked all respondents who stated that they had consumed cannabis before whether they had ever spoken with their GP about their cannabis use or received advice about it. We estimated the proportion including 95% confidence intervals and assessed possible associations with person characteristics using univariate logistic regression models.

Results: Of 2,057 people who have ever used cannabis, 7.0% [95%CI = 5.9; 8.2%] (n = 139) reported having spoken to their general practitioner about their cannabis use or having sought advice in this regard. This response was associated with older age (65 +), low educational attainment, low income and frequent cannabis use. Conversation with a GP was also more common among people who had used cannabis in the past year (16.2%; 95%CI = 13.5; 19.6%).

Conclusions: Around one in fifteen people who have used cannabis before has ever spoken with his or her GP, or received advice, about his or her cannabis consumption. In people with past-year and especially frequent use, the proportions are highest, ranging between 16 to 26%. The awareness of this topic among GPs needs to be increased. Furthermore, a future re-evaluation of what impact cannabis legalisation will have on the frequency of consultation about cannabis consumption in primary care is necessary.