Cannabis Use Among Veterans Versus Non-Veterans in the USA, 2016-2023: A Cross-Sectional Analysis.

Abstract

Veterans have a unique health profile and risk for substance use, but few studies compare cannabis use patterns among US military Veterans and non-veteran civilians. To examine differences in age-specific patterns, modes of use, and sociodemographic correlates of cannabis use between Veterans and non-Veterans. We conducted a cross-sectional analysis of Behavioral Risk Factor Surveillance System data from 2016 to 2023. The analytic sample included 907,136 adults aged 18 to 80 years with complete data on self-reported veteran status and cannabis use. Primary outcomes were past 30-day cannabis use (yes/no), frequency of use in the past 30 days, and inhalational vs. non-inhalational use methods. Multivariable logistic regressions were used to assess sociodemographic and behavioral correlates of cannabis use. Analyses were conducted from March to June 2025. Among participants, 114,193 (12.6%) were Veterans. Although overall cannabis use was lower among Veterans than non-Veterans, age-specific patterns differed. Veterans aged 50-64 years were 43% (95% CI, 28-59%) more likely to report cannabis use than non-Veterans, and those aged 65-80 were 22% (95% CI, 9-37%) more likely. Older Veterans also reported more frequent cannabis use in the past 30 days (mean 18.4 versus 15.8 days among those aged 50-64 years; 17.3 vs. 14.5 days among those aged 65-80 years). Inhalational use was more common among Veterans than non-Veterans (90.0%; 95% CI, 87.8-91.9% vs. 83.7%; 95% CI, 82.5-84.9%). Some correlates of cannabis use were shared across groups; however, educational attainment was differentially associated with cannabis use by veteran status. Veterans aged ≥ 50 years were more likely to report cannabis use and used it more frequently than their non-veteran peers, suggesting they may need tailored interventions to address cannabis use.