Mental Health, Cannabis Use Motives, and Cannabis Use Disorder: A Path Analysis From a Swiss Regulated Cannabis Cohort
1
Addiction Psychiatry, University of Geneva, Geneva, Switzerland
Popul. Med. 2026;8(Supplement Supplement 1):A2835
ABSTRACT
BACKGROUND:
Understanding pathways leading from cannabis use to cannabis use disorder (CUD) is a key public health challenge. Beyond consumption patterns alone, mental health and use motives—particularly coping-related motives—may play a central role in the development of problematic use. Clarifying these relationships is essential to inform prevention strategies within regulated cannabis frameworks.
METHODS:
We analyzed baseline data from a three-year longitudinal cohort embedded in the Geneva regulated cannabis distribution project. The sample comprised 698 adult regular cannabis users recruited through a legally regulated access point. Health status was assessed using the Short Form-20 Health Survey (SF-20), cannabis use motives with the Marijuana Motives Measure (MMM), and problematic use with the Cannabis Use Disorders Identification Test–Revised (CUDIT-R). Path analysis with maximum likelihood estimation examined direct and indirect associations between health dimensions, cannabis use motives, and CUD severity, with standard model-fit indices and bootstrap procedures applied.
RESULTS:
Across models, the SF-20 Mental Health dimension was the only health variable consistently associated with CUD severity. Better mental health was directly linked to lower CUDIT-R scores and indirectly linked to reduced CUD severity through lower endorsement of cannabis use motives, including coping, enhancement, social, conformity, and expansion. Other health dimensions (physical functioning, pain, role and social functioning) were not significantly associated with CUD severity.
CONCLUSIONS:
Mental health appears to be a central driver of cannabis use motives and the risk of cannabis use disorder. From a public health perspective, these findings suggest that improving mental health may be more effective in preventing problematic cannabis use than interventions focusing solely on consumption patterns. Integrating mental health promotion into regulated cannabis policies could therefore strengthen prevention efforts and reduce CUD burden at the population level.
Understanding pathways leading from cannabis use to cannabis use disorder (CUD) is a key public health challenge. Beyond consumption patterns alone, mental health and use motives—particularly coping-related motives—may play a central role in the development of problematic use. Clarifying these relationships is essential to inform prevention strategies within regulated cannabis frameworks.
METHODS:
We analyzed baseline data from a three-year longitudinal cohort embedded in the Geneva regulated cannabis distribution project. The sample comprised 698 adult regular cannabis users recruited through a legally regulated access point. Health status was assessed using the Short Form-20 Health Survey (SF-20), cannabis use motives with the Marijuana Motives Measure (MMM), and problematic use with the Cannabis Use Disorders Identification Test–Revised (CUDIT-R). Path analysis with maximum likelihood estimation examined direct and indirect associations between health dimensions, cannabis use motives, and CUD severity, with standard model-fit indices and bootstrap procedures applied.
RESULTS:
Across models, the SF-20 Mental Health dimension was the only health variable consistently associated with CUD severity. Better mental health was directly linked to lower CUDIT-R scores and indirectly linked to reduced CUD severity through lower endorsement of cannabis use motives, including coping, enhancement, social, conformity, and expansion. Other health dimensions (physical functioning, pain, role and social functioning) were not significantly associated with CUD severity.
CONCLUSIONS:
Mental health appears to be a central driver of cannabis use motives and the risk of cannabis use disorder. From a public health perspective, these findings suggest that improving mental health may be more effective in preventing problematic cannabis use than interventions focusing solely on consumption patterns. Integrating mental health promotion into regulated cannabis policies could therefore strengthen prevention efforts and reduce CUD burden at the population level.
| eISSN: | 2654-1459 |
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