Currently, boys and men use cannabis at higher rates than girls and women, but the gender gap is narrowing. With the legalization of recreational cannabis use in Canada and in multiple US states, these trends call for urgent attention to the need to consider how gender norms, roles and relations influence patterns of cannabis use to inform health promotion and prevention responses. Based on a scoping review on sex, gender and cannabis use, this article consolidates existing evidence from the academic literature on how gender norms, roles and relations impact cannabis-use patterns. Evidence is reviewed on: adherence to dominant masculine and feminine norms and cannabis-use patterns among adolescents and young adults, and how prevailing norms can be both reinstated or reimagined through cannabis use; gendered social dynamics in cannabis-use settings; and the impact of gender roles and relations on cannabis use among young adults of diverse sexual orientations and gender identities. Findings from the review are compared and contrasted with evidence on gender norms, roles and relations in the context of alcohol and tobacco use. Recommendations for integrating gender transformative principles in health promotion and prevention responses to cannabis use are provided.
Cannabis is the second most frequently used substance in the world and regulated or legalized for recreational use in Canada and fourteen US states and territories. As with all substances, a wide range of sex and gender related factors have an influence on how substances are consumed, their physical, mental and social impacts, and how men and women respond to treatment, health promotion, and policies. Given the widespread use of cannabis, and in the context of its increasing regulation, it is important to better understand the sex and gender related factors associated with recreational cannabis use in order to make more precise clinical, programming, and policy decisions. However, sex and gender related factors include a wide variety of processes, features and influences that are rarely fully considered in research. This article explores myriad features of both sex and gender as concepts, illustrates their impact on cannabis use, and focuses on the interactions of sex and gender that affect three main areas of public interest: the development of cannabis use dependence, the impact on various routes of administration (ROA), and the impact on impaired driving. We draw on two separate scoping reviews to examine available evidence in regard to these issues. These three examples are described and illustrate the need for more comprehensive and precise integration of sex and gender in substance use research, as well as serious consideration of the results of doing so, when addressing a major public health issue such as recreational cannabis use.
1 December 2017 in Sexual & Reproductive Healthcare
Pregnancy is often framed as a "window of opportunity" for intervening on a variety of health practices such as alcohol and tobacco use. However, there is evidence that interventions focusing solely on the time of pregnancy can be too narrow and potentially stigmatizing. Indeed, health risks observed in the preconception period often continue during pregnancy. Using a scoping review methodology, this study consolidates knowledge and information related to current preconception and interconception health care interventions published in the academic literature. We identified a total of 29 intervention evaluations, and summarized these narratively. Findings suggest that there has been some progress in intervening on preconception health, with the majority of interventions offering assessment or screening followed by brief intervention or counselling. Overall, these interventions demonstrated improvements in at least some of the outcomes measured. However, further preconception care research and intervention design is needed. In particular, the integration of gender transformative principles into preconception care is needed, along with further intervention design for partners/ men, and more investigation on how best to deliver preconception care.
Pregnancy is a key time to leverage receptivity to smoking reduction or cessation in both pregnant women and their partners. A partner’s smoking status and support for the pregnant/postpartum woman’s efforts to reduce or quit smoking may impact her smoking behavior. A systematic literature review of interventions to enhance partner support for pregnant/postpartum women’s smoking reduction or cessation and cessation treatments for the partners themselves identified 855 unique references, which were examined for relevance, yielding 9 intervention studies. This narrative review analyzed a range of interventions including mass media campaigns, ultrasound scans, video, self-help manuals, counselling, and nicotine replacement therapies (NRTs) aimed at pregnant women and/or their partners. One randomized controlled trial (RCT) showed significant results for an intervention, which included a partner-targeted component in which pregnant women received health counselling, video and printed information, while partners received a booklet explaining the importance of quitting together. Three studies (1 RCT cluster, 1 pre–post test, 1 RCT) demonstrated no effect in improving smoking cessation among pregnant women. Two RCTs included free NRTs, telephone counselling, and multiple contacts as components of effective intervention for male partners, but impact on overall quit rates may not be sustainable postpartum. Seven studies (4 pre–post test, 2 RCT, 1 RCT cluster) found no effect of the intervention on partner smoking cessation. Despite the importance of partner smoking, there are very few effective smoking cessation interventions for pregnant/postpartum women that include or target male partners, suggesting the need for further intervention development and research to establish the utility of this approach.
Background. National data from Canada and the United States identify women to be at greater risk than men for the misuse of prescription opioid medications. Various sex- and gender-based factors and patient and physician practices may affect women’s use and misuse of prescription opioid drugs.Objectives. To explore the particular risks, issues, and treatment considerations for prescription opioid misuse among women who experience chronic noncancer pain and trauma.Methods. A scoping review for articles published between January 1990 and May 2014 was conducted on sex- and gender-based risks and treatment considerations among women who experience chronic noncancer pain and trauma.Results. A total of 57 articles were identified. The present narrative review summarizes the specific risks for the misuse of prescription opioid medication among women who have experienced violence and trauma, Aboriginal women, adolescents and young women, older women, pregnant women, women of a sexual minority, and transwomen.Discussion. The majority of the literature is descriptive, with few studies that evaluate approaches and interventions to respond to the issue of chronic pain, trauma, and misuse of prescription opioids among women, particularly vulnerable subgroups of women.Conclusions. Trauma-informed and women-centred approaches that address women’s vulnerabilities and complex needs require further attention.
Aims: To examine existing evidence on the effectiveness of interventions that are designed to prevent the illegal sale of tobacco to young people. The review considers specific sub-questions related to the factors that might influence effectiveness, any differential effects for different sub-populations of youth, and barriers and facilitators to implementation. Methods: A review of studies on the impact of interventions on young people under the age of 18 was conducted. It included interventions that were designed to prevent the illegal sale of tobacco to children and young people. The review was conducted in July 2007, and included 20 papers on access restriction studies. The quality of the papers was assessed and the relevant data was extracted. Results: The evidence obtained from the review indicates that access restriction interventions may produce significant reductions in the rate of illegal tobacco sales to youth. However, lack of enforcement and the ability of youth to acquire cigarettes from social sources may undermine the effectiveness of these interventions. Conclusions: When access interventions are applied in a comprehensive manner, they can affect young people’s access to tobacco. However, further research is required to examine the effects of access restriction interventions on young people’s smoking behaviour.