Global temporal and regional trends in cannabis use among medical students: a systematic review and meta-analysis

Given the interest in the potential effects of cannabis on medical students, this study aims to establish the prevalence of recreational use within this population. We searched MEDLINE, LILACS, PubMed, Embase, PsycINFO/PsycArticles/APA Books), and SciELO for observational studies published before June 9, 2025, that reported cannabis use prevalence among medical students. We conducted subgroup analyses based on gender, study cycle, school type, decade of publication, and world region. Data were pooled using a random-effects model. Our search identified 109 studies meeting the inclusion criteria, published between 1971 and 2025, encompassing data from 62,444 participants from 32 countries. Lifetime prevalence was 29.2%, past year 20.5%, past month 9.2%, and past week 5.1%. Global prevalence declined from 38.4% in the 1970s (95% CI 19.2-57.7) to 18.1% in the 2000s (95% CI 13.6-23.8), increased to 30.4% in the 2020s (95% CI 19.2-41.6), driven by trends in Latin America, Asia, and Africa. The lowest prevalence was in Asia (11.5%, 95% CI 07.1-15.8) and the highest in Anglo-Saxon America (59.7%, 95% CI 53.1-66.3). Cannabis use is prevalent among medical students, with increasing trends and regional variations. Targeted interventions are needed to raise awareness of associated risks.