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Associations Between Marijuana Use and Involuntary Job Loss in the United States

Representative Longitudinal and Cross-Sectional Samples

Okechukwu, Cassandra A., ScD, MSN; Molino, Janine, MS, PhD; Soh, Yenee, MS

Journal of Occupational and Environmental Medicine: January 2019 - Volume 61 - Issue 1 - p 21–28
doi: 10.1097/JOM.0000000000001463

Objective: To investigate whether marijuana use is associated with involuntary job loss.

Methods: Multivariable survey logistic analysis of longitudinal (2001 to 2002/2003 to 2004) and cross-sectional data (2012 to 2013) from National Epidemiologic Survey on Alcohol and Related Conditions (NESARC).

Results: Marijuana use increased for all user groups with most workers who use marijuana using marijuana monthly (2.7% in 2001 to 2002 and 10.8% in 2012 to 2013). Past year marijuana users in 2001 to 2002 had higher odds of involuntary job loss in 2003 to 2004 (odds ratio [OR] 1.27; 95% confidence interval [CI] 1.13 to 1.41). Daily marijuana use is associated with higher odds of job loss in adjusted analyses using longitudinal (OR 2.18; 95%CI 1.71 to 2.77) and cross-sectional data (OR 1.40; 95%CI 1.06 to 1.86). Income significantly modifies these effects.

Conclusions: Findings indicate that job loss may be an overlooked social cost of marijuana use for US workers. Future studies using an occupational health perspective are needed.

Harvard T.H. Chan School of Public Health, Boston, Massachusetts (Dr Okechukwu, Ms Soh); Brown University School of Public Health, Providence, Rhode Island (Dr Molino).

Address correspondence to: Cassandra A. Okechukwu, ScD, MSN, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115; MITRE, 7515 Colshire Drive, Mclean, VA (

Funding: This work was supported by the National Institute on Drug Abuse: R03DA038697.

Conflict of Interest: None.

Copyright © 2019 by the American College of Occupational and Environmental Medicine