Substance Use
Causal decomposition to explore disparities in cannabis-Impaired Driving: A Sociodemographic and Behavioural Analysis Based on the Canadian Automobile Association (CAA) Surveys in Ontario, 2021-2023 Renzo Calderon Anyosa* Renzo Calderon Anyosa Robert Colonna Christine M. Wickens Michael Stewart Brice Batomen
Objective: To assess the influence of behavioral and sociodemographic characteristics on the prevalence of driving under the influence of cannabis (DUIC) in Ontario, identifying modifiable factors that account for prevalence disparities across demographic characteristics such as age, gender, and education.
Methods: Utilizing ‘Drug Impaired Driving’ survey data from 2021-2023, provided by the Canadian Automobile Association, we targeted English-speaking Ontario residents, aged 19-75, who consume cannabis and hold a valid driver’s license. The main outcome was DUIC prevalence by demographic and behavioral characteristics. Causal decomposition analysis was applied to further our understanding of why certain demographic groups, demonstrate higher levels of DUIC prevalence, focusing on behavioral mediators including perceptions of impaired driving, concerns regarding cannabis edibles, general cannabis concerns, and concerns related to alcohol consumption.
Results: The Lifetime DUIC prevalence of 27.3%, with annual rates of 13.1% in 2021, 12.6% in 2022, and 18.0% in 2023 among the 1,897 participants. Higher DUIC prevalences were elevated among men, individuals under 35, those with secondary education or less, widowed persons, those with an income under $49,999, and daily cannabis users. Those less concerned about the impact of cannabis-impaired driving on their own safety and that of their loved ones had a higher past 12-month DUIC prevalence. Individuals believing that cannabis-impaired driving had no worse effect or was better than non-impaired driving had a higher DUIC prevalence. These patterns persisted over the survey years.
The causal decomposition identified the perception of cannabis-impaired driving as safer or benign as the primary factor in the DUIC prevalence disparity by gender, education, and age, accounting for 40%-60% of the existing prevalence differences.
Conclusion: The study identifies key demographics with higher DUIC prevalence, suggesting the need for focused intervention and policy reform. Although sociodemographic aspects are relevant, the perceptions of cannabis’s effects on driving emerge as the main driver of existing disparities. Comprehensive strategies, including tailored interventions to impaired driving perceptions, are recommended to address DUIC.
