Illicit cannabis use among workers in Australia: A nationally representative cross-sectional analysis of prevalence, determinants, and associated absenteeism

Cannabis is the most used illicit substance among workers in Australia, yet the epidemiology of frequent use and risk of harm remains underexplored. This study investigated the prevalence and determinants of, as well as absenteeism associated with, weekly illicit cannabis use and risk of cannabis-related harm among Australian workers. The study used data from the 2019 and 2022–23 National Drug Strategy Household Surveys (N = 24,954). Weekly cannabis use was reported by 5.0% (SE = 0.2) of respondents, while 2.2% (SE = 0.1) were classified as at risk of harm. Workers in construction and hospitality, as well as labourers and tradesmen, exhibited elevated rates of use and harm. Significant determinants of weekly illicit cannabis use identified in multivariate regression models include being male, younger (14–39 years), never married, born in Australia, smoking (current or former), and heavy episodic drinking (HED). Determinants of being at risk of harm were being male, never married, born in Australia, residing in a major city, experiencing psychological distress, smoking (current or former), and HED. Being a current smoker displayed the strongest associations with both outcome measures. Weekly illicit cannabis use and being at risk of harm were associated with 2.8 and 6.9 additional days absent from work due to illness or injury, respectively. By identifying the determinants and consequences of frequent illicit cannabis use and being at risk of harm among employed individuals, these findings provide key insights necessary to develop targeted behavioural change and workplace substance use interventions. • 5.0% of employed Australians reported weekly illicit cannabis use, and 2.2% were at risk of cannabis-related harm due to their weekly use. • Workers in construction and hospitality industries and occupations such as labourers and technicians/trades exhibited the highest prevalence of weekly use and risk of harm. • Smoking status was the strongest determinant, with current smokers having nearly 10 times higher odds of weekly use and 17 times higher odds of risk of harm. • Weekly use and being at risk of cannabis-related harm were associated with approximately 2.8 and 6.9 additional days absent annually, respectively.