Global health. The current scenario and future perspectives

216 Since 2018, four studies have been conducted: 2018, 2019, 2020 and 2021. The main results (Government of Canada, 2021) show a significant increase in the past-year prevalence of cannabis use from 25% to 27% between 2019 and 2020, with a significant decrease to 25% in 2021. While there was a significant increase in the segment aged between 16 and 19 years old from 2018 to 2019 (36% to 44%), the study in 2021 showed a prevalence of 37% in this group (similar to 2018), with a significant decrease compared to 2020. Furthermore, in 2021, 26% of Canadians who used cannabis in the past year reported using it daily or almost daily, no change from previous studies. The average age of initiation of cannabis use increased from 18.9 in 2018 to 20.4 years old in 2021. Another interesting result is that for 53% of those who reported using marijuana in the past year in Canada, their usual source of access was a legal store, in contrast to 41% in 2020 and 24% in 2019. In addition, 11% (13% in 2020) indicated that their usual purchasing channel is a legal online source. Lastly, among past-year users, there has been a decrease in the proportion of those who reported driving a vehicle after using cannabis: from 27% in 2018 to 16% in 2021. Uruguay approved the law in 2013 and in August 2014, registration for self-cultivation began (13,441 registered individuals as of December 31 st , 2021). In October of that same year, registration for cannabis clubs started (7,032 registered individuals as of December 31 st , 2021), and in May 2017, the registration for pharmacy sales began (47,515 registered individuals as of December 31 st , 2021) (IRCCA, 2022). In terms of the magnitude of indicators on cannabis use, the report from the latest secondary school population study (Junta Nacional de Drogas, 2020b) shows an increasing trend in past-year prevalence of marijuana use between 2011 and 2014 from 12% to 15.5%. It then increased to 19.8% in 2016 and it remained at 19.7% in 2018. In the historical series from 2003 to 2016, the past-year prevalence of marijuana use among that population was higher in males than females, with a significant difference in 2011, with 14.8% among male students and 9.6% among female students. From that year on, the differences decrease and reach equal figures in the study of 2018 at 19.7%. At the same time, the report from the general population study aged 15 to 65 years in 2018 (Junta Nacional de Drogas, 2020a) shows that the past-year prevalence of marijuana use increased from 1.4% in 2001 to 8.3% in 2011, then rose to 9.3% in 2014 and to 14.6% in the last study in 2018. When comparing the results of 2018 with 2016 (Junta Nacional de Drogas, 2016) by age group, the smallest increase in past-year prevalence of marijuana use is observed in the 15 to 18-year-old group, from 14.8% to 19.1%, which represents a growth of 29%. Another result of the general population study in 2018 is that among last-year marijuana users, legal access reached 27.3% of users, i.e., a significant number of users who at that time resorted to some form of