Re: Knowledge and attitude of college students towards cannabis use in urban India: A comparative perspective of users and non-users

In a previous issue of this journal, Ali et al. presented the results of a cross-sectional study investigating knowledge and attitude toward cannabis use among 260 college students in Mumbai.¹ The study used socio-demographic data and a self-reported questionnaire and found that 11.2% of participants used cannabis, and 15% of those users expressed a desire to use cannabis in the future. Seventy-two percent of cannabis users were introduced to the drug by friends. The most common reasons for using cannabis were peer pressure (29.6%), stress relief (23.5%), and experimentation (21.9%). Non-users considered cannabis to be more harmful and addictive than users did. While the study is noteworthy, some points require further discussion.

The first point is the use of questionnaires that must be completed by participants without the investigator’s presence or control. Such questionnaires have the disadvantage that it cannot be ensured that the addressee is really the one who answers, that the answers really reflect the facts or are only made up, that the correctness of the answers cannot be checked, and that it cannot be verified whether the addressee is mentally capable of answering the questions correctly.²

The second point is that it is doubtful that all students who actually use cannabis have admitted to doing so. Cannabis use is illegal in India, so people who admit to using cannabis may fear that their confession could lead to legal problems or other disadvantages. Therefore, it is quite unlikely that the 11% of participants who admitted to using cannabis is actually the correct figure. It is more likely that the actual number of cannabis users among the students is much higher.

The third point is that the cultural characteristics of a country in which cannabis plays a major role in religion and social relations mean that the use of cannabis is trivialized. According to a survey conducted in 2019, an estimated 31 million people in India, i.e. 2.8% of the Indian population aged 10 to 75, are current cannabis users.³ This makes cannabis the second most commonly used psychoactive substance in India after alcohol.

The fourth point is that people are generally not well-informed about the medical risks and side-effects of cannabis. Cannabis use can lead to a range of side-effects, affecting various aspects of physical and mental health.⁴ Short-term effects include altered sensory perception, impaired coordination, slower reaction times, and mood swings. Long-term use can lead to dependence, respiratory problems, and possible effects on cognitive function and mental health.⁴ Cannabis is also closely linked to the development of psychosis and psychiatric diagnoses, negative effects on neuro-logical development and academic performance, poorer sleep, and gastrointestinal effects. Research also shows potential risks for the pulmonary, and cardiovascular systems.⁵

In summary, the population, especially schoolchildren and students, should be informed about the negative effects of cannabis.