How Health Care Experiences Shape Marijuana Use Motivations and Perceptions Among U.S. Adults

Background: Cannabis use among U.S. adults has increased substantially alongside expanding legalization and shifting public perceptions regarding its risks and benefits. While prior studies have examined sociodemographic patterns of cannabis use, limited research has explored how health care experiences, including trust in the health care system, satisfaction with care, and patient-provider communication, influence motivations for marijuana use and perceptions of its effects. Objective: To examine associations between health care experiences and marijuana use motivations and perceptions among U.S. adults using nationally representative survey data. Methods: This cross-sectional study analyzed data from the 2024 National Cancer Institute Health Information National Trends Survey (HINTS 7), including 6,665 U.S. adults after exclusion of incomplete responses. Dependent variables included marijuana use category, reason for use (medical, recreational, both medical and recreational), and perceived effects (harmful, both harmful and beneficial, neither harmful nor beneficial, beneficial, or uncertain). Independent variables included perceived quality of care, opportunities for patient-provider communication, physician openness to health information, and trust in the health care system. Multinomial logistic regression assessed associations while controlling for age, race/ethnicity, education, and income. Statistical significance was set at p < 0.05. Results: Marijuana use patterns varied across sociodemographic groups, with adults aged 50–74 years representing the largest proportion of users across most consumption categories and reporting the highest levels of medical (18.39%) and combined medical/recreational use (20.33%). Lower perceived quality of care was significantly associated with greater likelihood of marijuana use for medical reasons (RRR = 1.91, p = 0.046) and both medical and recreational reasons (RRR = 2.45, p < 0.001). Participants reporting fewer opportunities to ask health care questions were more likely to report medical use (RRR = 1.80, p = 0.034) and combined medical/recreational use (RRR = 2.04, p = 0.003). Lower trust in the health care system was consistently associated with increased likelihood of medical and combined marijuana use and reduced likelihood of perceiving marijuana as harmful ( p < 0.05). Conclusion: Health care experiences, including trust, perceived quality of care, and patient-provider communication, are significantly associated with marijuana use motivations and perceptions among U.S. adults. Strengthening patient-centered communication and fostering trust within health care settings may support more informed, evidence-based decision-making regarding marijuana use.