Cannabis use has been more prevalent among men than women and prior work has found differing impact of recreational cannabis laws (RCL) by age. We examined changes in the prevalence of past-year and past-month cannabis use, past-month daily cannabis use, and DSM-5-proxy cannabis use disorder (CUD) in the past-year before and after RCL enactment by gender alone and stratified by age using 2008–2017 repeated cross-sectional samples of the US National Survey on Drug Use and Health. Changes in cannabis outcomes were estimated using adjusted multi-level logistic regression with state random intercepts and two-way and three-way interactions between RCL, gender, and age group. Enactment of RCL was associated with higher increases in the past-year (+ 3.2%; aOR = 1.30 [95%CI = 1.19 to 1.41]) and past-month (+ 2.3; 1.37 [1.24 to 1.51]) cannabis use in women than men (+ 2.1%; 1.15 [1.06 to 1.25] and + 1.7%; 1.19 [1.08 to 1.30]). No increases in past-month daily cannabis use and past-year DSM-5 CUD among those using cannabis were observed after RCL enactment. There were no increases in any cannabis outcomes after RCL enactment among those 12–20 years old. RCL enactment may contribute to the narrowing of the cannabis gender gap. Ongoing surveillance is essential to ensure that the social justice aims of legalization are achieved without negative public health consequences.

大麻的使用在男性中比女性更普遍，之前的研究发现娱乐性大麻法 (RCL) 对不同年龄的影响不同。我们检查了过去一年和过去一个月的大麻使用率、过去一个月的每日大麻使用率以及过去一年 RCL 颁布前后的 DSM-5 替代大麻使用障碍 (CUD) 的变化，仅按性别划分，使用 2008-2017 年美国国家药物使用和健康调查的重复横截面样本按年龄分层。使用调整后的多级逻辑回归与状态随机截距以及 RCL、性别和年龄组之间的双向和三向交互作用来估计大麻结果的变化。 RCL 的颁布与过去一年（+ 3.2%；aOR = 1.30 [95%CI = 1.19 至 1.41]）和过去一个月（+ 2.3；1.37 [1.24 至 1.51]）女性大麻使用量的增加有关比男性高（+ 2.1%；1.15 [1.06 至 1.25] 和 + 1.7%；1.19 [1.08 至 1.30]）。 RCL 颁布后，大麻使用者过去一个月的每日大麻使用量和过去一年的 DSM-5 CUD 没有增加。 RCL 颁布后，12-20 岁人群的大麻结果没有增加。 RCL 的颁布可能有助于缩小大麻性别差距。持续的监测对于确保实现合法化的社会正义目标而不产生负面的公共卫生后果至关重要。