Marijuana Users More Likely to Be Fired or Laid Off

Impact on Involuntary Job Loss Has Increased Since Early 2000s

As US rates of marijuana use continue to rise, workers who use marijuana may be at higher risk of losing their jobs, suggests a study in the January 2019 Journal of Occupational and Environmental Medicine.

"Job loss may be an overlooked social cost of marijuana use," according to the new research by Cassandra A. Okechukwu, ScD, MSN, of Harvard T.H. Chan School of Public Health and colleagues. They analyzed nationally representative data from about 22,000 respondents to a 2001-2002 survey, with follow-up in 2003-2004; and 21,439 respondents to a 2012-13 survey. Analyses were limited to participants who were employed or actively seeking work.

The percentage of workers who reported using marijuana in the past year increased from about 4.50 percent in 2001-02 to 10.25 percent in 2012-13. The percentage meeting DSM-IV diagnostic criteria for marijuana use disorder increased from 1.2 to 2.6 percent.

Overall, marijuana users were more likely to experience involuntary job loss: being fired or laid off. With adjustment for other factors, workers who reported marijuana use in 2001-2002 had 27 percent higher odds of losing their jobs in 2003-04. In the 2012-13 survey, the odds of job loss were 50 percent higher for workers reporting marijuana use.

In both surveys, daily marijuana use was associated with increased odds of job loss. The 2012-2013 data also found higher odds of job loss for workers who used marijuana weekly or monthly.

The relationship between marijuana use and job loss was unaffected by race/ethnicity, but was significantly modified by income. Overall, marijuana use was linked to increased odds of job loss in both the highest and lowest income categories. Yet in higher-income workers, weekly marijuana use was associated with lower odds of job loss.

At a time of changing attitudes toward marijuana, there are few data on the rates and impact of marijuana use in the US workforce. The new findings show that marijuana use has sharply increased among US workers and is associated with involuntary job loss.

"Even though job loss places workers at increased risks for ill-health and occupational injuries, it remains underexplored in discussions of the potential health and social impacts of marijuana use," Dr. Okechukwu and coauthors conclude. "Future studies using an occupational health perspective are needed."
About the Author — Dr. Okechukwu may be contacted for interviews at
About ACOEM — ACOEM (, an international society of 4,500 occupational physicians and other health care professionals, provides leadership to promote optimal health and safety of workers, workplaces, and environments.
About the JOEM — The Journal of Occupational and Environmental Medicine ( is the official journal of the American College of Occupational and Environmental Medicine. Edited to serve as a guide for physicians, nurses, and researchers, the clinically oriented research articles are an excellent source for new ideas, concepts, techniques, and procedures that can be readily applied in the industrial or commercial employment setting.


Okechukwu CA, Molino J, Soh Y. Associations between marijuana use and involuntary job loss in the United States: representative longitudinal and cross-sectional samples. J Occup Environ Med. 2019;61(1):21-8.