Racial/Ethnic Differences in Age at Menarche and Lifetime Nonmedical Marijuana Use: Results from the NHANES 2005-2016

Early age at menarche has been linked to many adverse health outcomes among women, including substance use. However, little is known on the association between age at menarche and nonmedical use of marijuana, and no study has assessed the potential racial/ethnic differences. In this study, the 2005-2016 National Health and Nutrition Examination Survey data were used to investigate the association between age at menarche and the risk of lifetime nonmedical use of marijuana. Logistic regression models were used to examine such association adjusting for sociodemographic factors. Interactions between age at menarche and race/ethnicity were also assessed. Among the 10,302 women included, 53.9% had lifetime nonmedical use of marijuana. The regression model shows that women with early menarche had 1.26 (95% CI 1.09, 1.45) times the odds of having lifetime nonmedical use of marijuana compared with women with normal age at menarche. When assessing the association by race/ethnicity, marginally positive associations were observed for both the early and late menarche groups among non-Hispanic White women. However, among women with race/ethnicity other than non-Hispanic White, early menarche is significantly associated with increased risks of lifetime nonmedical marijuana use, while late menarche is significantly associated with decreased risks. This study suggests that early menarche may be a risk factor of lifetime nonmedical use of marijuana, and racial/ethnic differences may exist in the association. Future studies are warranted to examine and confirm these findings.