Five-year longitudinal study of cannabis users in three remote Aboriginal communities in Arnhem Land, Northern Territory, Australia K. S. KYLIE LEE 1,2 , KATHERINE M. CONIGRAVE 2,3 , ALAN R. CLOUGH 1,4 , TIMOTHY A. DOBBINS 5 , MURIEL J. JARAGBA 6 & GEORGE C. PATTON 7 1 School of Public Health,Tropical Medicine and Rehabilitation Sciences, James Cook University, Cairns, Australia, 2 Faculty of Medicine, University of Sydney, Sydney,Australia, 3 Drug Health Services, Royal Prince Alfred Hospital, Sydney, Australia, 4 School of Indigenous Australian Studies, James Cook University, Cairns, Australia, 5 School of Public Health, University of Sydney, Sydney, Australia, 6 Top End Division of General Practice, Darwin,Australia, and 7 Centre for Adolescent Health, University of Melbourne, Melbourne, Australia Abstract Introduction and Aims. To examine predictors of cannabis use at 5 year follow up in an Australian Aboriginal cohort. Design and Methods. A longitudinal study consisting of two waves of data collection 5 years apart was conducted. Of the 100 Aboriginal residents (aged 13–36 years) interviewed about cannabis use in 2001, 83 were re-interviewed in 2005–2006 from three remote communities in Arnhem Land, Northern Territory, Australia. Self-reported cannabis use was categorised at each time point (none; former use, quit 3 months; lighter use, <6 cones, 2–3 times weekly; daily use, 6 cones, daily) and summarised as any current use, heavy use, dependence or cessation. Other substance use, employment and involvement in school or training were also compiled. Results. Most respondents who reported cannabis use at baseline again reported use at follow up. A history of petrol sniffing predicted later heavy cannabis use (P < 0.05).Trends were evident for men to have persisting cannabis use, and for employment and/or engagement in school or training to be associated with cannabis cessation. Discussion and Conclusions. Ongoing heavy cannabis use is commonplace in this Aboriginal cohort and raises concerns for the physical, social and psychiatric burden on these already vulnerable communities. Prevention, treatment and intervention programs developed with communities are badly needed. [Lee KSK, Conigrave KM, Clough AR, DobbinsTA, Jaragba MJ, Patton GC. Five-year longitudinal study of cannabis users in three remote Aboriginal communities in Arnhem Land, Northern Territory, Australia. Drug Alcohol Rev 2009;28:623–630] Key words: cannabis, Indigenous Australian, petrol sniffing. Introduction Cannabis is the most commonly used illicit drug world- wide with 160 million users, equivalent to 3.8% of the world’s population (aged 15–64 years) [1]. Indigenous people commonly have higher levels of use than their non-Indigenous counterparts. Cannabis prevalence is higher among Canada’s First Nation population (aged 18 years) than other Canadians (aged 15 years; 26.7% vs. 14.1%) [2,3], among North America’s Indig- enous population than other Americans (aged 12 years, 13.5% vs. 10.6%) [4] and among Maori compared with non-Maori New Zealanders (aged 13–65 years; 20.8% vs. 14.0%) [5]. In Australia, the national household surveys suggest that Aboriginal and Torres Strait Islander (Indigenous) Australians (aged 15 years) have higher rates of can- nabis use compared with the remainder of the popula- tion (aged 14 years; 23% use in the past 12 months vs. 9.1%) [6,7]. Similarly in Albany,Western Australia (WA), cannabis use by Aboriginal young people (aged 14–19 years) was nearly twice as common as for the K. S. Kylie Lee BMus (Hons), PhD student, Research Assistant, Katherine M. Conigrave FAChAM, FAFPHM, PhD, Staff Specialist in Addiction Medicine, Associate Professor, Alan R. Clough PhD, Associate Professor,Timothy A. Dobbins PhD, Lecturer in Biostatistics, Muriel J. Jaragba Cert III (Mental Health), Aboriginal Mental Health Worker, George C. Patton MD, FRANZCP, Professor of Adolescent Health Research. Correspondence to Ms K. S. Kylie Lee, Page Building, Royal Prince Alfred Hospital, Missenden Road, Camperdown, NSW 2050, Australia.Tel: +61 2 9515 7314; Fax: +61 2 9515 8970; E-mail: kylie.lee@usyd.edu.au Received 20 August 2008; accepted for publication 09 November 2008. Drug and Alcohol Review (November 2009), 28, 623–630 DOI: 10.1111/j.1465-3362.2009.00067.x © 2009 Australasian Professional Society on Alcohol and other Drugs