In this study, we identified characteristics of adults who use cannabis prior to and during exercise, including types of cannabis products used, types of physical activities engaged in under the influence, where and when people are using, and their motives for combining cannabis with exercise. We found considerable heterogeneity in types of physical activity participation under the influence of cannabis, as well as perceived benefits of use. The focus of this discussion will be on how we can use the information gathered from the current survey to inform future research directions in the field of cannabis and exercise science.

The respondents of this study were mostly heavy chronic cannabis users, reporting daily use for over 5 years. Of the respondents who completed the demographics section of the survey, we found an equal number of male and female participants with one identifying as non-binary. This finding is similar to that of Lisano et al. (2019), who also found an equal number of male and female participants, but in contrast to YorkWilliams et al. (2019) and Zeiger et al. (2019), who reported a greater percentage of male participants in their survey. With regard to the top 5 activities people participated in under the influence of cannabis, females paired cannabis with walking and with yoga significantly more than male participants, but there were no other significant gendered differences (such as unanticipated experiences, or how they felt about exercise under the influence). Future research could continue to investigate the role that gender identity may play in the use of cannabis with exercise, particularly in the transgender and non-binary communities where there are more barriers to physical activity participation (Jones et al. 2017).

The most common forms of physical activity under the influence of cannabis reported in our study included: hiking, yoga, aerobic machines, walking, and weight lifting. These activities are fairly representative of the common forms of exercise in Americans (Bureau of Labor Statistics, U.S. Department of Labor 2016), though in our sample we had a higher frequency of participants who reported yoga, and a lower frequency of running and swimming. However, these findings are similar to those from Lisano et al. (2019), where the most frequent activities reported in people who use cannabis before exercise were hiking, running, yoga, cycling, and resistance training, and those who used cannabis during physical activity were hiking, golf, yoga, and skiing/snowboarding. The slight differences between our findings and those from Lisano et al. (2019) may be related to activities that are common and accessible based on geographic location.

Something to consider moving forward is that the relative ratio of cannabis users may be different depending on the sport or activity. For example, while hiking was the most common activity cited in our study, we do not expect that the majority of people hiking are incorporating cannabis into their hikes. Previous research has found that cannabis use was more common in adolescents who participated in more extreme “sliding” sports such as windsurfing, skiing, snowboarding, and surfing (Lorente et al. 2005). The relative percentage of cannabis users within each sport/activity is likely different, and may reveal an interesting link between cannabis and the psychosocial, neuromotor, and physiological domains of sport.

Ultimately, we found that people engage in a variety of physical activities under the influence of cannabis, which is in line with previous research (Lisano et al. 2019). With nearly 60 physical activities reported in our sample, there were a variety of activities that require different energy systems, levels of concentration, power outputs, levels of competitiveness, precision, accuracy, time, and a mix of team and individual sports. This finding opens the door to an almost limitless supply of research questions for future investigations regarding how cannabis may impact exercise performance. For example, of the six most common forms of physical activity, five would be considered more aerobic activities, with weight lifting typically considered more anaerobic. Sparling et al. (2003) first discovered that moderate intensity aerobic exercise stimulates the endocannabinoid system, leading to the “runner’s high” which may increase the motivation to exercise. Perhaps consuming cannabis prior to a workout may stimulate the endocannabinoid system so that the user feels the effects of the “runner’s high” earlier in the workout. Participants could also be using cannabis to increase the sense of reward of an activity they are participating in at a lower intensity level, or an anaerobic activity that has not been found to activate this system. In future investigations, it will be important to critically evaluate the timing, dosage, method of consumption, and their effects on both aerobic and anaerobic performance (Ogle, 2021).

The majority of our sample reported intermediate or advanced skill levels in the activities they were engaging in while co-using. When considering the most common modes of physical activity reported (i.e., hiking, yoga, aerobic machines, walking), an intermediate or advanced skill level is appropriate. A small percent of the sample reported being a novice, potentially indicating that individuals were not learning new activities under the influence of cannabis. Previous research has shown lower levels of plasma brain-derived neurotrophic factor (BDNF) in physically active cannabis users compared to nonusers (Lisano et al. 2020). Because of BDNF’s role in neuroplasticity and motor learning (Fritsch et al. 2010), further investigations on the impact of cannabis on motor learning is warranted. Also, a small percent of the sample reported professional status in the sport that they participated in, similar to Zeiger et al. (2019). This small number of professional athletes in our sample of those who exercised with cannabis could be a reflection of the small number of professional athletes compared to the general population. However, it also may be related to regular drug testing in some professional sports, which would discourage professional athletes from using cannabis (for more information on cannabis prohibition in sport see Huestis et al. (2011) or Ogle (2021).

Only a small portion of our sample reported not knowing the cannabis strain consumed prior to physical activity, suggesting our sample may have had an educated approach towards consumption before exercise. In addition, the majority of participants reported using Sativa-dominant strains, typically associated with more of an energizing effect (Backes 2017) so it is reasonable that more people would prefer to use sativa-strains prior to exercise. This finding agrees with previous research, where participants reported greater use of Sativa products before physical activity, and Indica products after physical activity (Lisano et al. 2019). While a terpene profile (organic compounds that provide aroma and flavor in cannabis), may be more helpful in identifying the effects of cannabis on humans (Piomelli and Russo 2016), at this time cannabis products are typically marketed as Indica-dominant, sativa-dominant, or hybrid. Future research on cannabis and exercise should carefully consider these profiles, especially when evaluating the effects on human performance.

For participants who reported unintended experiences, most reported that they did not know the strains they were using. Based on the analyses performed, there also did not appear to be a relationship between gender or length of time participants had been using and unanticipated experiences. It is important to note that there were zero cases of negative experiences when people reported using non-psychoactive CBD products prior to exercise. The consumption type that led to the unanticipated experience was primarily smoking flower, edibles, and dabs. This is interesting because edibles were not a common method of administration overall in this study, but produced a relatively large percentage of the negative experiences. Research has found that people who use edibles have greater odds of an unexpected high (Allen et al. 2017), which could be related to unintended overconsumption or due to label inaccuracies (Vandrey et al. 2015).

We found that the majority of our sample reported smoking cannabis (bowl, joint, or bong), followed by vaporizing, extracts, edibles, and topicals. Survey data has shown that smoking continues to be the most common method of THC administration (Hazekamp et al. 2013; Knapp et al. 2019), and this finding supports the findings of Lisano et al. (2019) who also identified that inhalation was the most common method of administration before, during, and after physical activity. Each of these methods of administration are worth investigating further as it relates to exercise performance. Edibles take longer to metabolize, so the effects take longer to take effect, and last longer as compared to smoking (Allen et al. 2017). Therefore, future investigations should consider time of ingestion when looking at the effects of different modes of ingestion on exercise function, similar to the design by Renault et al. (1971).

Participants reported using cannabis when exercising outside, and typically use cannabis shortly before exercise: using either at home, outside or at the gym. Logistically, this means that some people may be using at home, and then driving to exercise locations. Cannabis consumption prior to driving presents a safety risk, particularly with those who are only occasional users (Hartman and Huestis 2013). While a further investigation into this is outside the scope of the current study, it is worth contextualizing the reality of using cannabis before exercise.

With our sample, the most common reasons for using cannabis in conjunction with exercise included: “helped me focus/concentrate,” “helps me enjoy the exercise experience,” “enhances mind/body/spirit connection,” and “keeps me in the zone.” Helping with focus/concentration is similar to “staying in the zone” in terms of concentrating one’s mind on a task at hand and shutting out distractions. Helping enjoy exercise may indicate that cannabis increased the reward value of activity, while enhancing mind-body-spirit connection may indicate that cannabis may increase the reward, but in more than just purely the physical realm. Enhancing body awareness may indicate that cannabis allows the participant a better understanding of how their body is responding to the activity. These results are similar to, but do not quite match the reasons for cannabis use before, during, or after physical activity from those of Lisano et al. (2019). They found pain management/relief, improving focus, and relaxation were the most reported reasons for use of cannabis before exercise, with to increase energy, improve enjoyment of activity, and pain management as the most common reasons to use cannabis during physical activity. This could be related to the number of options available to participants in the present study as compared to the survey by Lisano et al. (2019), where respondents provided open-ended answers to questions about reasons for use of cannabis before, during, and after physical activity, which was then coded and presented in their results.

The majority of our sample agreed that they felt more satisfied, focused, and productive during their workouts. These results support YorkWilliams et al. (2019) where cannabis increased enjoyment of, and motivation to exercise. We did not find as high percentages of participants claiming use of cannabis to aid in recovery as YorkWilliams et al. (2019) but this may be because we were specifically interested in only people who used before or during exercise, rather than those who use cannabis after exercise.

The present study expanded upon and provided more in-depth choices than previous studies in order to gain a more complete picture of the myriad of reasons why adults would combine cannabis and exercise. Participants’ reasons for exercising with cannabis span the physiological, psychological, neuromotor, and even spiritual domains. What is not clear yet is whether these perceived benefits of using cannabis prior to exercise actually lead to measurable changes in exercise performance. Older cannabis and exercise research found mixed results about the effects of cannabis on different aspects of performance (Maksud and Baron 1980; Steadward and Singh 1975; Kvålseth 1977; Renaud and Cormier 1986; Renault et al. 1971; Peters et al. 1976; Manno et al. 1970; Tashkin et al. 1973), but the strains used in the studies do not reflect the strains that are commercially available today (Vergara et al. 2017; Bidwell et al. 2018), and therefore need to be reassessed to determine the actual impact on performance. Our expanded list of reasons why adults use cannabis with exercise should guide future research endeavors based on the experiences of those who combine the two. Of particular interest, future research should carefully consider how to assess changes in focus/concentration, and body awareness when pairing cannabis with exercise, and how that may impact performance.

While our participants felt they personally benefited from pairing cannabis and exercise, it may not be beneficial to all. About one third of our participants reported having an unanticipated or undesired experience while using cannabis in conjunction with physical activity. Yet, 78% of the participants in this study had been exercising with cannabis for over 3 years making them experienced users, and no significant relationship was found between years of use and unanticipated experiences. Previous research has found that the effects of cannabis on different aspects of performance may differ between long-term and short-term cannabis users (Kirk and de Wit 1999; OʼLeary et al. 2003; Solowij 2002), so the impact of length of use should be considered in future investigations of cannabis and human performance.

The most common unanticipated experiences include heart racing, got too high to be effective at exercise, anxiety, paranoia, and lightheadedness. Cannabis has been shown to be a bronchodilator, and increases heart rate immediately after use (Renault et al. 1971; Kennedy 2017), so the experience of “heart racing” may be related to an individual’s physiological response to cannabis consumption, or could also be due to psychological responses like anxiety or paranoia. Anxiety, paranoia, and lightheadedness might be related to dosage, and will need to be carefully considered in future lab-based studies. The finding of “got too high to be effective at exercise” feeds into the “lazy stoner” archetype, but is likely related to dosage. Dietrich and McDaniel (2004) noted that people may experience a biphasic response to cannabis where, depending on the dosage, can elicit either motor inhibition or excitation. If the goal is to exercise under the influence of cannabis, we assume that participants could adjust their cannabis dosage to ensure they are not overconsuming so that they can participate as intended. Future research and educational outreach should consider the harm reduction and benefit maximization for those who decide to combine cannabis use with exercise.