Background and Aims To test prospective associations between cannabis disorder symptoms/frequency of cannabis use and health issues and to investigate stability versus transience in cannabis use trajectories. Design Two waves of data collection from the longitudinal Cohort Study on Substance Use Risk Factors (C‐SURF). Setting A representative sample of young Swiss men in their early 20s from the general population. Participants A total of 5084 young men (mean age 19.98 ± 1.19 years at time 1). Measurements Cannabis use (life‐time use, frequency of use, cannabis disorder symptoms) and self‐reported measures of health issues (depression, mental/physical health, health consequences) were assessed. Significant changes in cannabis use were tested using t‐test/Wilcoxon's rank test for paired data. Cross‐lagged panel models provided evidence regarding longitudinal associations between cannabis use and health issues. Findings Most of the participants (84.5%) remained in the same use category and cannabis use kept to similar levels at times 1 and 2 (P = 0.114 and P = 0.755; average of 15 ± 2.8 months between times 1 and 2). Cross‐lagged panel models showed that cannabis disorder symptoms predicted later health issues (e.g. depression, β = 0.087, P < 0.001; health consequences, β = 0.045, P < 0.05). The reverse paths from health issues to cannabis disorder symptoms and the cross‐lagged panel model between frequency of cannabis use and health issues were non‐significant. Conclusions Patterns of cannabis use showed substantial continuity among young Swiss men in their early 20s. The number of symptoms of cannabis use disorder, rather than the frequency of cannabis use, is a clinically important measure of cannabis use among young Swiss men.