A Tobacco Control Framework for Regulating Public Consumption of Cannabis: Multistate Analysis and Policy Implications

Abstract

Eleven US states and Washington, DC, legalized recreational (adult use) cannabis. Seven states—Alaska, California, Colorado, Massachusetts, Nevada, Oregon, and Washington—allow cannabis sales. A public health concern is that exemptions in state or local smoke-free laws for public cannabis smoking or vaping will weaken smoke-free laws, expose the public to secondhand cannabis, and renormalize smoking. We describe the experience of the seven states and challenges faced in maintaining smoke-free laws. Using elements of a tobacco control framework, we identify best practices in cannabis regulation by comparing each state’s smoke-free laws and allowances for public cannabis use. All states prohibit public cannabis use; two lack 100% smoke-free protections; one lacks vaping devices in its smoke-free law; three allow cannabis use in retailers; two allow cannabis use in social consumption lounges; and two allow cannabis use in tourism venues. States should close gaps in smoke-free laws and not expand where cannabis use is permitted to ensure public health.

Substance Abuse and Public Health: A Multilevel Perspective and Multiple Responses

“…The most common illicit types of substances include cannabis, amphetamines, ketamine, methamphetamines, cocaine, ecstasy and heroin [2,6], which are largely banned in most countries. However, marijuana products have recently been legalized and commercialized in some northern American and Western states and regions under the umbrella of "control of reasonable use," which casts a contemplative doubt over the original intent of reducing cannabis-related criminality and public health problems; hence, more research is needed on this subject [26][27][28]. Tobacco and alcohol are two legally approved types of substances that have been widely used by different social groups across different societies and cultures [6,11,29].…”

Examination of cannabis use patterns, heavy user characteristics, and cannabis-related harms: results from 2012-2013 US national cross-sectional survey data

“…Future research should further explore cannabis use and harms associated with accessing marijuana by individuals aged 10 to 17 years old. Public policy development should continue to focus on reducing the exposure of youth to cannabis, similar to approaches used with tobacco (Steinberg et al, 2020).…”

“…Similar to tobacco use, allowing cannabis smoking and vaping in public settings may expose non-users to second-hand smoke and normalize cannabis smoking behaviours in youth (Tobacco Control Network, 2016). A publication by Steinberg et al (2020) described the experiences and challenges of maintaining smoke-free laws in the seven states that allow recreational cannabis sale: Alaska, California, Colorado, Massachusetts, Nevada, Oregon, and Washington. Within these states, components of a tobacco control framework were applied to identify best practices in cannabis regulation.…”

“…Within these states, components of a tobacco control framework were applied to identify best practices in cannabis regulation. The authors described how, as legalization grows in the United States, local jurisdictions have been experiencing challenges with finding acceptable locations for cannabis users to consume legally without violating the smoke-free air laws and ultimately compromising the health of the public (Steinberg et al, 2020).…”

“…To add to the complexity, recreational cannabis use is illegal at the federal level in the United States, and thus cannabis users who rent or stay in government housing that bans federally designated illegal substances may incur fines or evictions if cannabis is used on the property, causing a social equity issue (Steinberg et al, 2020). These individuals often belong to the low-income communities that have already been negatively affected by "the war on drugs" and United States drug laws.…”