Initial indicators of the public health impacts of non-medical cannabis legalization in Canada

Fischer, Benedikt; Lee, Angelica; O’Keefe-Markman, Caroline; Hall, Wayne

doi:10.1016/j.eclinm.2020.100294

Cited by 20 publications

(20 citation statements)

References 4 publications

(9 reference statements)

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“…In the three studies that assessed concurrent co-use [39][40][41], tobacco use rates appear to be greater in legal versus illegal cannabis states while only one study has assessed co-administration, but only among cigarette smokers [41], where no consistent pattern emerges. This preliminary literature on the impact of cannabis legalization on cannabis and tobacco use patterns does not allow for definitive conclusions to be drawn regarding any harmful or beneficial impact of legalization and may be a function of policy transition effects [35]. The conclusion from this literature is that even in studies interested in co-use patterns, the data available to answer those questions may not be sufficient or granular enough.…”

Section: Effects Of Medical and Recreational Cannabis Laws On Co-usementioning

confidence: 93%

“…The issue of how macro-level cannabis laws influence population-level use of cannabis and other drugs is important, because legalization has already been associated with increases in cannabis use, CUD [3,35,36], the development of new products, reductions in price and increases in potency [36]. However, some suggest that the overall health effects of cannabis legalization will be shaped by what happens to the consumption of tobacco and other substances [33].…”

Section: Effects Of Medical and Recreational Cannabis Laws On Co-usementioning

confidence: 99%

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Unknown population‐level harms of cannabis and tobacco co‐use: if you don't measure it, you can't manage it

Hindocha

McClure

2020

Addiction

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Background Nationally representative data of cannabis-tobacco co-use have shown that these substances are closely entwined and have significant adverse health consequences, although population-level harms of co-use are largely unknown. Current epidemiological research does not assess co-use in a manner that has yielded the necessary data to draw conclusions regarding health effects. This has given rise to a hidden population of co-users who go under-served. Therefore, this paper has two aims: (1) to review new challenges in the collection of co-use data due to rapidly changing regulations of cannabis and nicotine products and (2) to provide recommendations for the terminology and assessment of couse. Argument We argue that: (1) the prevalence of co-use is not being assessed accurately at a population level and (2) changes in legalization have created novel challenges, but without proper monitoring the impact on co-use will go undetected. We propose a three-level tiered set of recommendations for co-use assessments, which includes assessments of cannabis, tobacco and co-use metrics ranging from least burdensome (self-report of co-administered products) to most burdensome (assays, event-level data). Conclusions We propose that clinical studies begin to incorporate cannabistobacco co-use assessments to justify better their inclusion in clinical trials and national surveillance surveys. Integration of co-use assessments will aid in understanding the true impact on co-use of the changing cannabis and tobacco/nicotine regulatory environments. Co-use is prevalent and problematic, and the ability to make conclusions about its health outcomes is hindered by lack of nuance in data collection. If you do not measure it, you cannot manage it.

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Section: Effects Of Medical and Recreational Cannabis Laws On Co-usementioning

confidence: 93%

Section: Effects Of Medical and Recreational Cannabis Laws On Co-usementioning

confidence: 99%

Unknown population‐level harms of cannabis and tobacco co‐use: if you don't measure it, you can't manage it

Hindocha

McClure

2020

Addiction

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“…However in “legalization” jurisdictions an extensive illegal sector has remained, even with a substantial amount of purchases from legal cannabis sources (Caulkins et al, 2018; Fischer, Lee, O’Keefe-Markman, & Hall, 2020; Smart et al, 2017; Wadsworth et al, 2019). For example, about half of users in Canada used some legal sources 1-year post-legalization, yet only about one-in-three exclusively relied on legal sources for their supply.…”

Section: Introductionmentioning

confidence: 99%

“…Despite the substantial decreases in the prices for legal product, as much as 50% in three years, it appears that illegal suppliers are selling at still lower prices (Caulkins et al, 2018; Smart et al, 2017; Wadsworth et al, 2019). Prices of illegal cannabis in Canada recently were reported to be about half of those for legal products ($6/gram vs. $10/gram) (Fischer, Lee, O’Keefe-Markman, & Hall, 2020).…”

Section: Introductionmentioning

confidence: 99%

Toward a “Post-Legalization” Criminology for Cannabis: A Brief Review and Suggested Agenda for Research Priorities

Fischer

Daldegan‐Bueno

Reuter

2020

Contemporary Drug Problems

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Cannabis control policies in a few countries have recently shifted from criminal prohibition-based regimes to legalization of use and supply. While cannabis’ newly emerging status of legality may suggest a coming “end” for criminology-based interest in the drug, these fundamental changes rather open a window to a new set of criminological research issues and questions, mostly focusing on cannabis use and related behaviors, and their relation to crime and justice. Based on a joint, personal record of several decades of criminological research on cannabis, we briefly review the rationale for five fundamental topics and issues of cannabis-related research associated with legalization. These include: 1) the deterrent effect of prohibition; 2) illicit production, markets and supply in a legalization regime; 3) use enforcement; 4) cannabis-impaired driving; 5) cannabis and crime. This constitutes an—albeit subjectively selective—“post-legalization” research agenda for a cannabis-focused criminology. Other possible areas of research focus or interest within fundamentally different paradigms of criminology (e.g., “critical criminology”) are identified and encouraged for development. Overall, the proposed research agenda for a post-legalization cannabis criminology should both contribute discipline-specific knowledge to improved cannabis-related public health and safety as well as allow for important debate and development in this evolving and important research field while entering a new (“post-legalization”) era.

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“…In the case of cannabis legalization, the industry has been provided a readymade argument to resist price controls, as these supposedly undermine their ability to compete with and eliminate the black market. Recent experience in Canada shows that the black market can respond to legal competition by lowering their prices [12], putting further pressure on the legal market to respond with even lower prices, and undermining regulatory efforts to keep the legal price at a certain level. We have argued that reducing the cannabis black market should not be an over‐riding goal of legalization, as it leads to a weak regulatory regime and low legal prices.…”

mentioning

confidence: 99%

The rejection of cannabis legalization in New Zealand: issues with the Cannabis Legalization and Control Bill or wider concerns?

Wilkins

Rychert

2021

Addiction

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Initial indicators of the public health impacts of non-medical cannabis legalization in Canada

Cited by 20 publications

References 4 publications

Unknown population‐level harms of cannabis and tobacco co‐use: if you don't measure it, you can't manage it

Unknown population‐level harms of cannabis and tobacco co‐use: if you don't measure it, you can't manage it

Toward a “Post-Legalization” Criminology for Cannabis: A Brief Review and Suggested Agenda for Research Priorities

The rejection of cannabis legalization in New Zealand: issues with the Cannabis Legalization and Control Bill or wider concerns?

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