June 15, 2023

A study that is scheduled to be published in the July 2023 issue of the Journal of Health Economics found that adult-use cannabis, also known as recreational cannabis, are associated with a lagged reduction in adult tobacco use that includes cigarettes, cigars, pipe tobacco, and e-cigarettes. This is an important finding as public health experts believe that cannabis legalization may normalize smoking and undermine progress made by tobacco control policies.

The study noted three main findings related to cannabis’ impact on tobacco use. The first was that the data from both the Population Assessment of Tobacco and Health (PATH) and National Survey on Drug Use and Health (NSDUH) show consistent results that adult-use cannabis laws increase prior-month cannabis use by 2 percent – 5 percent, including through vaping. Controlling for confounders, the study found this increase among people who have not previously consumed cannabis. The second main finding was that the study found no evidence that adult-use cannabis laws increased adult tobacco use. In fact, the researchers identified that cannabis legalization is associated with a lagged reduction in all tobacco use including cigarettes, pipe tobacco, cigars, electronic cigarettes, and nicotine vaporizers according to the longitudinal data from PATH and NSDUH combined with data from the Electronic Nicotine Delivery Systems (ENDS). This lagged reduction is apparent as states with adult-use laws saw up to a 2 percent decrease in tobacco use after 2 – 3 years of the law being enacted. The third main finding was that the opening of dispensaries is associated with larger reductions in tobacco use, meaning the accessibility and availability of dispensaries aid in the substitution of tobacco with cannabis. The authors noted that these findings are consistent with other research studies that find cannabis being used as a substitute for cigarettes and other tobacco products.

This study is an important development in studying the impact of cannabis legalization on population health as longitudinal data allow for a more comprehensive analysis of tobacco use over time, which can reduce bias and strengthen inferences regarding linkages between cannabis laws and tobacco use.