{"title":"The Effects of Recreational Cannabis Laws on Alcohol and Tobacco Use Among U.S. Adults, 2012-2022.","authors":"Prabal K De, Ruoyan Sun","doi":"10.1016/j.amepre.2025.01.024","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Many states have legalized the use of cannabis for medicinal and recreational purposes in the past decade. However, it remains unclear how recreational cannabis laws affect alcohol and tobacco use among adults.</p><p><strong>Methods: </strong>This was a cross-sectional study of 4.8 million adults from the 2012-2022 Behavioral Risk Factor Surveillance System. A difference-in-differences approach was used to examine the impact of recreational cannabis laws on alcohol and tobacco use, adjusting for individual-level characteristics and time-varying state-level factors. The analyses were performed in 2024.</p><p><strong>Results: </strong>Three alcohol-use outcomes (current, binge, and heavy drinking) and 2 tobacco-use outcomes (current and smokeless tobacco use) were examined. Considering the passage of laws as cannabis law implementation, recreational cannabis laws were not associated with any alcohol or tobacco use outcomes in the fully adjusted model. However, considering operational dispensary as cannabis law implementation, recreational cannabis laws were associated with a decrease of 0.95 percentage point (95% CI=1.80, 0.09) in current drinking and a decrease of 0.48 percentage point (95% CI=0.85, 0.10) in current cigarette use. Subgroup analysis showed that recreational cannabis laws were associated with reductions in current drinking, binge drinking, and current cigarette use in multiple groups. However, recreational cannabis laws were associated with increases in current smokeless tobacco use for some groups.</p><p><strong>Conclusions: </strong>The findings suggest that although the overall effects of recreational cannabis laws on the use of alcohol and tobacco may be limited, there are heterogeneous associations between recreational cannabis laws and drinking and smoking by age, sex, race and ethnicity, education, and income.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":""},"PeriodicalIF":4.3000,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Preventive Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.amepre.2025.01.024","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction: Many states have legalized the use of cannabis for medicinal and recreational purposes in the past decade. However, it remains unclear how recreational cannabis laws affect alcohol and tobacco use among adults.
Methods: This was a cross-sectional study of 4.8 million adults from the 2012-2022 Behavioral Risk Factor Surveillance System. A difference-in-differences approach was used to examine the impact of recreational cannabis laws on alcohol and tobacco use, adjusting for individual-level characteristics and time-varying state-level factors. The analyses were performed in 2024.
Results: Three alcohol-use outcomes (current, binge, and heavy drinking) and 2 tobacco-use outcomes (current and smokeless tobacco use) were examined. Considering the passage of laws as cannabis law implementation, recreational cannabis laws were not associated with any alcohol or tobacco use outcomes in the fully adjusted model. However, considering operational dispensary as cannabis law implementation, recreational cannabis laws were associated with a decrease of 0.95 percentage point (95% CI=1.80, 0.09) in current drinking and a decrease of 0.48 percentage point (95% CI=0.85, 0.10) in current cigarette use. Subgroup analysis showed that recreational cannabis laws were associated with reductions in current drinking, binge drinking, and current cigarette use in multiple groups. However, recreational cannabis laws were associated with increases in current smokeless tobacco use for some groups.
Conclusions: The findings suggest that although the overall effects of recreational cannabis laws on the use of alcohol and tobacco may be limited, there are heterogeneous associations between recreational cannabis laws and drinking and smoking by age, sex, race and ethnicity, education, and income.
期刊介绍：
The American Journal of Preventive Medicine is the official journal of the American College of Preventive Medicine and the Association for Prevention Teaching and Research. It publishes articles in the areas of prevention research, teaching, practice and policy. Original research is published on interventions aimed at the prevention of chronic and acute disease and the promotion of individual and community health.
Of particular emphasis are papers that address the primary and secondary prevention of important clinical, behavioral and public health issues such as injury and violence, infectious disease, women''s health, smoking, sedentary behaviors and physical activity, nutrition, diabetes, obesity, and substance use disorders. Papers also address educational initiatives aimed at improving the ability of health professionals to provide effective clinical prevention and public health services. Papers on health services research pertinent to prevention and public health are also published. The journal also publishes official policy statements from the two co-sponsoring organizations, review articles, media reviews, and editorials. Finally, the journal periodically publishes supplements and special theme issues devoted to areas of current interest to the prevention community.
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