Estimating tobacco product availability prevalence in medical cannabis dispensaries in Oklahoma, USA, 2024.

Introduction: As an increasing number of US states legalise cannabis use, they are faced with creating policies to regulate cannabis sales. In this observational cross-sectional study in Oklahoma, we estimate the prevalence of medical cannabis dispensaries selling tobacco products, which may increase the risk of tobacco use and cannabis co-use due to increased exposure to tobacco retail marketing and availability.

Methods: We downloaded publicly available medical cannabis dispensary and tobacco licence lists from the Oklahoma Medical Marijuana Authority and the Oklahoma State Department of Health (April 2024). Using fuzzy matching techniques, we identified businesses that were on both the cannabis and tobacco licensing lists. Then, we conducted online Google business and image searches to assess the availability or marketing (yes/no) of tobacco products in cannabis dispensaries by looking for tobacco products (eg, cigarillos) and marketing (eg, cigarette ads on window fronts).

Results: There were 2166 licensed medical cannabis dispensaries and 4974 licensed tobacco retailers in Oklahoma. We identified 56 licensed cannabis dispensaries that potentially sold tobacco (56/2166=2.6% of all dispensaries) and 91 licensed tobacco retailers that potentially sold cannabis (91/4974=1.8% of all tobacco retailers).

Conclusions: As cannabis legalisation increases, cannabis dispensaries and tobacco retailers may begin selling both substances, potentially leading to initiation, increased use and co-use and decreased cessation of tobacco and cannabis products. To address these health risks, state and local laws that clearly prohibit retailers from selling both substances simultaneously are needed.