A panel of nine substance use policy experts rated state monopoly over cannabis production and retail as the most effective policy for reducing youth use, excessive use, and impaired driving, while noting that almost no direct evidence exists for most cannabis policies.
Policymakers, public health professionals, and researchers studying cannabis regulation.
State monopoly rated #1 across all three public health outcomes
What the researchers found
State monopoly (government-owned production through retail) was rated most effective across all three outcome areas. Restrictions on retail availability, taxes, price restrictions, and retail operations restrictions were also highly rated. Policies targeting businesses were judged more effective than those targeting consumers. Experts reported little or no direct evidence from cannabis literature for most policies.
Why it matters
As more jurisdictions legalize cannabis, this expert consensus identifies which regulatory approaches are theoretically most promising while frankly acknowledging the almost complete absence of direct evidence.
The numbers in context
9 panelists rated 18 policies across 3 outcomes. State monopoly ranked #1 for all three outcomes. A small number of policies were rated highly effective across all domains.
How the study worked
Modified Delphi approach with nine panelists (researchers and policy consultants) rating 18 cannabis policies on their theoretical efficacy for reducing youth use, excessive adult use, and cannabis-impaired driving using Likert scales.
What this study cannot tell us
Expert opinion, not empirical evidence. Only nine panelists. Ratings are theoretical since most policies have not been empirically evaluated. U.S.-focused panel may not reflect international perspectives.
How to read the evidence
Expert panel consensus using modified Delphi method. Theoretical ratings, not empirical evidence.
When this study was published
Published in 2022.
The bigger picture
The finding that supply-side regulations (business-focused) are rated more effective than demand-side policies (consumer-focused) parallels lessons from alcohol and tobacco policy, where restricting commercial availability has consistently outperformed individual-level interventions.
Questions still open
- Will any U.S. state adopt a cannabis monopoly model? Can these theoretical ratings be validated with real-world outcomes data? Do political realities make the most effective policies impractical?
Common questions
What type of cannabis policy did experts consider most effective?
Is there direct evidence that these policies work?
Read the original research
Rating the comparative efficacy of state-level cannabis policies on recreational cannabis markets in the United States.
The International journal on drug policy, 106, 103744
Citation
Blanchette, Jason G; Pacula, Rosalie Liccardo; Smart, Rosanna; Lira, Marlene C; Boustead, Anne E; Caulkins, Jonathan P; Kilmer, Beau; Kerr, William C; Treffers, Ryan; Naimi, Timothy S. (2022). Rating the comparative efficacy of state-level cannabis policies on recreational cannabis markets in the United States.. The International journal on drug policy, 106, 103744. https://doi.org/10.1016/j.drugpo.2022.103744