More Cannabis Stores Means More Cannabis Use — But Less Heavy Drinking for Some | Research

The takeaway

Oregon adults with greater local cannabis retail access showed up to 59% higher odds of cannabis use in a dose-response pattern, while adults aged 21-24 and 65+ in high-access areas showed reduced heavy alcohol use — suggesting substitution in some groups.

State and local cannabis regulators, zoning officials, public health planners, and researchers studying retail access effects.

What the researchers found

Oregon adults in highest-access areas had 59% higher odds of 30-day cannabis use (AOR=1.59, 95% CI=1.36-1.86) than those in pre-market periods, with dose-response across access levels. Heavy alcohol use decreased with retail access among ages 21-24 and 65+, suggesting substitution effects in these groups.

Why it matters

This study provides state-level evidence that cannabis retail density directly drives use in a dose-dependent manner, while also showing alcohol substitution effects — a mixed public health picture that informs retail policy.

The numbers in context

Oregon BRFSS 2014-2022; lowest third AOR=1.31, middle AOR=1.47, highest AOR=1.59 for cannabis use; frequent use also increased; ages 18-20 not significant; heavy alcohol decreased for ages 21-24 and 65+; associations significant in every adult age group except 18-20

How the study worked

Analysis of 2014-2022 Oregon BRFSS data matched with geospatial cannabis retail density by ZIP code, using multivariable logistic regression with time-trend adjustment to examine associations between retail access and cannabis/alcohol use across age groups.

What this study cannot tell us

BRFSS self-report; ZIP-level retail measure may not capture individual access; time-trend adjustment may not fully account for secular changes; Oregon may not generalize to other states; alcohol substitution only in two age groups.

How to read the evidence

Multi-year state-representative data with geospatial retail measures and dose-response finding provides strong evidence for retail access effects.

When this study was published

Published 2026; covers Oregon 2014-2022 spanning pre-market to mature market.

The bigger picture

The dose-response between retail density and cannabis use, combined with selective alcohol substitution, provides a nuanced framework for local zoning decisions about dispensary placement.

Questions still open

What is the optimal dispensary density to balance access and public health? Why does alcohol substitution occur only in young and older adults? Would similar patterns emerge in states with different cannabis cultures?

Common questions

Do more dispensaries mean more cannabis use?

Yes — Oregon data shows a clear dose-response: adults in areas with the most dispensaries had 59% higher odds of cannabis use compared to the pre-market period, with each level of access showing progressively higher use.

Does cannabis retail access reduce alcohol use?

For some groups — adults aged 21-24 and those 65+ in high-access areas showed reduced heavy alcohol use, suggesting substitution effects. However, this wasn't seen in middle-aged adults, and cannabis use increased broadly.

Read the original research

Oregon Adults' Cannabis and Alcohol Use: Associations With Local Cannabis Retail Access, 2014-2022.

American journal of preventive medicine, 70(2), 108164

View on PubMed ↗Publisher’s paper ↗

Citation

Kerr, David C R; Dilley, Julia A; Everson, Erik M; Hummel, Haley M. (2026). Oregon Adults' Cannabis and Alcohol Use: Associations With Local Cannabis Retail Access, 2014-2022.. American journal of preventive medicine, 70(2), 108164. https://doi.org/10.1016/j.amepre.2025.108164