More Cannabis Stores Means More Cannabis Use — But Less Heavy Drinking for Some
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.
Quick Facts
What This Study 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.
Key Numbers
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 They Did This
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.
Why This Research 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 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.
What This Study Doesn't 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.
Questions This Raises
- ?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?
Trust & Context
- Key Stat:
- Evidence Grade:
- Multi-year state-representative data with geospatial retail measures and dose-response finding provides strong evidence for retail access effects.
- Study Age:
- Published 2026; covers Oregon 2014-2022 spanning pre-market to mature market.
- Original Title:
- Oregon Adults' Cannabis and Alcohol Use: Associations With Local Cannabis Retail Access, 2014-2022.
- Published In:
- American journal of preventive medicine, 70(2), 108164 (2026)
- Authors:
- Kerr, David C R(3), Dilley, Julia A(7), Everson, Erik M(2), Hummel, Haley M
- Database ID:
- RTHC-08382
Evidence Hierarchy
Frequently Asked 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 More on RethinkTHC
Cite This Study
https://rethinkthc.com/research/RTHC-08382APA
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
MLA
Kerr, David C R, et al. "Oregon Adults' Cannabis and Alcohol Use: Associations With Local Cannabis Retail Access, 2014-2022.." American journal of preventive medicine, 2026. https://doi.org/10.1016/j.amepre.2025.108164
RethinkTHC
RethinkTHC Research Database. "Oregon Adults' Cannabis and Alcohol Use: Associations With L..." RTHC-08382. Retrieved from https://rethinkthc.com/research/kerr-2026-oregon-adults-cannabis-and
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.