Cannabis Legalization Increased Cannabis Use But Did Not Affect Tobacco Use or Co-Use
In a national US cohort tracked from 2017-2021, cannabis use rose 3.3% while tobacco declined 1.9%, with both medical and recreational legalization increasing cannabis use but having no spillover effect on tobacco or co-use.
Quick Facts
What This Study Found
Cannabis use increased 3.3% from 2017-2021 while tobacco/nicotine use declined 1.9%. Both medical and recreational legalization were associated with increased cannabis use, with recreational legalization having 1.13 times larger effect. Neither type of legalization was associated with changes in tobacco/nicotine use or co-use of cannabis and tobacco.
Key Numbers
9,003 participants in 2017; cannabis use +3.3%; tobacco use -1.9%; co-use +0.2% (not significant); recreational legalization 1.13x larger effect than medical; age range 18-94
How They Did This
Longitudinal study using a nationally representative web-based panel of 9,003 US adults surveyed in 2017, 2020, and 2021, with weighted adjusted binary logistic GEE models assessing legalization associations.
Why This Research Matters
A major concern about cannabis legalization has been potential spillover effects on tobacco use or development of polysubstance use patterns. This study provides reassurance that legalization increases cannabis use without worsening tobacco or co-use patterns.
The Bigger Picture
This is important for policy because it suggests that cannabis legalization's effects are cannabis-specific rather than driving broader substance use changes. The tobacco decline continuing during cannabis expansion challenges the 'gateway' narrative.
What This Study Doesn't Tell Us
Self-reported substance use. Panel attrition (70% and 74% retention). Cannot account for all confounders. Binary cannabis use measure does not capture frequency or quantity changes.
Questions This Raises
- ?Will longer-term legalization eventually affect co-use patterns?
- ?Does legalization change the demographic profile of cannabis users over time?
Trust & Context
- Key Stat:
- Cannabis legalization had no spillover effect on tobacco use or co-use
- Evidence Grade:
- Nationally representative longitudinal panel with appropriate modeling, though panel attrition and self-report are limitations.
- Study Age:
- Published in 2024 with 2017-2021 data.
- Original Title:
- Cannabis legalization and changes in cannabis and tobacco/nicotine use and co-use in a national cohort of U.S. adults during 2017-2021.
- Published In:
- The International journal on drug policy, 134, 104618 (2024)
- Authors:
- Pravosud, Vira(4), Glantz, Stanton(2), Keyhani, Salomeh(22), Ling, Pamela M, Lempert, Lauren K, Hoggatt, Katherine J, Hasin, Deborah, Nguyen, Nhung, Graham, Francis Julian L, Cohen, Beth E
- Database ID:
- RTHC-05634
Evidence Hierarchy
Follows a group of people over time to track how outcomes develop.
What do these levels mean? →Frequently Asked Questions
Does cannabis legalization increase tobacco use?
No. This study found tobacco use continued declining in states that legalized cannabis, with no spillover effect.
Does legalization increase cannabis use?
Yes. Both medical and recreational legalization were associated with increased cannabis use, with recreational having a slightly larger effect.
Read More on RethinkTHC
- 30-days-without-weed
- 420-sober-survival-guide
- 6-months-sober-weed-what-to-expect
- 90-days-no-weed
- CBT-cannabis-recovery
- benefits-of-quitting-weed
- boredom-after-quitting-weed
- boredom-after-quitting-weed-nothing-fun
- cannabis-relapse-cycle-pattern
- cold-turkey-vs-taper-quit-weed
- creativity-without-weed-quitting-artist-musician
- dating-sober-after-quitting-weed
- exercise-quitting-weed-anxiety-brain
- grieving-quitting-weed-loss
- help-someone-quit-weed
- hobbies-after-quitting-weed
- how-to-quit-weed
- identity-after-quitting-weed
- journaling-weed-withdrawal
- leaving-stoner-culture-identity
- marijuana-anonymous-SMART-recovery-compare
- meditation-mindfulness-weed-withdrawal
- money-saved-quitting-weed-calculator
- one-year-sober-weed
- partner-still-smokes-weed
- partner-still-smokes-weed-quitting
- pink-cloud-sobriety-cannabis
- quit-weed-cold-turkey
- quit-weed-or-cut-back-which-is-better
- quit-weed-regret-went-back
- quitting-weed-20s
- quitting-weed-30s
- quitting-weed-after-years
- quitting-weed-creativity
- quitting-weed-during-crisis-divorce-job-loss
- quitting-weed-exercise
- quitting-weed-face-changes-skin
- quitting-weed-grief-loss-coping
- quitting-weed-legal-state
- quitting-weed-success-stories
- quitting-weed-triggers-environment
- quitting-weed-weight-loss-gain
- relapsed-smoking-weed-what-to-do
- relapsed-weed
- should-i-quit-weed
- sober-music-festival-concert-without-weed
- supplements-weed-withdrawal
- telling-friends-quitting-weed
- weed-relapse-prevention-plan
- weed-relapse-why-it-happens
- weed-ritual-replacement
- weed-ruined-relationships
- weed-social-media-triggers-quit
Cite This Study
https://rethinkthc.com/research/RTHC-05634APA
Pravosud, Vira; Glantz, Stanton; Keyhani, Salomeh; Ling, Pamela M; Lempert, Lauren K; Hoggatt, Katherine J; Hasin, Deborah; Nguyen, Nhung; Graham, Francis Julian L; Cohen, Beth E. (2024). Cannabis legalization and changes in cannabis and tobacco/nicotine use and co-use in a national cohort of U.S. adults during 2017-2021.. The International journal on drug policy, 134, 104618. https://doi.org/10.1016/j.drugpo.2024.104618
MLA
Pravosud, Vira, et al. "Cannabis legalization and changes in cannabis and tobacco/nicotine use and co-use in a national cohort of U.S. adults during 2017-2021.." The International journal on drug policy, 2024. https://doi.org/10.1016/j.drugpo.2024.104618
RethinkTHC
RethinkTHC Research Database. "Cannabis legalization and changes in cannabis and tobacco/ni..." RTHC-05634. Retrieved from https://rethinkthc.com/research/pravosud-2024-cannabis-legalization-and-changes
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.