Living Closer to Cannabis Stores Linked to Higher Prenatal Cannabis Use During the Pandemic

Prenatal cannabis use before (6.8%) and during (8.2%) the pandemic was associated with closer proximity to a retailer, greater retailer density, and living in jurisdictions that permitted rather than banned storefront retailers. While relative rate increases during the pandemic were similar regardless of retail access, the absolute increase was larger among those within a 10-minute drive of a retailer.

Cross-sectional population-based time series study of 99,127 pregnancies in Kaiser Permanente Northern California. Cannabis use measured by universal urine toxicology at entry to prenatal care. Proximity to nearest retailer, retailer density within 15-minute drive, and local storefront policies mapped. Interrupted time series models with Poisson regression.

This is among the largest studies to connect the physical retail environment to prenatal cannabis use. Finding that proximity to stores matters adds geographic accessibility to the list of factors influencing prenatal use, which could inform zoning and policy decisions.

As cannabis retail expands nationwide, understanding how the retail environment shapes use patterns, especially during pregnancy, can help policymakers balance access with public health. Buffer zones around certain areas are already debated, and this data adds pregnancy-relevant evidence.

Observational study cannot prove retailer proximity caused higher use. Limited to one health system in Northern California. Urine toxicology detects recent use but cannot distinguish frequency or amount. The pandemic created unique conditions that may not reflect typical patterns.