Among nearly 100,000 pregnancies in Northern California, prenatal cannabis use was more common among those living closer to cannabis retailers, and the absolute increase during the COVID-19 pandemic was greater for those within a 10-minute drive of a store.
Policymakers, public health officials, and people interested in how retail access affects prenatal cannabis use
99,127 pregnancies analyzed
What the researchers found
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.
Why it matters
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.
The numbers in context
99,127 pregnancies; 6.8% prenatal cannabis use pre-pandemic; 8.2% during pandemic; greater absolute increase within 10-minute drive of retailer; adjusted for age and race/ethnicity
How the study worked
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.
What this study cannot tell us
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.
How to read the evidence
Large population-based study with objective cannabis measurement, though observational design limits causal inference
When this study was published
2022 study
The bigger picture
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.
Questions still open
- Would zoning restrictions around residential areas reduce prenatal cannabis use? Does delivery availability negate the effect of physical store distance? How do these findings apply in states with different retail models?
Common questions
Does living near a cannabis store increase prenatal use?
Did the pandemic increase prenatal cannabis use?
Read the original research
Geographic Accessibility of Retail Cannabis in Northern California and Prenatal Cannabis Use During the COVID-19 Pandemic.
JAMA network open, 5(11), e2244086
Citation
Young-Wolff, Kelly C; Slama, Natalie E; Padon, Alisa A; Silver, Lynn D; Soroosh, Aurash; Alexeeff, Stacey E; Adams, Sara R; Does, Monique B; Campbell, Cynthia I; Ansley, Deborah; Conway, Amy; Goler, Nancy; Avalos, Lyndsay A. (2022). Geographic Accessibility of Retail Cannabis in Northern California and Prenatal Cannabis Use During the COVID-19 Pandemic.. JAMA network open, 5(11), e2244086. https://doi.org/10.1001/jamanetworkopen.2022.44086
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