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Carlini BH, Kellum LB, Garrett SB, Nims LN. Threaten, Distract, and Discredit: Cannabis Industry Rhetoric to Defeat Regulation of High-THC Cannabis Products in Washington State. J Stud Alcohol Drugs 2024; 85:322-329. [PMID: 38270913 PMCID: PMC11218453 DOI: 10.15288/jsad.23-00277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 11/21/2023] [Indexed: 01/26/2024] Open
Abstract
OBJECTIVE Washington State legislators have attempted to regulate high delta-9-tetrahydrocannabinol (THC) cannabis to reduce cannabis-related harms. Historically, industry actors of other health-compromising products have influenced governments' adoption of evidence-based regulation policies. A better understanding of the industry rhetoric can be used by public health advocates to develop counterarguments and disseminate alternative narratives that protect the public's health. We analyzed the arguments used by cannabis industry actors opposing regulations to de-incentivize the availability and use of high-THC products in Washington State. METHOD We analyzed 41 testimonies transcribed from 33 cannabis industry actors in 3 public bill hearings and one legislative work session that occurred between 2020 and 2023. Using a deductive thematic analysis, informed by industry actors' arguments opposing regulation of alcohol, tobacco, and high-sugar beverages, we developed a codebook to analyze and identify themes within cannabis industry rhetorical strategies. RESULTS We identified three main rhetorical strategies used by cannabis industry actors to oppose THC content regulation: threaten, distract, discredit. The most frequently used rhetorical strategy was threats to economic benefits, public health, and the will of the people. The other two most apparent strategies were distracting from the bill's focus by introducing a tangential topic and discrediting the science that supported regulation of cannabis products with high THC concentration or its advocates. CONCLUSIONS Cannabis industry actors have leveraged several arguments used by industry actors of other health-compromising products to undermine initiatives to advance public health. They have also adapted rhetoric from other industries to the unique conditions of the cannabis regulatory landscape.
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Affiliation(s)
- Beatriz H. Carlini
- Addictions, Drug, & Alcohol Institute, Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington
| | - Lyndsey B. Kellum
- Addictions, Drug, & Alcohol Institute, Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington
| | - Sharon B. Garrett
- Addictions, Drug, & Alcohol Institute, Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington
| | - Lexi N. Nims
- Addictions, Drug, & Alcohol Institute, Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington
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Rossheim ME, LoParco CR, Berg CJ, Tillett KK, Trangenstein PJ, Henry D, Yockey RA, Livingston MD, Jernigan DH, Sussman SY. Derived psychoactive cannabis products and 4/20 specials: An assessment of popular brands and retail price discounts in Fort Worth, Texas, 2023. Drug Alcohol Depend 2024; 256:111119. [PMID: 38350186 DOI: 10.1016/j.drugalcdep.2024.111119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 12/21/2023] [Accepted: 02/01/2024] [Indexed: 02/15/2024]
Abstract
BACKGROUND Retail sales of derived psychoactive cannabis products (DPCPs) have increased in the U.S. since passing the 2018 Farm Bill and is unregulated in most states. This study investigated the types and commonly sold brands of DPCPs as well as promotional pricing on April 20th, a day associated with cannabis use. METHODS On April 19-20, 2023, investigators conducted telephone surveys with 98 retail stores that sold DPCPs in Fort Worth, Texas (where the market was largely unregulated). RESULTS Delta-8, Delta-9, and Delta-10 THC products were widely available, with 97%, 72%, and 82% of stores selling each type, respectively. Fifteen additional DPCPs were identified, and selling blends containing multiple types of THC was common. Frequently sold brands included Cake, Medusa/Modus, Torch, Urb, Kik, Tyson, 3Chi, Casper, Hidden Hills, Esco Bars, Happi, Hometown Hero, STNR, Bomb Bars, Baked, Hi On Nature, Looper, and Space God. Overall, 45% reported having 4/20 specials discounting prices on DPCPs, smoking devices/accessories, or everything in the store. Several stores also sponsored 4/20 promotional events including free THC gummies and "live delta demos where people can test cartridges and try smoking flower in the store." CONCLUSIONS Findings highlight the growing complexity of the DPCP market, including numerous different intoxicating compounds and blends. Policymakers, researchers, and public health professionals should consider these complexities, as well as the commonly sold brands, when developing strategies to regulate DPCPs and protect consumer safety. Pricing policies may be an especially important form of harm reduction during events associated with heavy cannabis use, including 4/20.
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Affiliation(s)
- Matthew E Rossheim
- School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA.
| | - Cassidy R LoParco
- Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Carla J Berg
- Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Kayla K Tillett
- School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA
| | | | - Doug Henry
- Department of Anthropology, University of North Texas, Denton, TX, USA
| | - R Andrew Yockey
- School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA
| | | | | | - Steven Y Sussman
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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3
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Miller CR, Xu SS, Smith DM, Sutanto E, Goniewicz ML, Quah ACK, Fong GT. Assessing use of inhalable nicotine products within complex markets: the dilemma of heated tobacco products. Tob Control 2023; 33:103-109. [PMID: 35680384 PMCID: PMC10804002 DOI: 10.1136/tobaccocontrol-2021-057081] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 04/27/2022] [Indexed: 11/04/2022]
Abstract
The introduction of electronic inhalable products, such as nicotine vaping products (NVPs) and heated tobacco products (HTPs), has further diversified the nicotine market landscape. This poses unique challenges in measuring self-reported nicotine use behaviours, which have been the hallmark of tobacco surveillance systems. This paper raises concerns of potential measurement error for electronic inhalable product use in surveys due to similarities in product design between NVPs and HTPs, as well as changing trends in cannabis administration. We identify several strategies for addressing this issue (eg, including descriptive preambles in surveys that differentiate product classes from one another; incorporating survey questions that probe beyond an initial question regarding product use). In the absence of comprehensive validation studies, caution is warranted when interpreting survey results that rely on self-reported HTP use.
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Affiliation(s)
- Connor Richard Miller
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Steve S Xu
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
| | - Danielle M Smith
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Edward Sutanto
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Maciej Lukasz Goniewicz
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Anne C K Quah
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
| | - Geoffrey T Fong
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
- Ontario Institute for Cancer Research, Toronto, Ontario, Canada
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Rotering T, Bialous S, Apollonio D. Cannabis industry campaign expenditures in Colorado, 2005-2021. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2023; 119:104156. [PMID: 37557020 DOI: 10.1016/j.drugpo.2023.104156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 07/27/2023] [Accepted: 07/31/2023] [Indexed: 08/11/2023]
Abstract
BACKGROUND The cannabis industry has been described using the commercial determinants of health framework because it seeks to increase sales and profits through efforts to change the political environment. To increase understanding of these cannabis industry's efforts, this study describes cannabis industry campaign contributions in Colorado through an analysis of public records. METHODS We reviewed datasets posted online at the Colorado Secretary of State's Transparent in Contribution and Expenditure Reporting (TRACER) Campaign Finance System. We generated descriptive data on cannabis industry contributions to elections and conducted regressions to identify predictors of contributions, and associations between lagged contributions and a legislator's cannabis industry score (how closely aligned lawmaker's legislative history is with the cannabis industry from -1 to 1). RESULTS Between 2005-2021, 429 cannabis-affiliated contributors gave $4,658,385 (2021 inflation-adjusted) to 512 electoral committees. Contributions came primarily from non-profits (45%), businesses (27%), and individuals (25%). After recreational legalization in 2012, contributions from non-profit donors with industry ties gave way to contributions from cannabis businesses, business owners, and lobbyists. Cannabis industry contributions to local and state-wide ballot initiative campaigns historically made up the majority of the industry spending, but contributions to candidate committees more than tripled between the 2009-2010 legislative cycle and the 2019-2020 cycle. From 2017-2020, every $10,000 in lagged campaign donations from cannabis industry affiliated contributors was associated with a 0.245-point increase in a legislator's cannabis industry score (p=0.04). CONCLUSION Cannabis-affiliated interests made substantial campaign contributions in Colorado. Public health advocates should monitor industry connections to lawmakers and industry tactics used to mask the source of political contributions. Continued surveillance of the cannabis industry is essential to exposing conflicts of interest and preventing undue industry influence.
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Affiliation(s)
- Thomas Rotering
- Department of Clinical Pharmacy, University of California. UCSF Clinical Sciences Box 0622, 521 Parnassus Avenue, Floor 3 Room 3303, San Francisco, CA 94143, USA
| | - Stella Bialous
- School of Nursing, University of California. 490 Illinois St., Floor 12, Box 0612 San Francisco, CA 94143, USA
| | - Dorie Apollonio
- Department of Clinical Pharmacy, University of California. UCSF Clinical Sciences Box 0622, 521 Parnassus Avenue, Floor 3 Room 3303, San Francisco, CA 94143, USA.
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Montgomery BW, Allen J. Cannabis Policy in the 21st Century: Mandating an Equitable Future and Shedding the Racist Past. Clin Ther 2023; 45:541-550. [PMID: 37414505 DOI: 10.1016/j.clinthera.2023.05.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 03/27/2023] [Accepted: 05/01/2023] [Indexed: 07/08/2023]
Abstract
The cannabis legalization movement in the United States has experienced unprecedented success in the past decade due to a wave of grassroots reforms in states across the country. The current legalization movement began in 2012, when Colorado and Washington became the first two states to legalize the use and sale of cannabis for adults aged ≥ 21 years. Since then, the use of cannabis has been legalized in 21 states, Guam, the Northern Mariana Islands, and Washington, DC. Many of these states have explicitly framed the law change as a rejection of the War on Drugs and its harms, felt disproportionately in Black and Brown communities. However, racial inequities in cannabis arrests have increased in states that have legalized cannabis for adult use. Moreover, states working to implement social equity and community reinvestment programs have made little progress toward their goals. This commentary describes how US drug policy, racist in intention, gave way to drug policy that perpetuates racism, even when its ostensible or stated goal is equity. As the United States prepares for national legalization of cannabis, it is critical that we break away from past legislation and mandate equity in cannabis policy. Developing meaningful mandates will require us to acknowledge our history of using drug policy for the racist goals of social control and extortion, study the experience of states that are trying to implement social equity programs, listen to Black leaders and other leaders of color who have developed guidance for equity-focused cannabis policy, and commit to a new paradigm. If we are willing to do these things, we may be able to legalize cannabis in an anti-racist way that will stop causing harm and enable us to effectively implement reparative practices.
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Affiliation(s)
| | - Jane Allen
- RTI International, Waltham, Massachusetts
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6
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Wang LX, Wilson NJ. U.S. State approaches to cannabis licensing. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2022; 106:103755. [PMID: 35691088 DOI: 10.1016/j.drugpo.2022.103755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 05/28/2022] [Accepted: 05/31/2022] [Indexed: 10/18/2022]
Abstract
U.S. states have taken varied approaches to licensing cannabis businesses under federal prohibition, but up to now there is limited research on cross-state licensing approaches. This paper provides a systematic analysis of the current licensing strategies taken by all states that have passed medical cannabis laws (MCLs)/recreational cannabis laws (RCLs). We construct comprehensive data on cannabis business licenses offered in each state, as well as metrics for license categories, cost, and issuance volume. We then analyze patterns between these metrics, also considering how long ago states implemented MCLs/RCLs, qualitative licensing aspects, state ideology and voting preference, and state cannabis taxation data. We observe that states tend to license medical cannabis more restrictively than adult-use cannabis: i.e., by offering licenses in fewer categories, at higher cost, in lower issuance volume, and more often mandating vertical integration. Additionally, states that implemented MCLs/RCLs earlier tend to offer licenses in more categories, at lower cost, and in greater volumes. Further, though states that implemented MCLs recently lean conservative and Republican, we do not observe clear relationships between ideology or voting preference and licensing policy. In our supporting results, we observe that a greater share of states with complex licensing structures impose non-retail price cannabis taxes than states overall, and we discuss how states have changed their licensing policies over time.
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Affiliation(s)
- Lucy Xiaolu Wang
- Department of Resource Economics, University of Massachusetts Amherst, Amherst MA 01002, United States; Max Planck Institute for Innovation and Competition, Marstallplatz 1, Munich 80539, Germany; Canadian Centre for Health Economics, 155 College Street, Toronto, ON M5T 3M6, Canada.
| | - Nicholas J Wilson
- Max Planck Institute for Innovation and Competition, Marstallplatz 1, Munich 80539, Germany; Department of Economics, Ludwig Maximilian University of Munich, Ludwigstraße 28, Munich 80539, Germany.
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Rotering T, Apollonio DE. Cannabis industry lobbying in the Colorado state legislature in fiscal years 2010-2021. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2022; 102:103585. [PMID: 35085854 PMCID: PMC9632648 DOI: 10.1016/j.drugpo.2022.103585] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 01/04/2022] [Accepted: 01/10/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUND The cannabis industry has an interest in creating a regulatory environment which maximizes profits at the cost of public health, similar to the tobacco, alcohol, and food industries. This study sought to describe the cannabis industry's lobbying activities in the Colorado State Legislature over time. METHODS This retrospective observational study analyzed publicly available lobbying expenditures data from fiscal years (FY) 2010-2021. Measures included inflation-adjusted monthly lobbying expenditures by funder and lobbyist, origin of funding, and lobbyist descriptions of cannabis industry clients. This dataset was supplemented with business license documentation, legislative histories, and public testimony. RESULTS The cannabis industry spent over $7 million (inflation adjusted) from FY 2010-2021 to lobby the Colorado legislature on 367 bills. Over $800,000 (11% of total cannabis spending) was from out-of-state clients. In 48% of lobbyist reports lobbyists did not disclose their funder's cannabis affiliation, and cannabis organizations used strategies that may have obscured the true amount and source of funding. Lobbyists and agencies concurrently represented the alcohol, tobacco, and cannabis industries, possibly facilitating inter-industry alliances when interests align. CONCLUSION The cannabis industry dedicated significant resources towards lobbying the Colorado State Legislature on behalf of policies intended to increase cannabis use. Creating transparency about the relationships between the cannabis industry, related industries, and policymakers is essential to ensure appropriate regulation of cannabis products.
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Affiliation(s)
- Thomas Rotering
- Department of Clinical Pharmacy, University of California, UCSF Clinical Sciences Box 0622, 521 Parnassus Avenue, Floor 3 Room 3303, San Francisco, CA 94143, USA
| | - Dorie E Apollonio
- Department of Clinical Pharmacy, University of California, UCSF Clinical Sciences Box 0622, 521 Parnassus Avenue, Floor 3 Room 3303, San Francisco, CA 94143, USA.
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Ling PM, Kim M, Egbe CO, Patanavanich R, Pinho M, Hendlin Y. Moving targets: how the rapidly changing tobacco and nicotine landscape creates advertising and promotion policy challenges. Tob Control 2022; 31:222-228. [PMID: 35241592 PMCID: PMC9233523 DOI: 10.1136/tobaccocontrol-2021-056552] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 12/01/2021] [Indexed: 01/18/2023]
Abstract
Tobacco, nicotine and related products have and continue to change rapidly, creating new challenges for policies regulating their advertising, promotion, sponsorship and sales. This paper reviews recent commercial product offerings and the regulatory challenges associated with them. This includes electronic nicotine delivery systems, electronic non-nicotine delivery systems, personal vaporisers, heated tobacco products, nicotine salts, tobacco-free nicotine products, other nicotine products resembling nicotine replacement therapies, and various vitamin and cannabis products that share delivery devices or marketing channels with tobacco products. There is substantial variation in the availability of these tobacco, nicotine, vaporised, and related products globally, and policies regulating these products also vary substantially between countries. Many of these products avoid regulation by exploiting loopholes in the definition of tobacco or nicotine products, or by occupying a regulatory grey area where authority is unclear. These challenges will increase as the tobacco industry continues to diversify its product portfolio, and weaponises 'tobacco harm reduction' rhetoric to undermine policies limiting marketing, promotion and taxation of tobacco, nicotine and related products. Tobacco control policy often lags behind the evolution of the industry, which may continue to sell these products for years while regulations are established, refined or enforced. Policies that anticipate commercial tobacco, nicotine and related product and marketing changes and that are broad enough to cover these product developments are needed.
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Affiliation(s)
- Pamela M Ling
- Department of Medicine and Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, California, USA
| | - Minji Kim
- Department of Health Promotion, Education, and Behavior, University of South Carolina Arnold School of Public Health, Columbia, South Carolina, USA
| | - Catherine O Egbe
- Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Pretoria, Gauteng, South Africa
- Department of Public Health, Sefako Makgatho Health Sciences University, Pretoria, Gauteng, South Africa
| | - Roengrudee Patanavanich
- Department of Community Medicine, Mahidol University Faculty of Medicine Ramathibodi Hospital, Bangkok, Thailand
| | - Mariana Pinho
- Tobacco Control Project, ACT Health Promotion (Brazil), Rio de Janeiro, Brazil
| | - Yogi Hendlin
- Erasmus School of Philosophy, Erasmus University Rotterdam, Rotterdam, The Netherlands
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9
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Patanavanich R, Glantz S. Successful countering of tobacco industry efforts to overturn Thailand's ENDS ban. Tob Control 2021; 30:e10-e19. [PMID: 33229463 PMCID: PMC8141069 DOI: 10.1136/tobaccocontrol-2020-056058] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 08/08/2020] [Accepted: 08/26/2020] [Indexed: 11/04/2022]
Abstract
BACKGROUND After Thailand enacted laws to ban the import and sale of all types of electronic nicotine delivery systems (ENDS, including e-cigarettes and heated tobacco products (HTPs)) in 2015, pro-ENDS advocacy groups pressured the government to lift the ban, particularly after Philip Morris International (PMI) started promoting its HTP IQOS in 2017. METHODS We reviewed information related to ENDS in Thailand between 2014 and 2019 from Thai newspaper articles, meeting minutes and letters submitted to government agencies, websites and social media platforms of pro-ENDS networks and Thai tobacco control organisations. RESULTS The tobacco industry and the pro-ENDS groups used five tactics to try to reverse the Thai ban on ENDS: creating front groups, lobbying decision-makers, running public relations campaigns, seeking to discredit tobacco control advocates and funding pro-tobacco harm reduction research. ENDS Cigarette Smoking Thailand (ECST), a pro-ENDS group in Thailand, worked in parallel to Philip Morris Thailand Limited (PMTL) to oppose the ban. The group connected with international coalitions that promote harm reduction through the PMI-funded Foundation for a Smoke-Free World. CONCLUSION Although ECST and PMTL continuously worked to revoke the ban since 2017, the government still kept ENDS illegal as of October 2020. This decision resulted from the strong commitment and collaboration among Thai tobacco control organisations and their shared vision to protect the public's health from harmful tobacco products. The similar strategies used by the pro-ENDS movement in Thailand and the tobacco companies could inform health advocates and policy-makers in other low and middle income countries facing pressure to market ENDS.
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Affiliation(s)
- Roengrudee Patanavanich
- Center for Tobacco Control Research and Education, University of California, San Francisco, California, USA
- Department of Community Medicine, Faculty of Medicine Ramathibodi Hospital Mahidol University, Bangkok, Thailand
| | - Stanton Glantz
- Center for Tobacco Control Research and Education, University of California, San Francisco, California, USA
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10
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McCambridge J, Madden M. Think big about developing the science. Addiction 2021; 116:2947-2948. [PMID: 34060152 PMCID: PMC8650571 DOI: 10.1111/add.15568] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 05/11/2021] [Indexed: 12/22/2022]
Affiliation(s)
| | - Mary Madden
- Department of Health SciencesUniversity of YorkYorkUK
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Payán DD, Brown P, Song AV. County-Level Recreational Marijuana Policies and Local Policy Changes in Colorado and Washington State (2012-2019). Milbank Q 2021; 99:1132-1161. [PMID: 34407252 DOI: 10.1111/1468-0009.12535] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Policy Points In 2012, Colorado and Washington were the first states to legalize recreational marijuana through voter-initiated ballots. In these states, counties could restrict or ban local marijuana facilities through a variety of regulatory methods such as ordinances and zoning. County-level recreational marijuana policies in Washington and Colorado vary substantially, with 69.2% of Washington counties and 23.4% of Colorado counties allowing all types of recreational marijuana facilities as of April 1, 2019. After Colorado and Washington legalized recreational marijuana, many counties modified their marijuana policies over time, with shifts in county policy often preceded by advocacy and information-seeking activities. CONTEXT In 2012, Colorado and Washington were the first states to legalize recreational marijuana. Both allowed local governments to further regulate the availability of marijuana facilities in their jurisdictions. As early adopters, these states are important quasi-natural experiments to examine local marijuana policy and policy change processes, including key stakeholders and arguments. METHODS We conducted a policy scan of county-level recreational marijuana ordinances and regulations in Colorado and Washington. Data collected included policy documents from counties in both states and newspaper articles. We used a mixed-methods approach to describe the types of county-level recreational marijuana policies enacted by April 1, 2019; identify key policy stakeholders involved in local policy debates; and explore arguments used in support or opposition of county policies. We also selected four counties that represent three county policy environments (all marijuana facility types allowed, some marijuana facility types allowed, all marijuana facility types prohibited) and described the policy changes within these counties since recreational marijuana was legalized. FINDINGS By April 1, 2019, Colorado counties were less likely than Washington counties to allow marijuana facilities-48.4% of Colorado counties prohibited recreational marijuana facilities in their jurisdiction compared to 23.1% of Washington counties. Since state legalization, several counties in both states have made substantial marijuana facility policy modifications, often preceded by information-seeking activities. Primary stakeholders involved in policy debates included elected officials, law enforcement, individual growers/farmers, marijuana business license applicants, parents, and residents. Proponents referenced local economic gain, reduced crime, and potential health benefits of marijuana as arguments in favor of permitting local facilities, whereas opponents pointed to economic loss, negative health and public health issues, public safety concerns, and existing federal law. Both sides referenced local public opinion data to support their position. CONCLUSIONS By early 2019, a patchwork of local marijuana policies was in place in Colorado and Washington. We identify key areas of policy and public health research needed to inform future local marijuana policy decisions, including the impact of legalization on public health outcomes (particularly for youth) and public safety.
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Rychert M, Emanuel MA, Wilkins C. Foreign investment in emerging legal medicinal cannabis markets: the Jamaica case study. Global Health 2021; 17:38. [PMID: 33794932 PMCID: PMC8015746 DOI: 10.1186/s12992-021-00687-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 03/18/2021] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION The establishment of a legal market for medicinal cannabis under the Dangerous Drugs Amendment Act 2015 has positioned Jamaica at the forefront of cannabis law reform in the developing world. Many local cannabis businesses have attracted investment from overseas, including from Canada, US and Europe. AIM To explore the opportunities and risks of foreign investment in an emerging domestic legal cannabis market in a developing country. METHODS Thematic analysis of semi-structured face-to-face interviews with 22 key informants (KIs) from the Jamaican government, local cannabis industry, academia and civil society, and field observations of legal and illegal cannabis cultivators. RESULTS KIs from the Jamaican public agencies and domestic cannabis entrepreneurs saw foreign investment as an essential source of capital to finance the start-up costs of legal cannabis businesses. Local cannabis entrepreneurs prioritised investors with the greatest financial resources, brand reputation and export networks. They also considered how allied an investor was with their business vision (e.g., organic cultivation, medical vs. recreational). The key benefits of partnering with a foreign investor included transfer of technical knowledge and financial capital, which enhanced production, quality assurance and seed-to-sale tracking. Some KIs expressed concern over investors' focus on increasing production efficiency and scale at the expense of funding research and development (R&D) and clinical trials. KIs from the local industry, government agencies and civil society highlighted the risks of 'predatory' shareholder agreements and domestic political interference. Concerns were raised about the impact of foreign investment on the diversity of the domestic cannabis sector in Jamaica, including the commitment to transition traditional illegal small-scale cannabis cultivators to the legal sector. CONCLUSION While foreign investment has facilitated the commercialisation of the cannabis sector in Jamaica, regulatory measures are also needed to protect the domestic industry and support the transition of small-scale illegal cultivators to the legal regime. Foreign investments may alter the economic, social and political determinants of health in transitioning from illegal to legal cannabis market economy.
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Affiliation(s)
- Marta Rychert
- Shore & Whāriki Research Centre, College of Health, Massey University, Auckland, New Zealand.
| | - Machel Anthony Emanuel
- Department of Life Sciences, University of the West Indies, Mona Campus, Kingston, Jamaica
| | - Chris Wilkins
- Shore & Whāriki Research Centre, College of Health, Massey University, Auckland, New Zealand
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Bowling CM, Hafez AY, Glantz SA. Public Health and Medicine's Need to Respond to Cannabis Commercialization in the United States: A Commentary. J Psychoactive Drugs 2020; 52:377-382. [PMID: 32429772 PMCID: PMC7674246 DOI: 10.1080/02791072.2020.1761040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 12/11/2019] [Indexed: 10/24/2022]
Abstract
Cannabis legalization has resulted in rapid commercialization, making this new market increasingly attractive to tobacco, alcohol and beverage, agricultural, and pharmaceutical multinational corporations, who are well positioned to capitalize on the synergy between cannabis and their products. The fact that cannabis remains a Schedule I drug under the Controlled Substances Act is inhibiting research, which consequently prevents evidence-based regulation of modern, more potent, engineered cannabis products and their use. Without a research exemption for legitimate studies of commercially available products, cannabis' Schedule I classification makes it very difficult to conduct medical and scientific research to inform policymaking and regulation. As corporate commercialization looms large, public health organizations need to engage the issue of rapid commercialization of cannabis products and press for evidence-based policies based on public health best practices.
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Affiliation(s)
- Candice M Bowling
- Center for Tobacco Control Research and Education, Philip R. Lee Institute for Health Policy Studies, Department of Medicine, University of California, San Francisco , San Francisco, California, USA
| | - Amy Y Hafez
- Center for Tobacco Control Research and Education, Philip R. Lee Institute for Health Policy Studies, Department of Medicine, University of California, San Francisco , San Francisco, California, USA
| | - Stanton A Glantz
- Center for Tobacco Control Research and Education, Philip R. Lee Institute for Health Policy Studies, Department of Medicine, University of California, San Francisco , San Francisco, California, USA
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Kumar N, Puljević C, Heimer R. Understanding motivations for large US cannabis firms' participation in the cannabis space: Qualitative study exploring views of key decision-makers. Drug Alcohol Rev 2020; 39:347-355. [PMID: 32056335 DOI: 10.1111/dar.13040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 01/14/2020] [Accepted: 01/15/2020] [Indexed: 11/30/2022]
Abstract
INTRODUCTION AND AIMS Large for-profit firms supply the majority of US state-legal cannabis stores and some firms have attempted to shape cannabis-related policies. Understanding firms' motivations for participation in the cannabis space is critical, given firms' possible links to cannabis usage patterns. Key decision-makers (KDM) in the cannabis space may have information unavailable to lower ranking staff, and may influence firm decision-making and consequently US cannabis usage practises. We present the findings of a qualitative study investigating the views of KDMs in the cannabis market, on large cannabis firms' motivations for participation in the space. DESIGN AND METHODS Data were collected through 37 semi-structured interviews with a convenience sample of KDMs in the US cannabis space, representing both for-profit and non-profit organisations. Thematic analysis, with an inductive approach, was used to analyse the data. RESULTS KDMs reported three non-exclusive motivations for large cannabis firms' participation in the space; to seek profit, to mitigate social inequity and to provide cannabis as medicine. Within the theme relating to profit, findings suggest that for-profit and non-profit organisations in the space may be cognisant of the other's goals, representing a symbiotic relationship. DISCUSSION AND CONCLUSIONS We suggest that firms may have reasons to enter the space not necessarily centred on increasing use. Although non-profits and for-profits have different agendas, the bottom line for both groups is to expand access. Policy-makers should be aware of that fact, and set policies which consider the two groups as a unified whole.
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Affiliation(s)
- Navin Kumar
- Sociology Department, Yale University, New Haven, USA.,Yale Institute for Network Science, New Haven, USA.,Yale University Center for Interdisciplinary Research on AIDS, New Haven, USA
| | - Cheneal Puljević
- Centre for Health Services Research, The University of Queensland, Brisbane, Australia.,Griffith Criminology Institute, Griffith University, Brisbane, Australia
| | - Robert Heimer
- Yale University Center for Interdisciplinary Research on AIDS, New Haven, USA.,Yale School of Public Health, Yale University, New Haven, USA
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Shanahan M, Cyrenne P. Cannabis policies in Canada: How will we know which is best? THE INTERNATIONAL JOURNAL OF DRUG POLICY 2019; 91:102556. [PMID: 31563287 DOI: 10.1016/j.drugpo.2019.09.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 09/07/2019] [Accepted: 09/17/2019] [Indexed: 11/25/2022]
Abstract
BACKGROUND The recent legalisation of cannabis in Canada by the Federal Government, along with the accompanying laws and regulations of provincial and territorial governments provides an opportunity to assess the expected benefits and harms of legalisation. While the legislative changes have been initiated by the federal government, much of the responsibility for the implementation falls onto the provinces and territories. These jurisdictions are responsible for regulating the wholesale distribution, retail structures, cannabis consumption, as well as a host of other regulations. METHODS Key characteristics of policies outlined are categorised according to a framework previously developed by the authors (2018). The categories are: (1) government regulation or control, (2) social costs that accompany its use, and (3) legal sanctions that accompany its production and use. Towards that end, we develop a framework for a cost benefit analysis (CBA) outlining in some detail the data that is needed to undertake a credible economic evaluation of cannabis policies. RESULTS Key data issues discussed include consumer surplus, government receipts including legal and regulatory costs, impact on substitutes, change in profits to firms (growers, wholesalers, and retailers), incomes earned in the industry, health and other costs incurred by cannabis users. DISCUSSION This paper presents a summary of the expected categories of costs and benefits given the various provincial cannabis policies. Additionally, it provides a framework for subsequent cost benefit analyses which can quantify said harms and benefits.
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Affiliation(s)
- Marian Shanahan
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, 2052 NSW, Australia.
| | - Philippe Cyrenne
- Department of Economics, Faculty of Business and Economics, University of Winnipeg, Winnipeg, Manitoba, Canada
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Belackova V, Roubalova (Stefunkova) M, van de Ven K. Overview of “home” cultivation policies and the case for community-based cannabis supply. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2019; 71:36-46. [DOI: 10.1016/j.drugpo.2019.05.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 03/28/2019] [Accepted: 05/20/2019] [Indexed: 01/21/2023]
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Caulkins JP, Kilborn ML. Cannabis legalization, regulation, & control: a review of key challenges for local, state, and provincial officials. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2019; 45:689-697. [DOI: 10.1080/00952990.2019.1611840] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
| | - Michelle L. Kilborn
- Alberta Health Services, Population, Public and Indigenous Health Unit, Edmonton, Canada
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Schmidt LA. Commentary on Fergie et al. (2019): A new tool for unpacking policy debates over unhealthy commodities. Addiction 2019; 114:754-755. [PMID: 30854748 DOI: 10.1111/add.14586] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 02/13/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Laura A Schmidt
- Philip R. Lee Institute for Health Policy Studies, School of Medicine, University of California at San Francisco, San Francisco, USA.,Department of Anthropology, History and Social Medicine, School of Medicine, University of California at San Francisco, San Francisco, USA
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Shover CL, Humphreys K. Six policy lessons relevant to cannabis legalization. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2019; 45:698-706. [PMID: 30870053 DOI: 10.1080/00952990.2019.1569669] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Background: Cannabis (marijuana) has been legalized for recreational and/or medicinal use in many US states, despite remaining a Schedule-I drug at the federal level. As legalization regimes are established in multiple countries, public health professionals should leverage decades of knowledge from other policy areas (e.g., alcohol and tobacco regulation) to inform cannabis policy.Objectives: Identify policy lessons from other more established policy areas that can inform cannabis policy in the United States, Canada, and any other nations that legalize recreational cannabis.Methods: Narrative review of policy and public health literature.Results: We identified six key lessons to guide cannabis policy. To avoid the harms of "a medical system only in name," medical cannabis programs should either be regulated like medicine or combined with the recreational market. Capping potency of cannabis products can reduce the harms of the drug, including addiction. Pricing policies that promote public health may include minimum unit pricing or taxation by weight. Protecting science and public health from corporate interest can prevent the scenarios we have seen with soda and tobacco lobbies funding studies to report favorable results about their products. Legalizing states can go beyond reducing possession arrests (which can be accomplished without legalization) by expunging prior criminal records of cannabis-related convictions. Finally, facilitating rigorous research can differentiate truth from positive and negative hype about cannabis' effects.Conclusion: Scientists and policymakers can learn from the successes and failures of alcohol and tobacco policy to regulate cannabis products, thereby mitigating old harms of cannabis prohibition while reducing new harms from legalization.
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Affiliation(s)
- Chelsea L Shover
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA, USA
| | - Keith Humphreys
- Department of Psychiatry and Behavioral Sciences, Veterans Affairs Health Care System and Stanford University, Palo Alto, CA, USA
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Doroudgar S, Mae Chuang H, Bohnert K, Canedo J, Burrowes S, Perry PJ. Effects of chronic marijuana use on driving performance. TRAFFIC INJURY PREVENTION 2018; 19:680-686. [PMID: 30411981 DOI: 10.1080/15389588.2018.1501800] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 07/13/2018] [Accepted: 07/14/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVES The effects of marijuana on driving pose a significant public health concern. More studies on chronic marijuana use in driving are needed. The study objectives were to (1) assess differences in the Standardized Field Sobriety Test (SFST) and driving performance outcomes between chronic medical marijuana users and nonusers and (2) identify a cutoff tetrahydrocannabinol (THC) concentration above which chronic medical marijuana users demonstrate driving impairment. METHODS This prospective cross-sectional study assessed 31 chronic marijuana users and 41 nonusers. Rapid Detect Saliva Drug Screen 10-panel was administered to all participants. Participants were given a simple visual reaction time test (SVRT) and SFST consisting of the horizontal gaze nystagmus (HGN), the one leg stand (OLS), and the walk and turn (WAT) tests. The STISIM Drive M100 driving simulator assessed driving performance. Driving parameters included standard deviation of speed (SDS), deviation of mean lane position, off-road accidents, collisions, pedestrians hit, and car-following modulus, delay, and coherence. Cannabinoid blood plasma was obtained from marijuana users. RESULTS Marijuana users and nonusers did not differ in age (40.06 ± 13.92 vs. 41.53 ± 15.49, P = .6782). Marijuana users were more likely to fail the SFST (P = .005) and the WAT (P = .012) and HGN (P = .001) components. Marijuana users had slower SVRT (P = .031), less SDS (P = .039), and lower modulus (P = .003). Participants with THC >2 ng/mL (P = .017) and TCH >5 ng/mL (P = .008) had lower SDS. Participants with THC >2 ng/mL (P = .021) and THC >5 ng/mL (P = .044) had decreased modulus. CONCLUSION Chronic marijuana users had slower reaction times, deviated less in speed, and had difficulty matching a lead vehicle's speed compared to nonusers. The effects on SDS and modulus were present at cutoffs of 2 and 5 ng/mL.
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Affiliation(s)
- Shadi Doroudgar
- a College of Pharmacy , Touro University California , Mare Island, Vallejo , California
| | - Hannah Mae Chuang
- a College of Pharmacy , Touro University California , Mare Island, Vallejo , California
| | - Kimberly Bohnert
- a College of Pharmacy , Touro University California , Mare Island, Vallejo , California
| | - Joanne Canedo
- a College of Pharmacy , Touro University California , Mare Island, Vallejo , California
| | - Sahai Burrowes
- b Public Health Program, College of Education and Health Sciences , Touro University California , Mare Island, Vallejo , California
| | - Paul J Perry
- a College of Pharmacy , Touro University California , Mare Island, Vallejo , California
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Barry RA, Glantz SA. Marijuana Regulatory Frameworks in Four US States: An Analysis Against a Public Health Standard. Am J Public Health 2018; 108:914-923. [PMID: 29874509 PMCID: PMC5993386 DOI: 10.2105/ajph.2018.304401] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/26/2018] [Indexed: 11/04/2022]
Abstract
The movement to legalize and regulate retail marijuana is growing. We examined legislation and regulations in the first 4 states to legalize recreational marijuana (Colorado, Washington, Oregon, and Alaska) to analyze whether public health best practices from tobacco and alcohol control to reduce population-level demand were being followed. Only between 34% and 51% of policies followed best practices. Marijuana regulations generally followed US alcohol policy regarding conflict of interest, taxation, education (youth-based and problematic users), warning labels, and research that does not seek to minimize consumption and the associated health effects. Application of US alcohol policies to marijuana has been challenged by some policy actors, notably those advocating public health policies modeled on tobacco control. Reversing past decisions to regulate marijuana modeled on alcohol policies will likely become increasingly difficult once these processes are set in motion and a dominant policy framework and trajectory becomes established. Designing future marijuana legislation to prioritize public health over business would make it easier to implement legalization of recreational marijuana in a way that protects health.
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Affiliation(s)
- Rachel A Barry
- At the beginning of this study, Rachel A. Barry and Stanton A. Glantz were with the Center for Tobacco Control Research and Education, Department of Medicine, and Philip R. Lee Institute for Health Policy Studies, University of California San Francisco. Rachel A. Barry is a graduate student, School of Social and Political Science, University of Edinburgh, Edinburgh, Scotland
| | - Stanton A Glantz
- At the beginning of this study, Rachel A. Barry and Stanton A. Glantz were with the Center for Tobacco Control Research and Education, Department of Medicine, and Philip R. Lee Institute for Health Policy Studies, University of California San Francisco. Rachel A. Barry is a graduate student, School of Social and Political Science, University of Edinburgh, Edinburgh, Scotland
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Charlebois S, Somogyi S, Sterling B. Cannabis-infused food and Canadian consumers’ willingness to consider “recreational” cannabis as a food ingredient. Trends Food Sci Technol 2018. [DOI: 10.1016/j.tifs.2018.02.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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23
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Wilkins C. A “not-for-profit” regulatory model for legal recreational cannabis: Insights from the regulation of gaming machine gambling in New Zealand. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2018; 53:115-122. [DOI: 10.1016/j.drugpo.2017.12.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 12/05/2017] [Accepted: 12/05/2017] [Indexed: 11/24/2022]
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Caulkins JP. Hedging bets: Applying New Zealand’s gambling machine regime to cannabis legalization. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2018; 53:113-114. [DOI: 10.1016/j.drugpo.2017.12.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Accepted: 12/18/2017] [Indexed: 10/18/2022]
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25
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Orenstein DG, Glantz SA. Regulating Cannabis Manufacturing: Applying Public Health Best Practices from Tobacco Control. J Psychoactive Drugs 2018; 50:19-32. [PMID: 29438634 DOI: 10.1080/02791072.2017.1422816] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
State legalization and regulation of cannabis, despite continued federal illegality, is a massive shift in regulatory approach. Manufactured cannabis, including concentrates, extracts, edibles, tinctures, topicals and other products, has received less attention than more commonly used dried flower, but represents emerging regulatory challenges due to additives, potency, consumption methods, and abuse and misuse potential. In November 2017, the California Department of Public Health (CDPH) released initial cannabis manufacturing regulations as part of a new state regulatory structure. As the largest U.S. medical cannabis market (and largest legal adult use market in the world beginning in 2018), California's regulatory approach will potentially influence national and global policy. Comparing CDPH's initial regulations to tobacco control best practices reveals that, while the regulations recognize the need to protect public health, prioritizing public health over business interests requires stronger approaches to labeling, packaging, and product formulations. Based on tobacco best practices, we recommend that cannabis regulations incorporate large and proportionately sized informational labels, a prominent universal cannabis symbol, rotating and pictorial health warnings, mandatory plain packaging, a comprehensive ban on characterizing flavors and addictive additives, and strict limits on the potency of inhalable products and those easily confused with non-cannabis products.
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Affiliation(s)
- Daniel G Orenstein
- a Postdoctoral Fellow, Center for Tobacco Control Research and Education and Philip R. Lee Institute for Health Policy Studies, University of California San Francisco , San Francisco , CA , UA
| | - Stanton A Glantz
- b Professor of Medicine, Truth Initiative Distingished Professor of Tobacco Control, Center for Tobacco Control Research and Education, Philip R. Lee Institute for Health Policy Studies, and Department of Medicine , University of California San Francisco , San Francisco , CA , USA
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26
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Montgomery L, Mantey DS. Correlates of Blunt Smoking Among African American, Hispanic/Latino, and White Adults: Results From the 2014 National Survey on Drug Use and Health. Subst Use Misuse 2017; 52:1449-1459. [PMID: 28467153 DOI: 10.1080/10826084.2017.1284238] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Blunt use is highly prevalent in the United States and has been associated with several negative health consequences, such as an increased risk for cardiovascular and pulmonary diseases. Although recent studies have identified characteristics (e.g., gender) that are associated with blunt use, it is unclear if these factors correlate with blunt use equally across racial/ethnic groups. METHODS Using cross-sectional data from the 2014 National Survey on Drug Use and Health, this study aimed to determine if demographic, health and substance use correlates of current (i.e., past 30-day) and lifetime blunt use were similar across 37,628 non-Hispanic African American, Hispanic/Latino and non-Hispanic White adults. RESULTS Findings revealed 8.3% of African American, 3.3% of Hispanic/Latino and 2.5% of White adults reported current blunt smoking. Across all racial/ethnic groups, age and current and lifetime cigarette and illicit drug use were associated with current and lifetime blunt use. However, gender, educational level, income, current alcohol use and self-reported health status were differentially associated with current and lifetime blunt use across racial/ethnic groups. Employment status and lifetime depression were not associated with blunt use behaviors among any of the racial/ethnic groups. CONCLUSIONS The relationship between gender, socioeconomic status, alcohol use and self-reported health status and blunt use differs among African American, Hispanic/Latino and White adults. Researchers and providers should consider the heterogeneity in factors that are associated with blunt use when designing prevention and treatment interventions for African American, Hispanic/Latino and White adult blunt smokers.
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Affiliation(s)
- LaTrice Montgomery
- a Addiction Sciences Division , University of Cincinnati College of Medicine , Cincinnati , Ohio , USA
| | - Dale S Mantey
- b University of Texas Health Science Center at Houston, School of Public Health, Austin Campus , Austin , Texas , USA
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Marsiglia FF, Kulis SS, Kiehne E, Ayers SL, Libisch Recalde CA, Sulca LB. Adolescent substance-use prevention and legalization of marijuana in Uruguay: A feasibility trial of the keepin’ it REAL prevention program. JOURNAL OF SUBSTANCE USE 2017. [DOI: 10.1080/14659891.2017.1358308] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Flavio F. Marsiglia
- Center for International Translational Intervention Research, Arizona State University, Phoenix, AZ, USA
| | - Stephen S. Kulis
- Center for International Translational Intervention Research, Arizona State University, Phoenix, AZ, USA
| | - Elizabeth Kiehne
- Center for International Translational Intervention Research, Arizona State University, Phoenix, AZ, USA
| | - Stephanie L. Ayers
- Center for International Translational Intervention Research, Arizona State University, Phoenix, AZ, USA
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Allen JA, Davis KC, Duke JC, Nonnemaker JM, Bradfield BR, Farrelly MC. New product trial, use of edibles, and unexpected highs among marijuana and hashish users in Colorado. Drug Alcohol Depend 2017; 176:44-47. [PMID: 28514695 DOI: 10.1016/j.drugalcdep.2017.03.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Revised: 03/22/2017] [Accepted: 03/23/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVE This study examines the relationships between trial of new marijuana or hashish products and unexpected highs, and use of edible products and unexpected highs. METHODS We conducted an online survey of 634 adult, past-year marijuana users in Colorado. We used logistic regression models to examine the relationship between new product trial or edible use and unexpected highs. RESULTS In the first year that recreational marijuana was legal in Colorado, 71.4% of respondents tried a new marijuana or hashish product, and 53.6% used an edible product. Trial of new products was associated with greater odds of experiencing an unexpected high after controlling for age, gender, education, mental health status, current marijuana or hashish use, and mean amount of marijuana or hashish consumed in the past month (OR=2.13, p<0.001). Individuals who reported having used edibles had greater odds of experiencing an unexpected high, after controlling for the same set of variables (OR=1.56, p<0.05). CONCLUSION People who try new marijuana or hashish products, or use edible marijuana or hashish products, are at greater risk for an unexpected high. It is possible that some negative outcomes associated with marijuana use and unexpected highs may be averted through a better understanding of how to use product packaging to communicate with consumers.
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Affiliation(s)
- Jane A Allen
- RTI International,3040 E.Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC 27709, USA.
| | - Kevin C Davis
- RTI International,3040 E.Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC 27709, USA
| | - Jennifer C Duke
- RTI International,3040 E.Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC 27709, USA
| | - James M Nonnemaker
- RTI International,3040 E.Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC 27709, USA
| | - Brian R Bradfield
- RTI International,3040 E.Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC 27709, USA
| | - Matthew C Farrelly
- RTI International,3040 E.Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC 27709, USA
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Caulkins JP, Kilmer B. Considering marijuana legalization carefully: insights for other jurisdictions from analysis for Vermont. Addiction 2016; 111:2082-2089. [PMID: 28075542 DOI: 10.1111/add.13289] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Revised: 10/19/2015] [Accepted: 12/22/2015] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND AIMS In 2014 the legislature of Vermont, USA passed a law requiring the Secretary of Administration to report on the consequences of legalizing marijuana. The RAND Corporation was commissioned to write that report. This paper summarizes insights from that analysis that are germane to other jurisdictions. METHOD Translation of key findings from the RAND Corporation report to the broader policy debate. RESULTS Marijuana legalization encompasses a wide range of possible regimes, distinguished along at least four dimensions: which organizations are allowed to produce and supply the drug, the regulations under which they operate, the nature of the products that can be distributed and taxes and prices. Vermont's decriminalization had already cut its costs of enforcing marijuana prohibition against adults to about $1 per resident per year. That is probably less than the cost of regulating a legal market. Revenues from taxing residents' purchases after legalization could be many times that amount, so the main fiscal cost of prohibition after decriminalization relative to outright legalization may be foregone tax revenues, not enforcement costs. Approximately 40 times as many users live within 200 miles of Vermont's borders as live within the state; drug tourism and associated tax revenues will be important considerations, as will be the response of other states. Indeed, if another state legalized with lower taxes, that could undermine the ability to collect taxes on even Vermont residents' purchases. CONCLUSIONS Analysis of possible outcomes if Vermont, USA, legalized marijuana reveal that choices about how, and not just whether, to legalize a drug can have profound consequences for the effects on health and social wellbeing, and the choices of one jurisdiction can affect the options and incentives available to other jurisdictions.
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Affiliation(s)
- Jonathan P Caulkins
- Heinz College, Carnegie Mellon University, Pittsburgh, PA, USA.,RAND Drug Policy Research Center, Santa Monica, CA, USA
| | - Beau Kilmer
- RAND Drug Policy Research Center, Santa Monica, CA, USA
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Roditis ML, Delucchi K, Chang A, Halpern-Felsher B. Perceptions of social norms and exposure to pro-marijuana messages are associated with adolescent marijuana use. Prev Med 2016; 93:171-176. [PMID: 27746339 PMCID: PMC5268762 DOI: 10.1016/j.ypmed.2016.10.013] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2016] [Revised: 09/19/2016] [Accepted: 10/13/2016] [Indexed: 11/27/2022]
Abstract
Despite consistent declines in rates of cigarette use among adolescents in the last five years, rates of marijuana use have remained constant, with marijuana being the most widely used illegal drug among adolescents. More work is needed to understand how social norms, perceived risks and benefits, and social media messaging impact use of marijuana. This study compared perceptions and social norms related to marijuana, blunts and cigarettes. Additionally, we assessed how perceptions related to social norms, risks and benefits, and exposure to pro- versus anti-marijuana messaging is related to use. Participants were 786 adolescents from Southern and Northern California (36.7% male, 63.21% females; mean age=16.1years; SD=1.6). Participants came from diverse ethnic backgrounds, with 207 (26.61%) White, 171 (21.98%) Asian/Pacific Islander, 232 (29.82%) Hispanic, and 168 (21.59%) other. Results indicated that marijuana and blunts were consistently perceived as more socially acceptable and less risky than cigarettes (p<0.01). Participants who reported that their friends used marijuana had a 27% greater odds of using marijuana themselves. Further, seeing messages about the good things or benefits of marijuana use was associated with a 6% greater odds of use [OR 1.06 (CI 1.00, 1.12)]. This study's findings offer a number of important public health implications, particularly as states move towards legalization of marijuana for recreational use. As this occurs, states need to take adolescents' perceptions of risks, benefits, social norms, and peer influences into account as they implement strategies to reduce youth use of marijuana and blunts.
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Affiliation(s)
- Maria L Roditis
- Division of Adolescent Medicine, Department of Pediatrics, School of Medicine, Stanford University, 770 Welch Road, Palo Alto, CA 94304, USA
| | - Kevin Delucchi
- Department of Psychiatry, University of California San Francisco, 401 Parnassus Ave, San Francisco, CA 94143, USA
| | - Audrey Chang
- Division of Adolescent Medicine, Department of Pediatrics, School of Medicine, Stanford University, 770 Welch Road, Palo Alto, CA 94304, USA
| | - Bonnie Halpern-Felsher
- Division of Adolescent Medicine, Department of Pediatrics, School of Medicine, Stanford University, 770 Welch Road, Palo Alto, CA 94304, USA.
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Barry RA, Glantz S. A Public Health Framework for Legalized Retail Marijuana Based on the US Experience: Avoiding a New Tobacco Industry. PLoS Med 2016; 13:e1002131. [PMID: 27676176 PMCID: PMC5038957 DOI: 10.1371/journal.pmed.1002131] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Rachel Barry and Stanton Glantz argue that a public health framework that prioritizes public health over business interests should be used by US states and countries that legalize retail marijuana.
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Affiliation(s)
- Rachel Ann Barry
- Center for Tobacco Control Research and Education and Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, California, United States of America
| | - Stanton Glantz
- Center for Tobacco Control Research and Education and Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, California, United States of America
- Department of Medicine, University of California, San Francisco, San Francisco, California, United States of America
- * E-mail:
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Implications of Marijuana Decriminalization on the Practice of Pulmonary, Critical Care, and Sleep Medicine. A Report of the American Thoracic Society Marijuana Workgroup. Ann Am Thorac Soc 2016; 12:1700-10. [PMID: 26540421 DOI: 10.1513/annalsats.201504-195ar] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Wang JB, Ramo DE, Lisha NE, Cataldo JK. Medical marijuana legalization and cigarette and marijuana co-use in adolescents and adults. Drug Alcohol Depend 2016; 166:32-8. [PMID: 27460859 PMCID: PMC4983542 DOI: 10.1016/j.drugalcdep.2016.06.016] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Revised: 06/10/2016] [Accepted: 06/11/2016] [Indexed: 11/18/2022]
Abstract
BACKGROUND Medical marijuana legalization is associated with a higher prevalence of marijuana use which may affect cigarette use and nicotine dependence in co-users. In the present study, we examined relationships between statewide legalization of medical marijuana and prevalence of cigarette and marijuana co-use and nicotine dependence in co-using adolescents and adults. METHODS Data were analyzed from the 2013 National Survey on Drug Use and Health. We compared cigarette and marijuana co-use in the past 30days across age categories (12-64 years) by statewide medical marijuana legalization. Logistic regression models were used to estimate the odds of having nicotine dependence among current cigarette smokers who also reported past 30-day marijuana use and "ever but not current" marijuana use (vs. "never" use) adjusting for covariates including statewide legalization of medical marijuana. RESULTS Overall, 5.1% of the sample reported past 30-day cigarette and marijuana co-use and a higher proportion of co-users resided in states where medical marijuana was legal compared to illegal (5.8% vs. 4.8%; p=0.0011). Co-use was associated with greater odds of having nicotine dependence compared to cigarette-only use across age categories. Odds were highest and up to 3-times higher in adolescents aged 12-17 years (OR=3.54; 95%CI: 1.81-6.92) and adults aged 50-64 years (OR=3.08; CI: 1.45-6.55). CONCLUSION Marijuana policy could inadvertently affect cigarette and marijuana co-use and pose challenges to tobacco cessation.
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Affiliation(s)
- Julie B Wang
- Center for Tobacco Control Research and Education, Cardiovascular Research Institute, University of California, San Francisco, 530 Parnassus Avenue, San Francisco, CA 94143, USA.
| | - Danielle E Ramo
- Center for Tobacco Control Research and Education, Cardiovascular Research Institute, University of California, San Francisco, 530 Parnassus Avenue, San Francisco, CA 94143, USA; Department of Psychiatry and Weill Institute for Neurosciences, University of California, San Francisco, 401 Parnassus Avenue, Box RAM 0984, San Francisco, CA 94143, USA
| | - Nadra E Lisha
- Center for Tobacco Control Research and Education, Cardiovascular Research Institute, University of California, San Francisco, 530 Parnassus Avenue, San Francisco, CA 94143, USA
| | - Janine K Cataldo
- Center for Tobacco Control Research and Education, Cardiovascular Research Institute, University of California, San Francisco, 530 Parnassus Avenue, San Francisco, CA 94143, USA; Department of Physiological Nursing, University of San Francisco, 2 Koret Way, Box 0610, San Francisco, CA 94143, USA
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Wang X, Derakhshandeh R, Liu J, Narayan S, Nabavizadeh P, Le S, Danforth OM, Pinnamaneni K, Rodriguez HJ, Luu E, Sievers RE, Schick SF, Glantz SA, Springer ML. One Minute of Marijuana Secondhand Smoke Exposure Substantially Impairs Vascular Endothelial Function. J Am Heart Assoc 2016; 5:e003858. [PMID: 27464788 PMCID: PMC5015303 DOI: 10.1161/jaha.116.003858] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Accepted: 06/02/2016] [Indexed: 01/22/2023]
Abstract
BACKGROUND Despite public awareness that tobacco secondhand smoke (SHS) is harmful, many people still assume that marijuana SHS is benign. Debates about whether smoke-free laws should include marijuana are becoming increasingly widespread as marijuana is legalized and the cannabis industry grows. Lack of evidence for marijuana SHS causing acute cardiovascular harm is frequently mistaken for evidence that it is harmless, despite chemical and physical similarity between marijuana and tobacco smoke. We investigated whether brief exposure to marijuana SHS causes acute vascular endothelial dysfunction. METHODS AND RESULTS We measured endothelial function as femoral artery flow-mediated dilation (FMD) in rats before and after exposure to marijuana SHS at levels similar to real-world tobacco SHS conditions. One minute of exposure to marijuana SHS impaired FMD to a comparable extent as impairment from equal concentrations of tobacco SHS, but recovery was considerably slower for marijuana. Exposure to marijuana SHS directly caused cannabinoid-independent vasodilation that subsided within 25 minutes, whereas FMD remained impaired for at least 90 minutes. Impairment occurred even when marijuana lacked cannabinoids and rolling paper was omitted. Endothelium-independent vasodilation by nitroglycerin administration was not impaired. FMD was not impaired by exposure to chamber air. CONCLUSIONS One minute of exposure to marijuana SHS substantially impairs endothelial function in rats for at least 90 minutes, considerably longer than comparable impairment by tobacco SHS. Impairment of FMD does not require cannabinoids, nicotine, or rolling paper smoke. Our findings in rats suggest that SHS can exert similar adverse cardiovascular effects regardless of whether it is from tobacco or marijuana.
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Affiliation(s)
- Xiaoyin Wang
- Cardiovascular Research Institute, University of California, San Francisco
| | | | - Jiangtao Liu
- Division of Cardiology, University of California, San Francisco Department of Cardiovascular Surgery & Electro-chemotherapy, China-Japan Friendship Hospital, Beijing, People's Republic of China
| | - Shilpa Narayan
- Cardiovascular Research Institute, University of California, San Francisco Division of Cardiology, University of California, San Francisco
| | | | - Stephenie Le
- Division of Cardiology, University of California, San Francisco
| | - Olivia M Danforth
- Cardiovascular Research Institute, University of California, San Francisco
| | | | - Hilda J Rodriguez
- Division of Cardiology, University of California, San Francisco Eli and Edythe Broad Center of Regeneration Medicine and Stem Cell Research, University of California, San Francisco
| | - Emmy Luu
- Division of Cardiology, University of California, San Francisco
| | | | - Suzaynn F Schick
- Division of Occupational and Environmental Medicine, University of California, San Francisco
| | - Stanton A Glantz
- Cardiovascular Research Institute, University of California, San Francisco Division of Cardiology, University of California, San Francisco
| | - Matthew L Springer
- Cardiovascular Research Institute, University of California, San Francisco Division of Cardiology, University of California, San Francisco Eli and Edythe Broad Center of Regeneration Medicine and Stem Cell Research, University of California, San Francisco
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Jarlenski M, Tarr JA, Holland CL, Farrell D, Chang JC. Pregnant Women's Access to Information About Perinatal Marijuana Use: A Qualitative Study. Womens Health Issues 2016; 26:452-9. [PMID: 27131908 DOI: 10.1016/j.whi.2016.03.010] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Revised: 03/16/2016] [Accepted: 03/24/2016] [Indexed: 11/17/2022]
Abstract
BACKGROUND Marijuana is the most commonly used illicit substance in pregnancy. Little is known about how pregnant women who use marijuana obtain and understand information about perinatal marijuana use. We conducted a qualitative study among pregnant women who had used marijuana to understand their information-seeking patterns and perceptions of usefulness of available information about perinatal marijuana use. STUDY DESIGN We conducted semistructured interviews with 26 pregnant women who were receiving prenatal care and who either disclosed marijuana use or had urine samples testing positive for marijuana. Interviews assessed women's sources of information about risks of perinatal marijuana use and perceptions regarding the usefulness of such information. Interview data were coded independently by two coders who iteratively refined the codes and reviewed transcripts for themes. RESULTS Commonly reported sources of information about perinatal marijuana use included Internet searching and anecdotal experiences or advice from family or friends. Few women reported receiving helpful information from a health care provider or social worker. Women perceived a lack of evidence about harms of perinatal marijuana use, and reported being dissatisfied with the quality of information. Most women said they desired information about the effects of perinatal marijuana use on infant health. CONCLUSIONS Women who used marijuana before or during pregnancy did not find available information about perinatal marijuana use to be useful, and sought more information pertaining to infant health and well-being. Efforts to reduce perinatal marijuana use should focus on addressing this need in both clinical and public health settings.
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Affiliation(s)
- Marian Jarlenski
- Department of Health Policy and Management, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania.
| | - Jill A Tarr
- Magee-Womens Research Institute, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Cynthia L Holland
- Magee-Womens Research Institute, University of Pittsburgh, Pittsburgh, Pennsylvania
| | | | - Judy C Chang
- Magee-Womens Research Institute, University of Pittsburgh, Pittsburgh, Pennsylvania; Departments of Obstetrics, Gynecology and Reproductive Sciences and Internal Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
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Subritzky T, Pettigrew S, Lenton S. Issues in the implementation and evolution of the commercial recreational cannabis market in Colorado. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2015; 27:S0955-3959(15)00354-0. [PMID: 26777400 DOI: 10.1016/j.drugpo.2015.12.001] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Revised: 11/27/2015] [Accepted: 12/01/2015] [Indexed: 11/27/2022]
Abstract
BACKGROUND For almost a century, the cultivation, sale and use of recreational cannabis has been prohibited by law in most countries. Recently, however, under ballot initiatives four states in the US have legalised commercial, non-medical (recreational) cannabis markets. Several other states will initiate similar ballot measures attached to the 2016 election that will also appoint a new President. As the first state to implement the legislation in 2014, Colorado is an important example to begin investigating early consequences of specific policy choices while other jurisdictions consider their own legislation although the empirical evidence base is only beginning to accrue. METHOD This paper brings together material sourced from peer reviewed academic papers, grey literature publications, reports in mass media and niche media outlets, and government publications to outline the regulatory model and process in Colorado and to describe some of the issues that have emerged in the first 20 months of its operation. RESULTS These issues include tension between public health and profit, industry and investment, new methods of consumption, the black market and product testing. CONCLUSION The paper concludes that, while it is too early to determine the impact of the scheme, and noting that it includes some features designed to mitigate adverse impacts, it faces major challenges. Not least of these are the lack of an effective overarching federal regulatory structure, as a consequence of the federal prohibition on cannabis, combined with a rapidly growing cannabis industry which, like other industries, will seek to exploit loopholes to maximise profit.
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Affiliation(s)
- Todd Subritzky
- National Drug Research Institute, Faculty of Health Sciences, Curtin University, Perth, WA, Australia.
| | - Simone Pettigrew
- School of Psychology and Speech Pathology, Curtin University, Kent St, Bentley, WA, 6102, Australia
| | - Simon Lenton
- National Drug Research Institute, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
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Budney AJ, Sargent JD, Lee DC. Vaping cannabis (marijuana): parallel concerns to e-cigs? Addiction 2015; 110:1699-704. [PMID: 26264448 PMCID: PMC4860523 DOI: 10.1111/add.13036] [Citation(s) in RCA: 140] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Revised: 06/04/2015] [Accepted: 06/30/2015] [Indexed: 11/30/2022]
Abstract
The proliferation of vaporization ('vaping') as a method for administering cannabis raises many of the same public health issues being debated and investigated in relation to e-cigarettes (e-cigs). Good epidemiological data on the prevalence of vaping cannabis are not yet available, but with current trends towards societal approval of medicinal and recreational use of cannabis, the pros and cons of vaping cannabis warrant study. As with e-cigs, vaping cannabis portends putative health benefits by reducing harm from ingesting toxic smoke. Indeed, vaping is perceived and being sold as a safer way to use cannabis, despite the lack of data on the health effects of chronic vaping. Other perceived benefits include better taste, more efficient and intense effects and greater discretion which allows for use in more places. Unfortunately, these aspects of vaping could prompt an increased likelihood of trying cannabis, earlier age of onset, more positive initial experiences, and more frequent use, thereby increasing the probability of problematic use or addiction. Sales and marketing of vaping devices with no regulatory guidelines, especially related to advertising or product development targeting youth, parallels concerns under debate related to e-cigs and youth. Thus, the quandary of whether or not to promote vaping as a safer method of cannabis administration for those wishing to use cannabis, and how to regulate vaping and vaping devices, necessitates substantial investigation and discussion. Addressing these issues in concert with efforts directed towards e-cigs may save time and energy and result in a more comprehensive and effective public health policy on vaping.
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Affiliation(s)
- Alan J. Budney
- Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | | | - Dustin C. Lee
- Geisel School of Medicine at Dartmouth, Hanover, NH, USA
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Budney AJ, Sargent JD, Lee DC. Confirmation of the trials and tribulations of vaping. Addiction 2015; 110:1710-1. [PMID: 26471155 PMCID: PMC6131704 DOI: 10.1111/add.13155] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Accepted: 09/08/2015] [Indexed: 11/27/2022]
Abstract
Responses to our article indicate consensus on the need for expedited scientific and regulatory action related to vaping of cannabis and other substances to curtail untoward public health impact and identify potential benefits. How to speed up science, increase knowledge and enact responsible regulatory policy poses a formidable challenge.
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Schauer GL, Berg CJ, Kegler MC, Donovan DM, Windle M. Differences in Tobacco Product Use Among Past Month Adult Marijuana Users and Nonusers: Findings From the 2003-2012 National Survey on Drug Use and Health. Nicotine Tob Res 2015; 18:281-8. [PMID: 26009578 DOI: 10.1093/ntr/ntv093] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Accepted: 04/23/2015] [Indexed: 01/15/2023]
Abstract
INTRODUCTION This study assessed differences in individual tobacco product use between past month marijuana users and nonusers, and trends in overall tobacco use and use of specific tobacco products among marijuana users. METHODS Data were obtained from 378 459 adults participating in the 2003-2012 National Survey on Drug Use and Health, a cross-sectional, household interview survey conducted annually. Data from the most recent 2 years (2011-2012) were used to assess differences in the prevalence of various tobacco products by past month marijuana status. Data from all years were used to assess historical trends in overall tobacco use, and use of cigarettes, cigars, and blunts among marijuana users; trend significance was assessed using orthogonal polynomials. RESULTS From 2011-2012, the prevalence of any past month tobacco use among the 9727 past month marijuana users was 68.6% excluding blunts, and 78.3% including blunts (vs. 25.3% for nonusers, P < .0001); 77.3% of past month marijuana users reported past month combusted tobacco use (vs. 23.4% of non-MJ users, P < .0001). By product, 60.1% of past month marijuana users reported past month cigarette use, 42.0% reported past month blunt use, and 20.6% reported past month cigar use. Overall, adjusted trends in past month cigarette use decreased, while trends in past month blunt use increased; cigar use did not change. DISCUSSION Tobacco use is highly prevalent among adult marijuana users and represents an important potential comorbidity of marijuana use. In light of increasing policies legalizing marijuana, it is critical to monitor changes in overall and specific tobacco product use.
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Affiliation(s)
- Gillian L Schauer
- Department of Behavioral Sciences and Health Education, Emory University, Atlanta, GA;
| | - Carla J Berg
- Department of Behavioral Sciences and Health Education, Emory University, Atlanta, GA
| | - Michelle C Kegler
- Department of Behavioral Sciences and Health Education, Emory University, Atlanta, GA
| | - Dennis M Donovan
- Alcohol and Drug Abuse Institute, University of Washington, Seattle, WA
| | - Michael Windle
- Department of Behavioral Sciences and Health Education, Emory University, Atlanta, GA
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Hall W, Weier M. Assessing the public health impacts of legalizing recreational cannabis use in the USA. Clin Pharmacol Ther 2015; 97:607-15. [PMID: 25777798 DOI: 10.1002/cpt.110] [Citation(s) in RCA: 110] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Accepted: 03/05/2015] [Indexed: 11/10/2022]
Abstract
A major challenge in assessing the public health impact of legalizing cannabis use in Colorado and Washington State is the absence of any experience with legal cannabis markets. The Netherlands created a de facto legalized cannabis market for recreational use, but policy analysts disagree about how it has affected rates of cannabis use. Some US states have created de facto legal supply of cannabis for medical use. So far this policy does not appear to have increased cannabis use or cannabis-related harm. Given experience with more liberal alcohol policies, the legalization of recreational cannabis use is likely to increase use among current users. It is also likely that legalization will increase the number of new users among young adults but it remains uncertain how many may be recruited, within what time frame, among which groups within the population, and how many of these new users will become regular users.
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Affiliation(s)
- W Hall
- Centre for Youth Substance Abuse Research, University of Queensland, Herston, Australia.,Addiction Policy, National Addiction Centre, Kings College, London, UK
| | - M Weier
- Centre for Youth Substance Abuse Research, University of Queensland, Herston, Australia
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Greydanus DE, Kaplan G, Baxter LE, Patel DR, Feucht CL. Cannabis: The never-ending, nefarious nepenthe of the 21st century: What should the clinician know? Dis Mon 2015; 61:118-75. [DOI: 10.1016/j.disamonth.2015.01.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Ferraiolo K. Morality Framing in U.S. Drug Control Policy: An Example From Marijuana Decriminalization. WORLD MEDICAL & HEALTH POLICY 2014. [DOI: 10.1002/wmh3.114] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Wong K, Brady JE, Li G. Establishing legal limits for driving under the influence of marijuana. Inj Epidemiol 2014; 1:26. [PMID: 27747660 PMCID: PMC5005632 DOI: 10.1186/s40621-014-0026-z] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Accepted: 09/17/2014] [Indexed: 11/27/2022] Open
Abstract
Marijuana has become the most commonly detected non-alcohol substance among drivers in the United States and Europe. Use of marijuana has been shown to impair driving performance and increase crash risk. Due to the lack of standardization in assessing marijuana-induced impairment and limitations of zero tolerance legislation, more jurisdictions are adopting per se laws by specifying a legal limit of Δ9-tetrahydrocannabinol (THC) at or above which drivers are prosecuted for driving under the influence of marijuana. This review examines major considerations when developing these threshold THC concentrations and specifics of legal THC limits for drivers adopted by different jurisdictions in the United States and other countries.
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Affiliation(s)
- Kristin Wong
- Department of Anesthesiology, College of Physicians and Surgeons, Columbia University, 622 West 168th Street, New York, 10032 NY USA
| | - Joanne E Brady
- Department of Anesthesiology, College of Physicians and Surgeons, Columbia University, 622 West 168th Street, New York, 10032 NY USA
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, New York, 10032 NY USA
| | - Guohua Li
- Department of Anesthesiology, College of Physicians and Surgeons, Columbia University, 622 West 168th Street, New York, 10032 NY USA
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, New York, 10032 NY USA
- Center for Injury Epidemiology and Prevention, Columbia University Medical Center, 722 West 168th Street, Room 524, New York, 10032 NY USA
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