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Pechmann C'C, Calder D, Timberlake D, Rhee J, Padon A, Silver L. Young adult retail purchases of cannabis, product category preferences and sales trends in California 2018-21: Differences compared with older adults. Addiction 2024; 119:1774-1783. [PMID: 38988183 DOI: 10.1111/add.16617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 06/17/2024] [Indexed: 07/12/2024]
Abstract
AIMS The aim of this study is to identify cannabis products according to their appeal among young adults and measure product sales trends. DESIGN, SETTING AND PARTICIPANTS This was a retrospective comparative study using point-of-sale data from licensed recreational cannabis retailers that include buyer age with birth year entered by retailers, set in California, USA. Cannabis purchases by young adults (aged 21-24, GenZ) were compared with older adults (age 25+) over 4 years (2018-21). MEASUREMENTS Sales for six cannabis product categories were analyzed using a commercial data set with imputations and a raw data set. Age-appeal metrics were dollar and unit sales to young adults, and dollar and unit share ratios (young adults/older adults), where a share ratio of 100 denotes age-appeal comparability. A product category was considered more young-adult appealing than others if its mean on a metric was at least one standard deviation above the grand mean across all product categories. FINDINGS Flower (cannabis plant material) and vapor pen appealed to young adults based on absolute dollar sales, dominating young-adult spending compared with other cannabis products (37.24 and 31.83%, respectively). Vapor pen and concentrate appealed to young adults based on dollar share ratios of 152, meaning these products comprised a 52% greater share of young-adult cannabis spending relative to older-adult spending (31.83/20.97% and 10.47/6.88%, respectively). Less appealing to young adults were pre-roll, edible/beverage and absorbable products (tincture/sublingual, capsule and topical). Flower showed the largest dollar sales growth (B = +$3.50 million/month), next to vapor pen (B = +$1.55 million/month). Vapor pen tied for highest growth in the percent of product dollars from the largest package size (B = +0.85%/month) and showed the steepest price decline (B = -0.53 price per gram/month). CONCLUSIONS In California, USA, from 2018 to 2021, relative to older adults, young adults spent a greater share of their cannabis dollars on vapor pen and concentrate (products with high potency of delta-9-tetrahydrocannabinol).
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Affiliation(s)
| | - Douglas Calder
- Paul Merage School of Business, University of California, Irvine, Irvine, CA, USA
| | - David Timberlake
- Program in Public Health, Susan & Henry Samueli College of Health Sciences, University of California, Irvine, Irvine, CA, USA
| | - Joshua Rhee
- Program in Public Health, Susan & Henry Samueli College of Health Sciences, University of California, Irvine, Irvine, CA, USA
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Mital S, Bishop L, Bugden S, Grootendorst P, Nguyen HV. Association between non-medical cannabis legalization and alcohol sales: Quasi-experimental evidence from Canada. Drug Alcohol Depend 2024; 257:111137. [PMID: 38460325 DOI: 10.1016/j.drugalcdep.2024.111137] [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: 10/16/2023] [Revised: 02/04/2024] [Accepted: 02/18/2024] [Indexed: 03/11/2024]
Abstract
BACKGROUND There is increasing interest in understanding the impact of non-medical cannabis legalization on use of other substances, especially alcohol. Evidence on whether cannabis is a substitute or complement for alcohol is both mixed and limited. This study provides the first quasi-experimental evidence on the impact of Canada's legalization of non-medical cannabis on beer and spirits sales. METHODS We used the interrupted time series design and monthly data on beer sales between January 2012 and February 2020 and spirits sales between January 2016 and February 2020 across Canada to investigate changes in beer and spirits sales following Canada's cannabis legalization in October 2018. We examined changes in total sales, nationally and in individual provinces, as well as changes in sales of bottled, canned and kegged beer. RESULTS Canada-wide beer sales fell by 96 hectoliters per 100,000 population (p=0.011) immediately after non-medical cannabis legalization and by 4 hectoliters per 100,000 population (p>0.05) each month thereafter for an average monthly reduction of 136 hectoliters per 100,000 population (p<0.001) post-legalization. However, the legalization was associated with no change in spirits sales. Beer sales reduced in all provinces except the Atlantic provinces. By beer type, the legalization was associated with declines in sales of canned and kegged beer but there was no reduction in sales of bottled beer. CONCLUSIONS Non-medical cannabis legalization was associated with a decline in beer sales in Canada, suggesting substitution of non-medical cannabis for beer. However, there was no change in spirits sales following the legalization.
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Affiliation(s)
- Shweta Mital
- College of Pharmacy, University of Manitoba, Winnipeg, Canada
| | - Lisa Bishop
- School of Pharmacy, Memorial University of Newfoundland, St. John's, Canada
| | - Shawn Bugden
- School of Pharmacy, Memorial University of Newfoundland, St. John's, Canada
| | - Paul Grootendorst
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada
| | - Hai V Nguyen
- School of Pharmacy, Memorial University of Newfoundland, St. John's, Canada.
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Myran D, Friesen EL, Pugliese M, Milani C, Kurdyak P, Saraswat M, Tanuseputro P. Changes in health service use due to alcohol during the COVID-19 pandemic among individuals with and individuals without pre-existing alcohol-related medical diagnoses. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2023; 114:185-194. [PMID: 36719599 PMCID: PMC9888341 DOI: 10.17269/s41997-023-00739-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 01/05/2023] [Indexed: 02/01/2023]
Abstract
OBJECTIVE To compare changes in outpatient and acute care visits due to alcohol during the COVID-19 pandemic between individuals with and those without a history of alcohol-related health service use (AHSU). METHODS We conducted a cross-sectional analysis of health administrative data in Ontario, Canada. The Ontario population was stratified into those with and those without 1+ health service encounter(s) due to alcohol in the past 2 years. We compared age- and sex-standardized rates of alcohol-related outpatient visits, emergency department (ED) visits, and hospitalizations during the first 15 months of the pandemic (March 2020-May 2021) to those during the same 15-month period prior to the pandemic (March 2018-May 2019). RESULTS Of 13,450,750 eligible Ontarians on March 11, 2022, 129,434 (1.0%) had AHSU in the previous 2 years. Overall, rates of alcohol-related outpatient visits and hospitalizations increased, while rates of alcohol-related ED visits decreased during the pandemic. There was a similar relative increase in rates of alcohol-related outpatient visits and hospitalizations between those with and those without prior AHSU. However, the absolute increase in rates of alcohol-related outpatient visits and hospitalizations was higher among those with prior AHSU (outpatient rate difference (RD) per 10,000 population: 852.3, 95% confidence interval (CI): 792.7, 911.9; inpatient RD: 26.0, 95% CI: -2.3, 54.2) than among those without (outpatient RD: 6.5, 95% CI: 6.0, 6.9; inpatient RD: 0.4, 95% CI: 0.2, 0.7). CONCLUSION Rates of alcohol-related outpatient and inpatient care increased during the COVID-19 pandemic, and high rate of recurrent harm among individuals with pre-pandemic AHSU was an important contributor to this trend.
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Affiliation(s)
- Daniel Myran
- Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
- Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada.
- ICES uOttawa, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
| | - Erik Loewen Friesen
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Michael Pugliese
- ICES uOttawa, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Christina Milani
- Division of Palliative Care, Bruyere Research Institute, Ottawa, Ontario, Canada
| | - Paul Kurdyak
- ICES Mental Health & Addictions Research Program, Toronto, Ontario, Canada
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Manu Saraswat
- Public Health and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Peter Tanuseputro
- Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada
- ICES uOttawa, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Division of Palliative Care, Bruyere Research Institute, Ottawa, Ontario, Canada
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Smith BT, Schoer N, Sherk A, Thielman J, McKnight A, Hobin E. Trends in alcohol-attributable hospitalisations and emergency department visits by age, sex, drinking group and health condition in Ontario, Canada. Drug Alcohol Rev 2023; 42:926-937. [PMID: 36843065 DOI: 10.1111/dar.13629] [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: 07/18/2022] [Revised: 12/20/2022] [Accepted: 01/26/2023] [Indexed: 02/28/2023]
Abstract
INTRODUCTION Alcohol-attributable harms are increasing in Canada. We described trends in alcohol-attributable hospitalisations and emergency department (ED) visits by age, sex, drinking group, attribution and health condition. METHODS Hospitalisation and ED visits for partially or wholly alcohol-attributable health conditions by age and sex were obtained from population-based health administrative data for individuals aged 15+ in Ontario, Canada. Population-level alcohol exposure was estimated using per capita alcohol sales and alcohol use data. We estimated the number and rate of alcohol-attributable hospitalisations (2008-2018) and ED visits (2008-2019) using the International Model of Alcohol Harms and Policies (InterMAHP). RESULTS Over the study period, the modelled rates of alcohol-attributable health-care encounters were higher in males, but increased faster in females. Specifically, rates of alcohol-attributable hospitalisations and ED visits increased by 300% (19-76 per 100,000) and 37% (774-1,064 per 100,000) in females, compared to 20% (322-386 per 100,000) and 2% (2563-2626 per 100,000) in males, respectively. Alcohol-attributable ED visit rates were highest among individuals aged 15-34, however, increased faster among individuals aged 65+ (females: 266%; males: 44%) than 15-34 years (females:+17%; males: -16%). High-volume drinkers had the highest rates of alcohol-attributable health-care encounters; yet, low-/medium-volume drinkers contributed substantial hospitalisations (11%) and ED visits (36%), with increasing rates of ED visits in females drinking low/medium volumes. DISCUSSION AND CONCLUSIONS Alcohol-attributable health-care encounters increased overall, and faster among females, adults aged 65+ and low-/medium-volume drinkers. Monitoring trends across subpopulations is imperative to inform equitable interventions to mitigate alcohol-attributable harms.
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Affiliation(s)
- Brendan T Smith
- Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Toronto, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Nicole Schoer
- Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Toronto, Canada
| | - Adam Sherk
- Canadian Institute for Substance Use Research, University of Victoria, Technology Enterprise Facility, Victoria, Canada
| | - Justin Thielman
- Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Toronto, Canada
| | - Anthony McKnight
- Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Toronto, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Erin Hobin
- Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Toronto, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.,Canadian Institute for Substance Use Research, University of Victoria, Technology Enterprise Facility, Victoria, Canada
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Armstrong MJ. Relationships between sales of legal medical cannabis and alcohol in Canada . Health Policy 2023; 128:28-33. [PMID: 36443110 DOI: 10.1016/j.healthpol.2022.11.012] [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: 07/22/2022] [Revised: 09/19/2022] [Accepted: 11/21/2022] [Indexed: 11/24/2022]
Abstract
The extent to which legalizing cannabis use might lead to increased or decreased alcohol use has important implications for public health, economic growth, and government policy. This study analyzed Canada's monthly per capita sales of alcohol and legal medical cannabis using fixed effect panel data linear regressions. The data covered seven Canadian regions from January 2011 to September 2018, and controlled for changing levels of retail activity, alcohol prices, tertiary education, unemployment, and impaired driving penalties. The analysis estimated that each dollar of legal medical cannabis sold was associated with an average alcohol sales decrease of roughly $0.74 to $0.84. This suggests that medical cannabis was an economic substitute for alcohol in Canada, and that the country's 2017-2018 alcohol sales were roughly 1.8% lower than they would have been without legal medical cannabis. The results therefore indirectly imply that reduced alcohol consumption might have partly offset cannabis legalization's health and economic impacts.
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Affiliation(s)
- Michael J Armstrong
- FOIS, Brock University, 1812 Sir Isaac Brock Way, St. Catharines, ON, L2S 3A1, Canada.
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Aslam A, Kwo PY. Epidemiology and Disease Burden of Alcohol Associated Liver Disease. J Clin Exp Hepatol 2023; 13:88-102. [PMID: 36647400 PMCID: PMC9840073 DOI: 10.1016/j.jceh.2022.09.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 09/06/2022] [Indexed: 01/19/2023] Open
Abstract
Consumption of alcohol in excess leads to substantial medical, economic, and societal burdens. Approximately 5.3% of all global deaths may be attributed to alcohol consumption. Moreover, the burden of alcohol associated liver disease (ALD) accounts for 5.1% of all disease and injury worldwide. Alcohol use disorder (AUD) affects men more than women globally with significant years of life loss to disability in low, middle and well-developed countries. Precise data on global estimates of alcohol related steatosis, alcohol related hepatitis, and alcohol related cirrhosis have been challenging to obtain. In the United States (US), alcohol related steatosis has been estimated at 4.3% based on NHANES data which has remained stable over 14 years. However, alcohol-related fibrotic liver disease has increased over the same period. In those with AUD, the prevalence of alcohol related hepatitis has been estimated at 10-35%. Globally, the prevalence of alcohol-associated cirrhosis has been estimated at 23.6 million individuals for compensated cirrhosis and 2.46 million for those with decompensated cirrhosis. The contribution of ALD to global mortality and disease burden of liver related deaths is substantial. In 2016 liver disease related to AUD contributed to 50% of the estimated liver disease deaths for age groups 15 years and above. Data from the US report high cost burdens associated with those admitted with alcohol-related liver complications. Finally, the recent COVID-19 pandemic has been associated with marked increase in alcohol consumption worldwide and will likely increase the burden of ALD.
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Key Words
- AAPC, Average annual percentage change
- ABIC, Age, Serum bilirubin, INR and serum Creatinine
- ABV, Alcohol by volume
- ALD, Alcohol-associated liver disease
- AUD, Alcohol use disorder
- BAC, Blood alcohol concentration
- CDC, Centers for Disease Control and Prevention
- COVID-19, Coronavirus disease 2019
- GAHS, Glasgow alcoholic hepatitis score
- HE, Hepatic encephalopathy
- HRS, Hepatorenal syndrome
- ICD-10, International Classification of Diseases, 10th Edition
- MDF, Maddrey's Discriminant Function
- MELD, Model of end-stage liver disease
- MRI, Magnetic resonance imaging
- NHANES, National Health and Nutrition Examination Survey
- NIAAA, National Institute of Alcohol Abuse and Alcoholism
- NIS, National inpatient sample
- NSDUH, Annual National Survey on Drug Use and Health
- SAMHSA, Substance Abuse and Mental Health Services Administration
- US, United States
- USG, Ultrasonography
- WHO, World Health Organization
- YLD, Years of life lost to disability
- alcohol
- alcohol use disorder
- alcoholic cirrhosis
- alcoholic hepatitis
- alcoholic steatosis
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Affiliation(s)
- Aysha Aslam
- Stanford University School of Medicine, 430 Broadway, Pavilion C, 3rd Floor, Redwood City, CA 94063, USA
| | - Paul Y. Kwo
- Stanford University School of Medicine, 430 Broadway, Pavilion C, 3rd Floor, Redwood City, CA 94063, USA
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Geographical Determinants of Regional Retail Sales: Evidence from 12,500 Retail Shops in Qiannan County, China. ISPRS INTERNATIONAL JOURNAL OF GEO-INFORMATION 2022. [DOI: 10.3390/ijgi11050302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The rapid development of the Chinese economy has stimulated consumer demand and brought huge opportunities for the retail industry. Previous studies have emphasized the importance of estimating regional consumption potentiality. However, the determinants of retail sales are yet to be systematically studied, especially at the micro level. As a result, the realization of sustainable development goals in the retail industry is restricted. In this paper, we studied the determinants of retail sales from two aspects—location-based socioeconomic factors and spatial competition between shops. Using 12,500 retail shops as our sample and by adopting a grid-division strategy, we found that regional retail sales can be positively impacted by nearby population, road length, and most non-commercial points of interest (POIs). By contrast, the number of other commercial facilities, such as catering facilities and shopping malls, and the area of geographic barriers often caused negative impacts on retail sales. As to the competition effects, we found that the isolation and decentralization of shops in one area have a marginally positive effect on sales performance within a threshold distance of 226.19 m for a central grid and a threshold distance of 514.85 m for surrounding grids, respectively. This study explores the determinants of micro-level retail sales and provides decision makers with practical and realistic approaches for generating better site selection and marketing strategies, thus realizing the sustainable development goals of the retail industry.
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