Responses to Recreational Cannabis Legalization among Non-Users, Cannabis Users without a License and Cannabis Users with a License

Abstract

Significance: With the changing cannabis legalization landscape, it is important to assess how people may respond to new cannabis legalization policies to inform the effectiveness of such policies that balance public health with consumer needs and interests. Recent research compared intentions to use legalized cannabis among young adult never and ever cannabis users (Leung et al., 2020) and found 59% of never users and 41% of ever users intended to try cannabis if it were legal. However, past research has not examined differences in cannabis use intentions among different groups who report using cannabis for medical reasons versus non-medical reasons, even though past research has demonstrated the importance of differentiating the two groups (Roy-Byrne et al., 2015). As such, the present study aims to assess the unique correlates of responses to cannabis legalization across non-users, cannabis users without a license and cannabis users with a license. Method: Participants were adults living in Oklahoma (verified by self-reported zip code of residence) who participated in one wave of a 3-wave cross-sectional online survey (N = 5,248; 63.7%, non-past 30-day users, 15.8%, past 30-day cannabis users without a medical cannabis license, 17.8%, past 30-day cannabis users with a license) with an average age of 40.35 years. Participants were female (56.8%) and non-Hispanic White (70.3%). Participants completed measures related to past 30-day cannabis use, procession of a cannabis license, and were asked to “select all that apply” to a single item with 8 response options about how they would respond if recreational cannabis was legalized in their state. Results: Multivariable logistic regression models revealed significant differences in all 7 of the response options analyzed among non-users, cannabis users without a license and cannabis users with a license controlling for demographic characteristics (ps < .05; the 8th item “would use it less” was not assessed among non-users). Next, logistic regression models were examined in all 8 of the response options to compare cannabis users with a license and cannabis users without a license. Cannabis users with a license were more likely to report they would recommend cannabis to a friend or family member (AOR = 1.32, 95%CI: 1.04, 1.68), and they would use cannabis the same as they do now (AOR = 1.75, 95%CI: 1.43, 2.15). In contrast, cannabis users without a license were more likely to report they would use cannabis more than they do now (AOR = .44, 95%CI: 0.34, 0.57), they would use other types of cannabis (AOR = .62, 95%CI: 0.47, 0.80), and they would use cannabis more often to help treat their symptoms (AOR = .60, 95%CI: 0.47, 0.77). Conclusion: Findings support evidence of differences in how groups would respond to non-medical cannabis legalization with cannabis users without a license intending to use more cannabis. This greater use could become problematic as cannabis strands become more potent with non-medical legalization (Shover & Humphreys, 2019). Future research should continue to examine responses to non-medical cannabis legalization to inform cannabis harm prevention and policy changes related to legalizing non-medical cannabis.