Legalization Of Non-medical Cannabis Research Articles

Initial evaluation of Manitoba's cannabis surveillance system.

The Government of Manitoba created a cannabis public health surveillance system in 2018 in preparation for nonmedical cannabis legalization on 17 October, 2018. An initial evaluation was conducted to assess the usefulness, flexibility and simplicity attributes of the system, using an online stakeholder survey, website metrics, system analysis and interviews. Resulting recommendations included creating a detailed communication plan for surveillance products, changing the format and frequency of reporting, maintaining strong relationships with partners and building towards a centralized provincial substance use surveillance database and surveillance system.

Cannabis knowledge and implications for health: Considerations regarding the legalization of non-medical cannabis.

Cannabis contains over a hundred of different cannabinoids, of which Δ9-tetrahydrocannabinol (THC) and cannabidiol (CBD) are the most well studied. The use of high-potency cannabis, containing high concentrations of THC and low concentrations of CBD, has been linked to adverse health outcomes, particularly for adolescents and young adults. Recently, an increase in cannabis potency has been observed in jurisdictions that legalized the sale of cannabis for non-medical purposes. Moreover, an increase of cannabis use and cannabis-related emergency treatment have also been observed in these jurisdictions. At the same time, risk perception regarding cannabis use has decreased in these populations. Trivializing language and an increased appearance of commercial cannabis in the public space may lead to a generalized underestimation of the risks of cannabis use. New regulation models principally focus on the creation of a legal cannabis market economy, the diversion of profits from illegal markets, and the reduction of costs associated with prohibition. However, an approach that specifically focuses on the rights to the health and safety of the individual should be considered in order to reduce the risks associated with cannabis legalization. Such an approach should promote and protect individual and social health and safety, establish a strict quality control of legal cannabis products regulated according to THC and CBD content, and eliminate all sorts of incentives to use, thus providing a more consistent, sustainable, and ethical framework for the legalization of non-medical cannabis use.

Too young for Cannabis? Choice of minimum legal age for legalized non-medical Cannabis in Canada

BackgroundChoice of minimum legal age (MLA) for cannabis use is a critical and contentious issue in legalization of non-medical cannabis. In Canada where non-medical cannabis was recently legalized in October 2018, the federal government recommended age 18, the medical community argued for 21 or even 25, while public consultations led most Canadian provinces to adopt age 19. However, no research has compared later life outcomes of first using cannabis at these different ages to assess their merits as MLAs.MethodsWe used doubly robust regression techniques and data from nationally representative Canadian surveys to compare educational attainment, cigarette smoking, self-reported general and mental health associated with different ages of first cannabis use.ResultsWe found different MLAs for different outcomes: 21 for educational attainment, 19 for cigarette smoking and mental health and 18 for general health. Assuming equal weight for these individual outcomes, the ‘overall’ MLA for cannabis use was estimated to be 19 years. Our results were robust to various robustness checks.ConclusionOur study indicated that there is merit in setting 19 years as MLA for non-medical cannabis.

Considering the health and social welfare impacts of non-medical cannabis legalization.

Considering the health and social welfare impacts of non-medical cannabis legalization.

Initial indicators of the public health impacts of non-medical cannabis legalization in Canada

Initial indicators of the public health impacts of non-medical cannabis legalization in Canada

Emerging prospects for non-medical cannabis legalisation in New Zealand: An initial view and contextualization

New Zealand may be the next national jurisdiction where non-medical cannabis use and supply will be legalized. While the current New Zealand government's plans for possible cannabis legalization were rather unclear for some time, initial details on proposed key parameters (for example, age limits, production and supply modes, use restrictions) of a possible cannabis legalization framework have recently emerged. We provide initial basic examination and contextualization of the proposal's select key details, both vis-a-vis select legalization frameworks as they exist in other jurisdictions as well as in reference to key parameters of policy and controls governing other legal psychoactive substances in New Zealand. Overall, the proposed framework for non-medical cannabis legalization in New Zealand resembles other (e.g., Canada's) legalization models in spirit and main proposed regulations. There are, however, several proposed regulation elements where questions regarding both feasibility and/or policy coherence concerning other psychoactive substance areas arise and likely to lead to challenges or problems in practice. Evidently, substantially more thinking, consideration and development need to be invested towards a more complete and workable public health-oriented framework and roadmap for cannabis legalization in New Zealand. Furthermore, possible cannabis legalization reforms hinge on the successful outcome of a public referendum (in late 2020), adding the acute need for substantive pre-referendum public education as well as overall extrinsic uncertainty regarding the prospects of actual and material policy change.

Co-use and Mixing Tobacco With Cannabis Among Ontario Adults.

The legalization of nonmedical cannabis in 2018 may have important implications for tobacco use in Canada. There is a risk of renormalizing tobacco use with co-use of tobacco and cannabis introducing nontobacco users to tobacco. Co-use is the use of both substances by the same individual at the same time or on different occasions, as well as mixed together. This study assessed the prevalence of co-use and mixing of tobacco and cannabis among Ontario adults and the characteristics of the users. Data from the 1996 to 2017 cycles of the Centre for Addiction and Mental Health Monitor (n = 4481) were used to examine trends in prevalence and the proportion of Ontario adults co-using and mixing tobacco and cannabis. Logistic regression was used to study associations between user characteristics and co-use and mixing. Co-use of cigarettes and cannabis among cannabis users declined from 59.8% in 1996 to 41.7% in 2017. Past-year e-cigarette use was the only predictor of co-use. From 2015 to 2017, 31.1% (95% confidence interval 27.0, 35.9) of Ontario adults who used cannabis reported mixing it with tobacco in the past year. Being white, past-year e-cigarette use, having moderate or high nicotine dependence, and having moderate or high risk for cannabis problems were significant predictors of mixing among cannabis users. Given the well-established negative health effects associated with tobacco use, alongside a growing evidence base for negative health effects of cannabis smoking, co-use and mixing could pose a considerable public health concern in the context of legalization. Considerable effort has been expended to reduce tobacco smoking. However, current efforts to reduce tobacco smoking may be diminished since this study found the prevalence of mixing tobacco and cannabis among cannabis users in Ontario to be higher than expected. Mixing tobacco and cannabis may introduce nontobacco smokers to tobacco, exposing them to health risks associated with both cannabis and tobacco smoke. Therefore, there is a need to monitor changes in tobacco use and understanding implications for tobacco control and cessation programs within the changing environment of cannabis legalization in Canada and other jurisdictions.

Mental Health and Medical Cannabis Use among Youth and Young Adults in Canada

Background: In October 2018, Canada became the second country to legalize non-medical cannabis. However, medical cannabis has been legally available in Canada since 2001 and, in 2015, approximately 800,000 Canadians reported using cannabis for medical purposes. Mental health is a common reason reported for using medical cannabis. Objectives: The current study examined perceived mental health among four groups: (1) Non/ex-users; (2) Recent non-medical users; (3) Recent unauthorized medical users; and (4) Recent authorized medical users. Methods: A total of 867 Canadian cannabis users and nonusers aged 16 to 30 were recruited through an online consumer panel in 2017, one year before non-medical cannabis legalization. Logistic and multinomial regression models were fitted to examine differences among cannabis use status and mental health measures. All estimates represent weighted data. Results: Self-reported emotional and mental health problems were higher among unauthorized (83.9%) and authorized medical cannabis users (83.2%) compared to non-medical users and non/ex-users (44.5% and 39.5%, respectively). Medical users were more likely to report using cannabis to manage or improve mental health problems than non-medical users (p < .001). There were few differences between unauthorized and authorized medical users, and between non/ex-users and non-medical users. Conclusions: The findings highlight a discrepancy between the recommendation that individuals with some mental health problems should avoid cannabis and the widespread practice of using cannabis to manage mental health. Education and reduced stigma around using cannabis after legalization in Canada may help address users coming forwards regarding use of cannabis for mental health problems.

Perceptions of effectiveness and believability of pictorial and text-only health warning labels for cannabis products among Canadian youth

BackgroundHealth warnings have been shown to increase knowledge and awareness of health risks, influence social norms, and reduce consumption of tobacco products. With the legalization of non-medical cannabis in Canada and other subnational jurisdictions, there is a need for empirical studies to examine the impact of cannabis health warnings on consumer perceptions and behaviour relevant to cannabis. MethodsIn October 2017, a between-group experiment was conducted as part of an online survey of Canadians aged 16 to 30 years (N = 870) recruited from a national consumer panel. Participants rated the perceived effectiveness and believability of either text-only or pictorial cannabis health warnings and then completed a message recall task. Participants also reported their level of support for cannabis warnings, and support for including cessation information and a quitline on the warnings. ResultsPictorial health warnings for cannabis products were perceived as more effective and believable than text-only warnings (p < 0.001), and the superiority of pictorial warnings was found across different warnings: dose (p = 0.039), co-morbid drug use (p = 0.006), and pregnancy (p < 0.001). Pictorial warnings were also rated as more believable (p = 0.048). Overall, 87.7% respondents supported having health warnings on cannabis products, and 84.0% supported the inclusion of a quitline number on cannabis health warnings. ConclusionThe current study provides the first empirical test of cannabis health warnings, consistent with the considerable body of evidence on the effectiveness of pictorial warnings on tobacco products. There was strong support for the inclusion of picture warnings and the inclusion of resources and quitlines on cannabis packaging.

Trends in cannabis use over time among Canadian youth: 2004–2014

Cannabis is the most commonly used illicit substance among Canadian youth. The current study examined national trends in cannabis use among Canadian youth from 2004/05 to 2014/15 using nationally representative data from the Canadian Student Tobacco, Alcohol and Drugs Survey (CSTADS). Data were collected from students in Grades 7 to 12 as part of the Canadian Student Tobacco, Alcohol and Drugs Survey (formerly the Youth Smoking Survey) using a repeat-cross sectional survey across 6 biennial survey waves between 2004 and 2014 (N = 243,057). Regression models examined factors associated with cannabis use in the past 12 months, perceived ease of access, and a multilinear regression examined age of initiation across survey cycles. The findings indicate that use of cannabis in the past 12-months significantly decreased among Canadian youth. Past-year use peaked in 2008/09 at 27.3%; compared to 16.5%, in 2014/15. Mean age of initiation did not vary over time, while youth in recent cycles reported that cannabis was more difficult to access: in 2006/07, 77.1% reported that it would be easy to access cannabis compared to 49.0% in 2014/15. Overall, cannabis use among Canadian youth appears to have peaked around 2008/09, with substantial declines over the past decade. It will be critically important to examine any changes in patterns of use following legalization of non-medical cannabis in Canada.