Public health orientation of Cannabis and alcohol regulators: An analysis of state-level variation in the United States.

OBJECTIVES

To provide an analysis of state-level variation in how alcohol and adult-use cannabis regulatory agencies articulate their involvement in, and pursuit of, public health goals.

METHODS

An important slogan in state-level campaigns to legalize adult-use cannabis was to regulate cannabis "like alcohol." We conducted a content analysis of annual reports produced by state cannabis and alcohol regulatory agencies in the United States where adult-use cannabis has been legalized to compare the reported public health orientations of each agency. Our coding domains capture references to (1) stated public health goals, (2) data collaboration with public health agencies, (3) public health efforts, and (4) law enforcement efforts.

RESULTS

Adult-use cannabis regulatory agencies reported all public health indicators more often, while alcohol regulatory agencies reported engaging in law enforcement efforts more often than cannabis regulators. Compared to states that legalized adult-use cannabis through ballot initiatives, states that legalized through their legislatures reported more public health indicators for both cannabis and alcohol regulators. We find a positive correlation within states between the public health engagement of alcohol and cannabis regulators.

CONCLUSIONS

Cannabis regulatory agencies largely outperform alcohol regulatory agencies in terms of their articulated public health goals, activities, and policies. US states adopting adult-use cannabis legalization more recently, have predominantly legalized through their state legislatures and have cannabis regulators that report on a greater number of cannabis-related public health issues. More research is needed to assess whether public health-related actions reported by cannabis agencies translate into tangible public health benefits among cannabis using and affected populations.