Marijuana Regulatory Frameworks in the First Four US States to Legalize Adult Use: An Analysis Against a Public Health Standard

Rachel Barry and I just published “Marijuana Regulatory Frameworks in Four US States: An Analysis Against a Public Health Standard” in American Journal of Public Health.  This paper presents a normative framework for marijuana regulation based on best practices from tobacco and alcohol control and assess the laws in the first for states to legalize adult use marijuana.  In particular, we assess what has happened so far in the legalizing states against 67 public health best practices and find that, overall, only between 34% and 51% of states are following public health best practices. 

The paper also contains a detailed appendix assessing all four states against the specific policies and the sources for these policies.

Here is the 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.

The accompanying editorial published with the paper highlights the value of this exercise, but notes that we did not assess the public health consequences of the criminalization of marijuana.  That is an important issue, but we deemed that beyond the scope of the paper because of length limitations.

Recently Dan Orenstein and I published a legislative framework, including specific legislative language, for implementing marijuana legalization within a public health framework.  It is available here.

The full citation for the paper is Am J Public Health. 2018;108: 914–923. doi:10.2105/AJPH.2018.304401 and it is available here.