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MARIJUANA MOMENT
STATES THAT LEGALIZE MARIJUANA SEE REDUCED TOBACCO USE, STUDY FINDS
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SCIENCE & HEALTH
STATES THAT LEGALIZE MARIJUANA SEE REDUCED TOBACCO USE, STUDY FINDS
Published
8 hours ago
on
May 15, 2023
By
Ben Adlin
While some public health experts have expressed concerns that the legalization
of marijuana could fuel a rise in the use of tobacco products, a new study
instead concludes that state-level cannabis reforms are mostly associated with
“small, occasionally significant longer-run declines in adult tobacco use.”
Researchers did find “consistent evidence” that the adoption of state
recreational marijuana laws (RMLs) led to a slight uptick in cannabis use among
adults—of between about two and four percentage points, depending on the data
source—but tobacco didn’t follow that trend.
If the apparent substitution effect from cigarettes to marijuana that’s being
driven by legalization were extended nationally, it could result in healthcare
cost savings worth more than $10 billion per year, the study concluded.
“We find little empirical support for the hypothesis that RMLs increase the net
consumption of tobacco, as measured across a wide range of combustible tobacco
products as well as [e-cigarettes],” they wrote. “Rather, the preponderance of
evidence points to small, occasionally significant longer-run declines in adult
tobacco use.”
> “We conclude that [recreational marijuana laws] may generate tobacco-related
> health benefits.”
Authors at Bentley, San Diego State and Georgia State universities published the
findings in the Journal of Health Economics last month, calling the report “the
first to comprehensively examine the impact of recreational marijuana
legalization on tobacco use.” The study draws on federal data from the
Population Assessment of Tobacco and Health (PATH) and the National Survey on
Drug Use and Health (NSDUH).
At a time of surging public support for cannabis legalization, the researchers
write, “public health experts have taken a more cautious approach, urging more
research to assess the health benefits and costs of marijuana use, as well as to
understand potentially unintended consequences on other health behaviors.” Some
have raised concerns that reform could lead to the “renormalization” of smoking,
potentially reversing nearly half a century of declining cigarette use.
Cigarette smoking rates have fallen dramatically since the first Surgeon
General’s report in 1964, with rates among male adults dropping from 55 percent
to 16 percent and female smoking rates declining from 35 percent to 12 percent.
“While the causes of these declines are the subject of much debate,” the study
acknowledges, “most public health experts seek to preserve the health gains.”
Authors of the new study acknowledge that their analysis of the NSDUH data shows
that legalization has “a (largely) statistically insignificant 0.5 to 0.7
percentage-point decline in tobacco use,” which includes cigarettes, pipe
tobacco, smokeless tobacco and cigars. “However, this null effect masks small,
lagged tobacco effects of RMLs. Three or more years following the adoption of an
RML, we find that adult tobacco use falls by approximately 1.4 to 2.7
percentage-points.”
Looking specifically at cigarette use, they continue, “Again, while the overall
treatment effect is relatively small…three or more years following RML
enactment, we find evidence of a statistically significant 1.1 to 1.3
percentage-point decline in cigarette use among adults.”
To check, the study also analyzed states that legalized cannabis earlier than
others. “The results,” it says, “provide some support for the hypothesis that
tobacco use declined in several of the earliest adopting states, most notably in
Colorado and Washington, which are also those states that saw the largest
increases in marijuana use following RML enactment.”
> Legalization “is associated with a lagged reduction in electronic nicotine
> delivery systems (ENDS) use, consistent with the hypothesis that ENDS and
> marijuana are substitutes.”
The researches said that the reduction in tobacco use in legal states is
“primarily concentrated among men and for RMLs that are accompanied by open
recreational dispensaries,” findings that they say are “consistent with the
hypothesis that recreational marijuana and tobacco may be substitutes for some
adults.”
The paper notes that potential health care cost savings resulting from
substitution away from cigarettes and toward cannabis “could be substantial.”
“[O]ur estimates suggest a reduction in smoking prevalence by as many as 5.1
million, translating into tobacco-related healthcare cost savings of about $10.2
billion per year,” it concludes.
Because most states with legal cannabis first passed medical marijuana laws
(MMLs), the study notes it’s possible that “the RML effects could be conflated
with the long-run effects of MMLs,” especially in light of the delays states
often see between legalizing medical marijuana and actually beginning legal
sales.
Analyses of PATH data, meanwhile, yielded similar conclusions. “Consistent with
the NSDUH, we find no evidence that RML adoption significantly increased
prior-month combustible tobacco use or [e-cigarette] use,” authors write. “While
estimated lagged effects are positive in most cases for cigarette use, cigar
use, and all combustible tobacco products, the effects are uniformly below a
percentage-point—often under 0.5 percentage-points—and not statistically
distinguishable from zero at conventional levels.”
Further, the study found “no evidence that RML adoption significantly increases
initiation of tobacco products among baseline non-users or decreases cessation
among baseline tobacco users.”
Legalization was associated with a 1.2 to 1.3 percentage point increase in joint
use of tobacco and marijuana, however, which researchers said attributed
primarily to “marijuana initiation among the sub-population of individuals who
were already using tobacco prior to the policy shift.”
According to a Gallup poll published last year, more Americans now smoke
marijuana than cigarettes. A Monmouth University survey from October, meanwhile,
found that most Americans believe alcohol and tobacco are more dangerous than
cannabis.
And a federally funded study published earlier this year found that CBD could
help reduce nicotine cravings and help people quit.
> Minnesota Lawmakers Resolve Most Remaining Differences In Marijuana
> Legalization Bills During Second Conference Meeting
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Related Topics:featured
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Fears About Marijuana And Psychosis Need To Be Placed In Scientific Context, Not
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Ben Adlin
Ben Adlin is a Seattle-based writer and editor. He has covered cannabis as a
journalist since 2011, most recently as a senior news editor for Leafly.
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