ArticleThe International journal on drug policy2020
Changes in alcohol and cigarette consumption in response to medical and recreational cannabis legalization: Evidence from U.S. state tax receipt data.
Article in The International journal on drug policy, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The clouded debate: A systematic review of comparative longitudinal studies examining the impact of recreational cannabis legalization on key public health outcomes.Frontiers in psychiatry · 2022Pooled it
- Cannabis and Tobacco Product Use Classes and Psychosocial Correlates Among US Young Adults.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2026Article
- Use of Tobacco and Cannabis Following State-Level Cannabis Legalization.JAMA network open · 2025Article
- Changes in population-level alcohol sales after non-medical cannabis legalisation in Canada.Drug and alcohol review · 2025Observational
- Temporal Trends in Young Adult Cannabis and Tobacco Use in States with Different Cannabis Policies.Cannabis (Albuquerque, N.M.) · 2025Article
- Exploring the substitution of cannabis for alcohol and other drugs among a large convenience sample of people who use cannabis.Harm reduction journal · 2024Article
- Immigration status-related exclusive e-cigarette use and cannabis use and their dual use disparities associated with mental health disorder symptoms.Drug and alcohol dependence · 2024Article
- Health, safety, and socioeconomic impacts of cannabis liberalization laws: An evidence and gap map.Campbell systematic reviews · 2023Article
- The Stage-Based Model of Addiction-UsingInternational journal of molecular sciences · 2023Review
- Behavioral economic relationship between cannabis and cigarettes: Evidence from hypothetical purchase tasks.The International journal on drug policy · 2023Article
- The Genetically Informed Neurobiology of Addiction (GINA) model.Nature reviews. Neuroscience · 2023Review
- Association of Recreational Cannabis Legalization With Alcohol Use Among Adults in the US, 2010 to 2019.JAMA health forum · 2022Article
- Trends in Alcohol, Cigarette, E-Cigarette, and Nonprescribed Pain Reliever Use Among Young Adults in Washington State After Legalization of Nonmedical Cannabis.The Journal of adolescent health : official publication of the Society for Adolescent Medicine · 2022Article
- A difference-in-difference approach to examining the impact of cannabis legalization on disparities in the use of cigarettes and cannabis in the United States, 2004-17.Addiction (Abingdon, England) · 2022Article
- Relationships of Cannabis Policy Liberalization With Alcohol Use and Co-Use With Cannabis: A Narrative Review.Alcohol research : current reviews · 2022Review
- The effect of cannabis policies on treatment outcomes for cannabis use among U.S. adults.Journal of substance abuse treatment · 2021Article
- Marijuana liberalization policies and perinatal health.Journal of health economics · 2021Article
- Youth Cannabis use and Legalization in Canada - Reconsidering the Fears, Myths and Facts Three Years In.Journal of the Canadian Academy of Child and Adolescent Psychiatry = Journal de l'Academie canadienne de psychiatrie de l'enfant et de l'adolescent · 2021Article
- Recreational cannabis legalization and alcohol purchasing: a difference-in-differences analysis.Journal of cannabis research · 2021Article
- Dual trajectories of cannabis and alcohol use among young adults in a state with legal nonmedical cannabis.Alcoholism, clinical and experimental research · 2021Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
backgroundWhether medical or recreational cannabis legalization impacts alcohol or cigarette consumption is a key question as cannabis policy evolves, given the adverse health effects of these substances. Relatively little research has examined this question. The objective of this study was to examine whether medical or recreational cannabis legalization was associated with any change in state-level per capita alcohol or cigarette consumption.
methodsDependent variables included per capita consumption of alcohol and cigarettes from all 50 U.S. states, estimated from state tax receipts and maintained by the Centers for Disease Control and National Institute for Alcohol Abuse and Alcoholism, respectively. Independent variables included indicators for medical and recreational legalization policies. Three different types of indicators were separately used to model medical cannabis policies. Indicators for the primary model were based on the presence of active medical cannabis dispensaries. Secondary models used indicators based on either the presence of a more liberal medical cannabis policy ("non-medicalized") or the presence of any medical cannabis policy. Difference-in-difference regression models were applied to estimate associations for each type of policy.
resultsPrimary models found no statistically significant associations between medical or recreational cannabis legalization policies and either alcohol or cigarette sales per capita. In a secondary model, both medical and recreational policies were associated with significantly decreased per capita cigarette sales compared to states with no medical cannabis policy. However, post hoc analyses demonstrated that these reductions were apparent at least two years prior to policy adoption, indicating that they likely result from other time-varying characteristics of legalization states, rather than cannabis policy.
conclusionWe found no evidence of a causal association between medical or recreational cannabis legalization and changes in either alcohol or cigarette sales per capita.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.