When early states began to legalize cannabis, there was a fear amongst medical organizations that normalizing cannabis smoking would lead to an increase in tobacco smoking. But a new report published in the Journal of Health Economics found that increased cannabis consumption has actually led to less tobacco use.
This study is the first to comprehensively examine the impact of the legalization of recreational marijuana on adult tobacco use, and it determined a few things.
First, recreational marijuana laws, or RMLs as the authors call them, caused an increase in cannabis consumption – and vaping was a part of that increase. Usage also increased among people who hadn’t been cannabis consumers prior to the RMLs.
The study also found that the legalization of adult-use cannabis did not increase tobacco consumption. Instead, the opposite occurred. The data found that there was a slight decrease in cigarette smoking and e-cigarette usage.
NSDUH-based estimates suggest that two or more years after the adoption of an RML, legalization is associated with an approximately 0.5 to 2 percentage-point decline in tobacco use, including from cigarette consumption.
The study also noticed that the availability of dispensaries also helped consumers to cut back on tobacco consumption.
The study sourced information from a newly available nationally representative panel dataset, the Population Assessment of Tobacco and Health. It also drew auxiliary data from the National Survey on Drug Use and Health and employed difference-in-differences models using novel estimators developed by Callaway and Sant’Anna to expunge bias in two-way fixed effects models caused by heterogeneous and dynamic effects of RMLs on marijuana and tobacco use.
Good vs. Bad
Studies from the American Lung Association found that heavy cannabis smoking could be linked to lung disease, but that was mitigated in other cannabis form factors like edibles and beverages. The report cited that to the contrary, moderate marijuana use is associated with some important health benefits, including reduced risks of mortality and mobility, and alleviation of pain, anxiety, and many side effects of cancer and HIV treatments.
Moreover, relative to tobacco use, far fewer studies have linked marijuana consumption to cancers, heart disease, or stroke.
In contrast, tobacco use is the leading cause of preventable death in the United States, and the Centers for Disease Control and Prevention has linked it to nearly one-half million deaths per year. In addition, tobacco consumption leads to an increased risk of emphysema, cancers of the colon, liver, head, and lung, and stroke.
The study did point out that the tobacco market also underwent big changes at the same time as adult-use cannabis laws were enacted, specifically, the introduction of e-cigarettes. The ability to adapt vaping devices for marijuana consumption could result in a complementary relationship between e-cigarettes and marijuana.
On the other hand, if e-cigarettes and marijuana both serve to produce a high effect, generate utility from a smoking experience, or serve the ends of quitting cigarette smoking, then marijuana and e-cigarettes may be substitutes.
In addition to nicotine vapes, as adult-use cannabis laws were being enacted, taxes on tobacco were also increased dramatically. The minimum age to buy tobacco also jumped to 21 in 16 states, and eight states expanded clean indoor air laws. Any of these issues could have also contributed to a reduction in tobacco consumption stated the report.
Still, despite those reasons, the availability of recreational cannabis may have actually helped some people to stop smoking cigarettes.