Winfield-Ward Lauren, Wadsworth Elle, Driezen Pete, Rynard Vicki L, Hammond David
School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, ON, Canada.
RAND Europe, UK, Eastbrook, Shaftesbury Rd, Cambridge CB2 8BF, United Kingdom; Addiction and Mental Health Group, University of Bath, Claverton Down, Bath BA2 7AY, United Kingdom.
Drug Alcohol Depend. 2025 Sep 1;274:112787. doi: 10.1016/j.drugalcdep.2025.112787. Epub 2025 Jul 9.
A growing number of US states have legalized adult "recreational" cannabis; however, there is little evidence on the impact of cannabis policies on cannabis marketing exposure to date. The current study examined marketing exposure in the US, including differences between states where cannabis is illegal ('illegal' states), legal for medical use ('medical'), and legal for recreational use ('recreational').
Data are from the US component of the International Cannabis Policy Study: national repeat cross-sectional data from surveys conducted with 187,573 respondents aged 16-65 over 6 annual survey waves (2018-2023). Adjusted mixed effects logistic regression (GLIMMIX) models examined differences in self-reported exposure to cannabis marketing ('noticing') by state-level cannabis laws.
Self-reported exposure to cannabis marketing differed across policy changes. Noticing cannabis marketing was lowest in illegal states and increased in the first 12-months following medical legalization (35.4 % vs. 39.2 %: AOR=1.16; 95 % CI=1.01-1.33; p = 0.034). Noticing marketing was highest in 'recreational' states, with increases in the first 12-months following legalization (50.0 % vs. 41.1 %: AOR=1.41; 95 % CI=1.34-1.48; p < .001), and additional increases 1-3 years (56.2 %: AOR=1.20; 95 % CI=1.14-1.25; p < .001) and 4 or more years following legalization (63.9 %: AOR=1.21; 95 % CI=1.16-1.27; p < .001). Noticing was highest among people who consume cannabis and younger ages.
Self-reported exposure to cannabis marketing increases following medical and recreational legalization and is disproportionately noticed by underaged people. Cannabis regulations in 'legal' markets should account for marketing, which has been shown to promote cannabis use.
美国越来越多的州已将成人“娱乐性”大麻合法化；然而，迄今为止，几乎没有证据表明大麻政策对大麻营销曝光度有何影响。当前的研究调查了美国的营销曝光情况，包括大麻非法的州（“非法”州）、医疗用途合法的州（“医疗”州）和娱乐用途合法的州（“娱乐”州）之间的差异。
数据来自国际大麻政策研究的美国部分：在6次年度调查浪潮（2018 - 2023年）中对187,573名16 - 65岁受访者进行调查得到的全国重复性横断面数据。调整后的混合效应逻辑回归（GLIMMIX）模型研究了按州级大麻法律划分的自我报告的大麻营销曝光（“注意到”）差异。
自我报告的大麻营销曝光在政策变化中有所不同。在非法州注意到大麻营销的比例最低，在医疗合法化后的前12个月有所增加（35.4%对39.2%：调整后比值比[AOR]=1.16；95%置信区间[CI]=1.01 - 1.33；p = 0.034）。在“娱乐”州注意到营销的比例最高，在合法化后的前12个月有所增加（50.0%对41.1%：AOR = 1.41；95% CI = 1.34 - 1.48；p < 0.001），在合法化后1 - 3年还有额外增加（56.2%：AOR = 1.20；95% CI = 1.14 - 1.25；p < 0.001），以及在合法化后4年或更长时间增加（63.9%：AOR = 1.21；95% CI = 1.16 - 1.27；p < 0.001）。在大麻消费者和较年轻年龄段中注意到的比例最高。
自我报告的大麻营销曝光在医疗和娱乐合法化后增加，且未成年人中注意到的比例过高。“合法”市场中的大麻法规应考虑到营销，因为营销已被证明会促进大麻使用。
