The legalization of medical and recreational cannabis in various U.S. states has prompted discussions about its influence on tobacco consumption. Research indicates that cannabis legalization has not led to an increase in tobacco use; in some cases, it may be associated with a decline.

Research Findings

A study published in the International Journal of Drug Policy in November 2024 examined the relationship between cannabis legalization and tobacco use. Researchers from the University of California, San Francisco, analyzed data from a nationally representative cohort of 9,000 participants aged 18 to 94, spanning from 2017 to 2021. The study concluded that the adoption of state-level cannabis legalization laws did not increase participants’ likelihood of using tobacco or nicotine products. In fact, tobacco and nicotine use declined by 1.9% during the study period, while co-use of cannabis and tobacco/nicotine remained relatively stable.

Additionally, a fact sheet by the Truth Initiative, a nonprofit public health organization, highlights the evolving relationship between cannabis and tobacco use. The report notes that while overall cannabis use patterns have remained steady, including among youth in states where cannabis is legal, vaping cannabis as a commonly used method of consumption is on the rise. The fact sheet also discusses the co-use of cannabis and tobacco products among U.S. youth, indicating that many teens are combining the two substances.

Implications

The findings suggest that cannabis legalization has not contributed to an increase in tobacco use. The observed decline in tobacco consumption during the study period aligns with broader public health efforts to reduce smoking rates. However, the rise in cannabis vaping and the co-use of cannabis and tobacco among youth warrant attention, as they may have implications for public health strategies and education.

Takeaway

Current research indicates that the legalization of cannabis has not led to an increase in tobacco use; instead, there has been a slight decline in tobacco consumption. Nonetheless, the trends in cannabis vaping and the co-use of cannabis and tobacco products, particularly among youth, highlight the need for ongoing public health monitoring and targeted interventions.