Perceptions of public health consequences of marijuana legalization

Abstract

Background

As cannabis policy is rapidly evolving and support for marijuana legalization is increasing, understanding of the public’s perception of cannabis and its associated risks is important for prevention efforts.

Method

Adults in Michigan (n = 2,189) were recruited to complete a web-based survey focused on attitudes toward marijuana (August–September 2016). Participants were recruited through online and email advertisements from community-based agencies and a statewide advocacy coalition. Measures were adapted from previous public opinion research with input from advocacy coalition members. Logistic regression analyses were used to assess public perceptions of cannabis potency and the perceived impact of marijuana legalization on road safety, employee safety, and emergency department (ED) visits. Independent variables included demographics, political orientation, and marijuana-related variables (marijuana use, attitude toward marijuana legalization).

Results

Respondents ranged in age from 18 to 88 years (mean = 45.5 years) and were 72% female. Most adults (79.7%) were aware that marijuana is more potent today compared to the past. Over half of adults felt marijuana legalization would negatively affect road safety (55.5%), employee safety (58.8%), and lead to an increase in ED visits (62.8%). Differences in attitudes were found based on demographics (age, gender, race, and education), marijuana use, and attitudes toward legalization.

Conclusions

Although most adults recognize potential public health risks associated with cannabis legalization, a sizable minority of adults do not feel marijuana legalization will have negative public health consequences. As more states legalize, prevention efforts may be needed to reduce negative public health consequences associated with cannabis use.

Keywords:

• Marijuana legalization
• cannabis policy
• public attitude
• public perception

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1 Throughout this paper we use the term marijuana. Although use of the term cannabis has grown in popularity, ‘marijuana’ (or marihuana’) is the term used more frequently in state and local policies in the United States (Mikos and Kam 2019). We recognize that the term marijuana has a complex history. Historians, for example, have documented the term has been used as an anti-immigrant pejorative (Thompson 2013). However, other scholars suggest the term marijuana was initially developed as an act of open resistance in Mexico (Chen 2018) and that use of the term brings attention to the influence of Mexican immigrants on US culture (Woelfel 2019).

2 The Controlled Substances Act (CSA) is federal legislation that was signed into law in 1970 and regulates the manufacture, possession, use and distribution of medicines and illicit drugs (Blake and Finlaw 2014). The CSA classified marijuana as a “Schedule 1 substance”, along with heroin and LSD. This classification was for drugs considered to have a high potential for abuse, no accepted use even under medical supervision, and was subject to the most stringent regulatory controls.

3 As of April 2020, medical marijuana is legal in the District of Columbia and the following 33 states: Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Hawaii, Illinois, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Montana, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, Utah, Vermont, Washington and West Virginia. Ten states and the District of Columbia have legalized marijuana. They are Alaska, California, Colorado, Illinois, Maine, Massachusetts, Michigan, Nevada, Oregon, Vermont, and Washington.