Dynamics of Cannabis Market Environment Changes and Public Health Effects after Legalization: The Role of Local-Level Regulation Beyond the Short-Term in the Pacific Northwest

项目摘要/摘要 尽管联邦政府禁止吸食大麻，但越来越多的州正在实施 或者考虑大麻合法化。华盛顿州和俄勒冈州是第一批 合法化，在2012年和2014年。美国和海外的司法管辖区都在关注早期的国家 采用者，以确定州和地方政策的最佳实践，并了解 大麻合法化将在短期内完成。 作为对国家娱乐用大麻合法化的回应，许多社区 华盛顿州和俄勒冈州已经启动了额外的监管政策或税收。目前，有 没有证据基础来预测这些地方政策行动对缓和公众的有效性 大麻合法化后可能产生的健康或社会后果。 拟议研究的目的是： 1)监测和记录地方一级大麻政策、价格和市场活动的变化 (例如，密度、销售额)在俄勒冈和华盛顿州。 2)评估俄勒冈州和美国当地大麻政策、价格和市场活动的差异 华盛顿在短期内(5-10年)影响大麻的使用和相关的健康后果 在合法化后)在青年、孕妇和育儿妇女以及成年人中。 3)估计地方一级大麻政策的短期和长期影响、价格和 关于青少年烟酒使用率和使用频率的市场活动， 孕妇、新妈妈和所有成年人，以及药物使用治疗和 俄勒冈州和华盛顿州与酒精和阿片类药物有关的住院治疗。 我们将使用准实验方法和地理空间分析来解决这些目标 利用国家内部和跨时代的大麻政策、价格和市场差异 活动。我们将收集和审查两个州的地方大麻政策，零售商层面 许可和交易数据，并评估它们与相关行为、公众 健康和社会成果。我们将依靠多个既定的公共卫生监测和 其他数据报告系统，这在两个州基本上是通用的。 这项研究的结果将为政策制定者和其他利益相关者提供强有力的 关于地方大麻政策对公共卫生结果的有效性的证据。

PROJECT SUMMARY/ABSTRACT Despite federal cannabis prohibition, an increasing number of states are implementing or considering cannabis legalization. Washington and Oregon were among the first states to legalize, in 2012 and 2014. Jurisdictions in the U.S. and abroad are looking to the early state adopters to identify best practices for state and local policy, and to learn about the impact of cannabis legalization beyond the short-term. In response to state legalization of recreational cannabis, many communities in Washington and Oregon have initiated additional regulatory policies or taxes. Currently, there is no evidence base to predict the effectiveness of such local policy actions for moderating public health or social outcomes that may follow cannabis legalization. The Aims of the proposed study are to: 1) Monitor and document local-level changes in cannabis policies, prices, and market activities (e.g., density, sales) in Oregon and Washington. 2) Assess how local variation in cannabis policies, prices, and market activities in Oregon and Washington affect cannabis use and related health outcomes beyond the short-term (5-10 years after legalization) among youth, pregnant and parenting women, and adults. 3) Estimate the short-term and longer-term effects of local-level cannabis policies, prices and market activities on the prevalence and frequency of alcohol and tobacco use among youth, pregnant women, new mothers, and all adults, as well as substance use treatment and hospitalizations related to alcohol and opioids in Oregon and Washington. We will address these aims using quasi-experimental methods and geospatial analyses that exploit within-state and across-time variation in cannabis policies, prices, and market activities. We will collect and review local marijuana policies in both states, retailer-level licensing and transaction data, and assess their association with relevant behavioral, public health and social outcomes. We will rely on multiple established public health surveillance and other data reporting systems, which are largely common across both states. Findings from this study will provide policymakers and other stakeholders with strong evidence about the effectiveness of local cannabis policies on public health outcomes.