In Canada, the legalization of medical cannabis is associated with a reduction in alcohol sales

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A Canadian researcher has found a “significant negative association” between sales of medical cannabis and alcohol.

Professor Michael J. Armstrong’s study was published online in the journal Health Policy last November. She compared legal sales of medical cannabis to sales of beer, wine and other alcohol in Canada from 2015 to 2018.

Armstrong’s study found that every dollar of medical cannabis sold was associated with lower alcohol sales of between 74 cents Canadian (51 cents) and 0.84 cents Canadian.

“The negative association was robust to several alternative modeling choices,” writes the study author.

Armstrong said his study suggested medical cannabis use replaced some alcohol use, but said it did not prove causation.

The study found that alcohol sales in Canada in 2017-2018 were about 1.8% lower than they would have been without legal medical cannabis. She also suggests that reduced alcohol sales may partially offset the harms and benefits of cannabis legalization.

Armstrong’s 1.8% figure is much lower than the 15% drop in alcohol demand estimated for Washington state in a study that looked at recreational cannabis.

“For example, the increase in cannabis-related health problems could be accompanied by a decrease in those related to alcohol. And new government revenue from cannabis taxes could offset declining alcohol tax revenue,” Armstrong said.

The Canadian study took into account differences in alcohol prices, retail spending, unemployment rates and penalties for drunk driving. It can be read here.

A US analysis published in 2017 identified a similar drop in alcohol sales after the adoption of medical cannabis by the various US states, as did another 2021 study of data from the Youth Risk Behavioral Survey. In contrast, a more recent study evaluating the impact of the legalization of adult cannabis use in the United States reported an association with increased alcohol consumption among those aged 21 and older.

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