Page last updated: June 2022
Trends in alcohol, cigarette, e-cigarette, and nonprescribed pain reliever use among young adults after legalization of nonmedical cannabis

Cannabis legalisation is linked to a reduction in alcohol and cigarette consumption, as well as pain medication misuse among young adults, a new study has suggested.
The research, published in the Journal of Adolescent Health, assessed trends in alcohol, nicotine, and nonprescribed pain reliever use and changes in associations of cannabis use with these other substances among young adults in Washington State after nonmedical cannabis legalization.
Data from six annual waves of survey data from a state-wide sample from 2014 through 2019 including 12,694 young adult participants.
Prevalence of past-month alcohol use, heavy episodic drinking (HED), and cigarette use and prevalence of past-year pain reliever misuse decreased, while the prevalence of past-month e-cigarette use increased since 2016 (the first year assessed). Across years and age groups, the prevalence of substance use other than cannabis was higher among occasional and frequent cannabis users compared to cannabis nonusers. However, associations between both occasional (1–19 days in the prior month) and frequent (20+ days) cannabis use and pain reliever misuse and between frequent cannabis use and HED weakened over time among individuals ages 21–25.
The study authors say that contrary to concerns about spill over effects, implementation of legalized nonmedical cannabis coincided with decreases in alcohol and cigarette use and pain reliever misuse. They comment that the weakening association of cannabis use with the use of other substances among individuals ages 21–25 requires further research but may suggest increased importance of cannabis-specific prevention and treatment efforts.
Source: Trends in Alcohol, Cigarette, E-Cigarette, and Nonprescribed Pain Reliever Use Among Young Adults in Washington State After Legalization of Nonmedical Cannabis. Charles B. Fleming, Jason J. Ramirez, Isaac C. Rewritten A. Hultgren, Oren G. Hanson, Mary E. Larimer, Julia A. Dilley, Jason R. Kilmer, Katarina Guttmannova. Journal of Adolescent Health, Available online 9 May 2022.

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