As U.S. policymakers consider ways to ease prohibitions on marijuana, the public health approaches used to regulate alcohol and tobacco over the past century may provide valuable lessons, according to new RAND Corporation research.
Recent ballot initiatives that legalized marijuana in Colorado and Washington for recreational uses are unprecedented. The move raises important questions about how to best allow the production, sales and the use of marijuana while also working to reduce any related social ills.
A new study published online by the American Journal of Public Health outlines how regulations on alcohol and tobacco may provide guidance to policymakers concerned about the public health consequences of legalizing marijuana.
Among the issues outlined in the study are how to reduce youth access to marijuana, how to minimize drugged driving, how to curb dependence and addiction, how to restrict contaminants in marijuana products, and how to discourage the dual use of marijuana and alcohol, particularly in public settings.
"The lessons from the many decades of regulating alcohol and tobacco should offer some guidance to policymakers who are contemplating alternatives to marijuana prohibition and are interested in taking a public health approach," said Beau Kilmer, co-director of the RAND Drug Policy Research center and a co-author of the paper. "Our goal here is to help policymakers understand the decisions they face, rather than debate whether legalization is good or bad."
The analysis details some of the questions policymakers must confront when considering less-restrictive marijuana laws. Those questions include: Should vertical integration be allowed, or should there be separate licenses for growing, processing and selling marijuana? What rules are needed to make sure a marijuana product is safe? Should marijuana be sold in convenience stories or only in specialized venues? Should taxes be assessed per unit of weight, as a percent of the price or on some other basis, such as the amount of psychoactive ingredients in marijuana?
"Based on the national experience with alcohol and tobacco, it seems prudent from a public health perspective to open up the marijuana market slowly, with tight controls to test the waters and prevent commercialization too soon while still making it available to responsible adults," said Rosalie Liccardo Pacula, co-director of the RAND Drug Policy Research Center and a co-author of the paper. "Of course, perspectives other than public health objectives might motivate policymakers to adopt different or fewer regulations. These are simply lessons learned from a public health perspective."
The article discusses a variety of strategies used to control alcohol and tobacco that also may be appropriate for regulation of marijuana. Those include keeping prices artificially high to curb use, adopting a state-run monopoly on sales and distribution, limiting the types of products sold, restricting marketing efforts, and restricting consumption in public spaces.
Support for the study was provided by the Robert Wood Johnson Foundation's Public Health Law Research Program and RAND. Other authors of the report are Alexander C. Wagenaar of the University of Florida College of Medicine, Frank J. Chaloupka of the University of Illinois, Chicago, and Jonathan P. Caulkins of the Heinz School of Public Policy at Carnegie Mellon University.
Since 1989, the RAND Drug Policy Research Center has conducted research to help policymakers in the United States and throughout the world address issues involving alcohol and other drugs. In doing so, the center brings an objective and data-driven perspective to an often emotional and fractious policy arena.
American Journal of Public Health