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The Impact of Recreational Marijuana Legalization on Tobacco and Marijuana Co-Use

Institution: University of California, San Francisco
Investigator(s): Beth Cohen,
Award Cycle: 2019 (Cycle 30) Grant #: T30IR0988 Award: $1,091,974
Subject Area: Tobacco-Use Prevention and Cessation
Award Type: High Impact Research Project Award

Initial Award Abstract
California has been extremely successful in reducing rates of tobacco use through education and legislation and now has the second lowest rate of tobacco use in the country. However, the landscape of tobacco is changing. Tobacco companies have introduced a variety of new products, such as electronic cigarettes and vaping devices, that are being marketed as safer despite containing the same addictive nicotine as traditional cigarettes and numerous harmful chemicals and toxins. Even while tobacco smoking rates were declining, marijuana use has been increasing both nationally and in California. In contrast to tobacco, rates of marijuana use are higher than the national average in California and are poised to increased further with recreational legalization. There are many reasons to believe that recreational legalization and the expanded use of marijuana and novel products that are expected to follow it will increase tobacco use. Prior studies have found people who use marijuana are more likely to start using tobacco and to have a harder time quitting tobacco. Legalization can also be accompanied by changes in public perceptions of safety of marijuana use. People now regularly smoke and vape marijuana in California in public places where it would be socially unacceptable to smoke cigarettes. This increased acceptability could cross over to tobacco use, especially given the new marijuana and tobacco electronic delivery devices that are identical or highly similar. Understanding how recreational legalization impacts marijuana and tobacco use and public perceptions of the safety of these substances will be extremely important as the state works to develop laws to regulate marijuana and to continue to reduce exposure to harmful smoke. We are in an ideal position to provide this information. In 2017, we conducted a national survey with 9,003 respondents, including nearly 1,000 from California. This established pre-recreational legalization rates of tobacco and marijuana use and opinions on safety. We now propose to repeat our survey in 2019 and 2020. This will allow us to determine how tobacco and marijuana use and public opinions have changed following recreational legalization and compare these changes to those in other states. This work will inform policy and programs to protect the health of all Californians this changing landscape.