Five years ago, the Canadian government optimistically anticipated that greater market stability, data collection, investment in research and a mandatory three-year review would allow rapid evaluation of the impact of cannabis legalization.
However, there have been a few surprises along the way. The high-profile churn in industry leadership and the closure of many retail outlets are testimony to the fact that stability remains a challenge.
Due to the COVID-19 pandemic, much research was paused, re-scoped, or simply cancelled as health and academic resources were redirected. Federal funding supporting much of this research has not been renewed.
COVID-19 also clouded our understanding of whether changes in cannabis use were related to legalization or to the pandemic. Access to comparable and timely data across provinces and territories continues to be a challenge. The expert panel conducting the three-year review has only just released its first-phase report “What We Heard,” with the final report and recommendations anticipated in March 2024.
Assessing impact
To evaluate the impact of cannabis legalization according to the stated intentions of the policy, we need to know:
- Are young people accessing more or less cannabis?
- Is the legal market displacing the illegal market?
- Are fewer people involved in the criminal justice system due to cannabis?
- Are people aware of the health risks?
Relaxing the precautionary public health and safety components of the Cannabis Act – in particular those related to advertising and promotion – is premature given the delays in generating robust answers to the questions above. Amendments to the regulations should be informed by a strong understanding of potential health and safety impacts, and not driven by private economic interests.
Are young people accessing more or less cannabis?
The impact of legalization on youth consumption remains an issue of debate. Trends continue to fluctuate, but generally have downward or stable trajectories, according to the Canadian Cannabis Survey 2021 and the Ontario Student Drug Use and Health Survey in the same year.
However, there are also concerning trends in emergency department visits due to pediatric cannabis exposure. While we can’t be sure whether the cannabis that these children consumed came from a legal or illegal source, the trends reinforce the importance of child-proof packaging and education for adults and youth on the safe storage of cannabis products.
Youth consumption trends in Quebec are worth watching when evaluating diverse regulatory approaches. In 2020, Quebec raised the legal age of consumption to 21, versus 18 in Alberta and 19 in all other provinces and territories. Quebec also prohibits a broader scope of products that may appeal to youth, including chocolates, gummies and vape liquids.
While rates of use among youth are showing a promising decline in Quebec, it’s important to also consider that the decline in use among those 15-17 years in that province pre-dated the regulatory change.
Is the legal market displacing the illegal market?
Notable strides have been made in shifting consumers from the illegal market to a regulated supply. Among respondents in the Canadian Cannabis Survey who said they consumed cannabis in the previous 12 months, 68 per cent reported usually obtaining cannabis legally, either from legal storefronts (61 per cent) or online sources (7.7 per cent.)
Provinces and territories using a private retail model continue to have a higher number of outlets by population. While research has found that living very close to a retail cannabis store is associated with purchasing from a legal store, it does not necessarily predict reduced purchases from the illegal market.
Price, quality and convenience continue to be the dominant factors in determining purchasing sources, according to the 2022 Canadian Cannabis Survey and other reports.
The Cannabis Act provides important levers to promote product quality and safety, which appear to be having an impact. The 2022 International Cannabis Policy Survey found that only 15 per cent of past-year consumers surveyed in Canada perceived the legal product to be of lower quality. Increased standardization of testing as well as greater consistency in inspection and enforcement would ensure that the act’s quality levers are better utilized.
Ongoing monitoring of consumer behaviour – in particular, exploration of the barriers to transitioning to the legal market – is important to guide consumer education and potential regulatory amendments.
We also need to be realistic about the likelihood of a full transition. A price war with the illegal market would risk promoting consumption, and a product war would increase the availability of higher-risk product formats. Both options are counter to the other public health and safety objectives of the act.
Are fewer people involved in the criminal justice system due to cannabis?
Since legalization, police data show up to a 97-per-cent reduction in cannabis possession charges, as well as a lesser reduction in trafficking and sales charges. Post-legalization, possession charges remain for those under 18 years of age, for amounts in excess of 30 grams, or for product known to be illegal.
The most common cannabis-related offense in 2020 was distribution (33 per cent of all adults charged with cannabis-related offences), followed by production (23 per cent) and sale (22 per cent).
While the greatest decrease took place among adults, youth charges also decreased considerably following legalization, as illustrated in figure 1.
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The charges presented for youth refer only to arrests for the possession of more than five grams of cannabis.
The Cannabis Act provides provinces and territories with the opportunity to determine regulations for youth possession under five grams. Some provinces have introduced formal diversion schemes (such as educational and preventative e-courses or mentoring programs), while others have simply implemented ticketing systems.
The systematic collection of data on the application of these provincial regulations is a current gap that must be addressed.
In addition, the collection and reporting of racial data is necessary to determine whether the reduction in criminal justice involvement is being equitably experienced, particularly among communities that have traditionally been over-represented in that system.
Are people aware of the health risks of cannabis?
Policy sometimes has unintended consequences. The Cannabis Act and its regulations initially set the bar for approval of research involving human subjects at the level of clinical trials for pharmaceuticals instead of for comparable legally available products such as alcohol.
The act and its regulations were amended to streamline research approvals in 2022, but the delay before that time in receiving the approvals required to begin research means that we don’t yet have the information we would like about the impact and experiences of consuming different products.
This information is necessary to better understand and communicate the health risks of cannabis use, including the impact of different formats, such as edibles and concentrates, and different concentrations of compounds such as THC and CBD within the products.
Although current regulations require product labels to include levels of THC and CBD, research indicates that using a standard unit dose would be better understood than the current quantitative labelling of THC and CBD based on weight. The distinction between THC (active level of THC when purchased) and Total THC (level of THC when activated, e.g., heated) is particularly confusing.
A standard dose would also help to communicate and measure higher-risk use, particularly with newer product formats such as edibles, beverages and vaping oils, which are increasing in market share.
The next five years?
Regulatory flexibility has allowed Canada to adapt to the needs of consumers while waiting for public-health considerations to be explored more fully. As other jurisdictions consider their own approaches to cannabis legalization, Canada is positioned to provide the lessons it learned to guide effective, responsible and adaptable policies that address the complex challenges of a legalized cannabis landscape.
For this to happen, and for meaningful assessment of the Cannabis Act objectives, the government can take several important steps.
The first is re-committing to investment in research to better understand the relationship between health and safety impacts, and factors such as outlet density, variations in minimum age and product format restrictions. We have an excellent opportunity to leverage variations in regulatory approaches across provinces to support this research.
Second, a commitment to ongoing data collection and reporting is essential to realize this opportunity, and to ensure the ability to monitor key trends such as the prevalence of use, higher-risk use, and changing consumer patterns related to product formats and product source.
Data that can be disaggregated by factors such as race and income levels are also required to measure social justice impacts.
Finally, the government can commit to regularly revisiting the regulatory framework in light of emerging evidence; for example, through the series of independent reviews recommended by the expert panel in its Phase 1 report.
Taking these steps and using evidence to make tangible and timely changes to the regulatory framework, including strengthening or reducing industry regulation, will support the achievement of the objectives outlined in the Cannabis Act, and cement Canada’s position as the global leader in responsible cannabis regulation.
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