Our Publications & Reports

 

Informational Materials

Principles for a Public Health & Equity Approach to Cannabis Regulation

Getting it Right from the Start

The war on drugs has resulted in large scale unjust incarceration and other harmful social impacts. At the same time, legalizing cannabis without robust regulation and promoting the growth of an unfettered for-profit industry threatens our developing youth and public health, and risks further exacerbating social, economic, and health disparities. Download a simplified one-page Principles for a Public Health & Equity Approach to Cannabis Regulation.

Issue Brief – Complying with SB1186

Getting it Right from the Start, January 2024

Our new policy brief provides detailed recommendations and guidance for your locality to help determine whether to challenge the new law that overrode the foundational local control principle of Proposition 64 or how to modify your current policies around medical marijuana access to include strong guardrails that protect youth, promote public health, and advance social equity.

Intoxicating Hemp Products 

Getting it Right from the Start, June 2023

This policy brief for California local governments, particularly the County of Santa Clara Public Health Department, delves into the the unintentional consequences of Bill 45 (AB45), which legalized the manufacture and sale of products intended for human consumption that contain ingredients derived from industrial hemp. While the intent may have been to legalize hemp-derived cannabidiol (CBD), which is usually non-intoxicating, loopholes have allowed  psychoactive hemp products to be sold.

Health Harms of Cannabis Use: One Pager for General Public

Getting it Right from the Start, November 2023

In 2017, the National Academies of Sciences, Engineering and Medicine (NASEM) reviewed the available scientific evidence on the health effects of cannabis and cannabis products, and while noting substantial evidence of therapeutic effectiveness of medicinal cannabis for a limited number of indications, noted evidence of association of cannabis use with harm in a wide range of areas. We lay out some of the key conclusions from this landmark NASEM study.

Fact Sheet: Ten Tips for Safer Cannabis Use 

Getting it Right from the Start, June 2023

Every form of cannabis use can pose risks to your health. Cannabis products come in many forms and can be used in different ways; some are more hazardous than others. If you decide to use cannabis, follow these recommendations to lower risks to your health.

Fact Sheet: Cannabis vs. Hemp 

Getting it Right from the Start, May, 2023

Learn all about what makes them different, what they have in common, why it matters, what’s legal and what’s not, and what we can do to create a safer legal cannabis market.

Evaluation Checklist for Cannabis Laws and Regulations

By Getting it Right from the Start

This checklist aims to help evaluate the extent to which principles for protecting youth, public health and equity have been implemented in or addressed by state or local laws.

Setting the Record Straight: Fact-Checking Claims About California’s Legal Cannabis Industry

Getting it Right from the Start, 2022

 

In the nation’s most populous state, the legal landscape in the second year of adult-use commerce continues to largely favor economic opportunity over heeding lessons from tobacco control and other legal but harmful products to protect youth and public health.

Cannabis Products

By Getting it Right from the Start

Product diversification is a key and concerning strategy of today’s cannabis industry. From inhalables to edibles, these are some basics and examples of commonly used products.

Important Health Warnings About Cannabis

By Getting it Right from the Start

Every form of cannabis use can pose risks to your health, do you know what they are? Check out our Health Warnings About Cannabis flyer to learn more. The only way to avoid risks associated with cannabis use, is by choosing not to use. However, IF you choose to use, consider the safer use recommendations included with our flyer to lower the risks to your health.

California Cannabis Tax Revenues: A Windfall for Law Enforcement or an Opportunity for Healing Communities?

April 1, 2020

By Youth Forward | Getting it Right from the Start 

Proposition 64 promised to take cannabis revenues and invest them in youth programs, substance abuse treatment, and more. This report from Youth Forward and PHI’s Getting It Right from the Start, shows cities across California are are spending cannabis revenues on city and county law enforcement.

2024 Publications

Cannabis Use During Early Pregnancy Following Recreational Cannabis Legalization

Study by Kaiser Permanente and Getting it Right from the Start, JAMA Network, November, 2024

Study found that prenatal cannabis use surged in California areas with legal retailers post-legalization, while banned areas saw no spike. The findings highlight the influence of local retail access on use during pregnancy, raising public health concerns.

Association of Local Cannabis Policy and Retail Availability With Cannabis Use and Problematic Cannabis Use Among Adolescents in Northern California

Study by Kaiser Permanente and Getting it Right from the Start, American Journal of Public Health, November, 2024

Study found that adolescent cannabis use is higher where local sale or delivery is allowed, or protections are weaker. Greater retailer density and proximity to the home was linked with both increased use an increased problematic use in these areas.

REPORT AND RECOMMENDATIONS OF THE HIGH POTENCY CANNABIS THINK TANK TO THE STATE OF CALIFORNIA

By The High Potency Cannabis Think Tank, October 30, 2024

A new report by an independent panel of cannabis experts, convened by the California Department of Public Health (CDPH), analyzes the health impacts, including increased risk of dependency and serious mental health conditions, of the highly-potent cannabis products now available in California and offers 20 key policy recommendations to mitigate associated risk. 

Racial, ethnic, and neighborhood socioeconomic disparities in local cannabis retail policy in California

By Getting it Right from the Start, July 2024

Our latest study, published in the International Journal of Drug Policy, found that equity provisions in local cannabis licensing & hiring – a critical way to support communities most harmed by the War On Drugs and rectify some of the injustices of marijuana criminalization – have been distributed inequitably.

Young adult retail purchases of cannabis, product category preferences and sales trends in California 2018–21: Differences compared with older adults

By The Merage School and Getting it Right from the Start and others, July 2024

In this co-authored study, published in the journal Addiction, we found young adults, more prone to cannabis use disorders & psychosis, favor high-THC products like vape pens & concentrates. The findings highlight the need for stricter regulations.

Associations between e-cigarette marketing exposure and vaping nicotine and cannabis among U.S. adults, 2021

By Getting it Right from the Start and others, October 2024

In this co-authored study in Addictive Behaviors we found e-cigarette marketing exposure was associated with cannabis vaping and co-use among young adults. Marketing restrictions for e-cigarette may prevent harmful vape use.

Age-Gating and Marketing Differences Between Storefront and Non-Storefront Cannabis Retailers

By Joshua Rhee, Getting it Right from the Start and others, May 2024

New study (we co-authored) finds roughly one-fifth of websites for cannabis retailers in CA have no age-gating, 91% used method that is easily circumvented. Delivery-only retailers less likely to age-gate during checkout than storefronts licensees

Clinician perspectives on adolescent Cannabis-Related beliefs and behaviors following recreational cannabis legalization

By Kaiser Permanente and Getting it Right from the Start, April 2024

In this new research paper published in Science Direct, we found that clinicians reported a post-legalization rise in teen cannabis use and cannabis-related consequences alongside shifts in norms, access, marketing, and reduced harm perceptions

Countering online marketing and user endorsements with enhanced cannabis warning labels

Sijia Yang School of Journalism and Mass Communication, University of Wisconsin, Madison, WI, Getting it Right from the Start, and Others, March 2024

In a national experiment, we found that pro-cannabis online comments increased product appeal in youth-targeting cannabis online ads, increasing the risk for early and/or habitual cannabis use among adolescents. Using enhanced CWLs helped counter online pro-cannabis marketing and social influences, reducing product appeal and intentions for cannabis use among both adolescents and young adults.

2023 Publications

Neonatal Outcomes Associated with In Utero Cannabis Exposure: A Population-Based Retrospective Cohort Study

Getting it Right from the Start and Kaiser Permanente Division of Research, November 2023

We recently partnered with Kaiser Permanente Division of Research (norcal) on a report published in American Obsetrics & Gynecology that found cannabis use during pregnancy is associated with low birth weight, small for gestational age, preterm birth, neonatal intensive care, and infant respiratory support. 

Adolescent use and co-use of tobacco and cannabis in California: The roles of local policy and density of tobacco, vape, and cannabis retailers around schools

Science Direct, April 7, 2023
By Alisa Padon, Getting it Right from the Start (and numerous others)

Report highlights include: Retail environment policies were negatively associated with student past-month use of tobacco/vape, cannabis, and co-use. Retailer density near schools was positively associated with student past-month tobacco/vape use and co-use. Policies that reduce retailer density near schools may curb youth exposure and access to tobacco and cannabis retailers.

Presence of Content Appealing to Youth on Cannabis-Infused Edibles Packaging

National Library of Medicine, March 23, 2023
By Alisa Padon, Getting it Right from the Start (and numerous others)

Existing laws have not adequately limited content appealing to youth on U.S. cannabis-infused edibles packaging. Robust and consistent regulations in the U.S. are needed to ensure that the packaging of such products does not contain content that appeal to youth and lead to initiation or inadvertent ingestion.

Public health legislative priorities for cannabis legalization

Hennepin County Minnesota, February 17, 2023
Getting it Right from the Start and the Public Health Law Center

This report prioritizes a framework for regulating the new legal cannabis market to effectively protect public health, including limiting the amount and potency of THC in cannabis products, ensuring the primacy of public health in all aspects of regulation, and preserving local control.

2022 Publications

Geographic Accessibility of Retail Cannabis in Northern California and Prenatal Cannabis Use During the COVID-19 Pandemic

National Library of Medicine, November 2022
By Getting it Right from the Start’s Alisa A Padon, Lynn D Silver, and Aurash Soroosh (and numerous others)

Prenatal cannabis use was more common among individuals living in areas with greater retail availability of cannabis. Although relative rates increased similarly during the pandemic regardless of local cannabis retail and policy environment, there was a larger absolute increase associated with living closer to a storefront cannabis retailer. Continued monitoring of local cannabis policy, the retail environment, and prenatal cannabis use is needed.

Yet Again Conversations Matter

National Library of Medicine, October 2022
By Lynn Silver and Alisa Padon of Getting it Right from the Start (and numerous others)

These findings underscore the need to regulate online cannabis marketing and the importance of investing in online education campaigns to increase public understanding of the risks associated with cannabis consumption in young adulthood.

Textual and pictorial enhancement of cannabis warning labels: An Online experiment among at-risk U.S. young adults

National Library of Medicine, August 2022
By Lynn Silver, Alisa Padon of Getting it Right from the Start (and numerous others)

Given rapid expansion of the cannabis industry and declining perception of harm, currently required CWLs in the U.S. such as California’s, would benefit from redesign to improve public understanding of health risks and to prevent youth use.

California Cannabis Markets—Why Industry-Friendly Regulation Is Not Good Public Health

JAMA Network, July 8, 2022
By Kelly C. Young-Wolff, Rosalie Liccardo Pacula, Lynn D. Silver

The US legal cannabis market is growing rapidly, and California is leading the way. It has the largest legal cannabis market in the world, and the industry is expected to continue expanding. For better or for worse, many states have adopted practices similar to those in California; across the US, California has become a bellwether.

Local Laws Regulating Cannabis in California Two Years Post Legalization: Assessing Incorporation of Lessons from Tobacco Control

Research Society of Marijuana, July 24, 2022

By Alisa A. Padon, Kelly C. Young-Wolff, Lyndsay A. Avalos, Lynn D. Silver, July 24, 2022 (Prevention Policy Group, Public Health Institute, Division of Research, Kaiser Permanente Northern California)

In the nation’s most populous state, the legal landscape in the second year of adult-use commerce continues to largely favor economic opportunity over heeding lessons from tobacco control and other legal but harmful products to protect youth and public health.

2021 Publications

Impact of California’s tobacco and cannabis policies on the retail availability of little cigars/cigarillos and blunt wraps.

National Library of Medicine, September 2021
By Getting it Right from the Start’s Alisa A Padon, Lynn D Silver, and Aurash Soroosh (and numerous others), National Library of Medicine, September 2021

A tobacco flavor ban may be an effective strategy to reduce retail availability of LCCs, blunt wraps and possibly other tobacco in California jurisdictions. This finding is of particular relevance as the tobacco industry has successfully petitioned for a referendum vote on California’s statewide flavor ban in the 2022 election.

Association of Cannabis Retailer Proximity and Density With Cannabis Use Among Pregnant Women in Northern California After Legalization of Cannabis for Recreational Use

National Library of Medicine, March 2021
By Getting it Right from the Start’s Alisa A Padon and Lynn D Silver (and numerous others)

This cross-sectional study examines the association of cannabis retailer proximity and density with cannabis use among pregnant women after legalization of cannabis for recreational use in California.

Moving Toward Health and Social Equity for Women Who Use Cannabis During Preconception, Pregnancy, and Lactation

JAMA Open Network, February 2021
By Getting it Right from the Start’s Alisa A Padon and Lynn D Silver (and numerous others)

Improvements in primary prevention and education are vital but also necessary are legal and regulatory policies that protect infants and children, inform women of risks, prohibit health and therapeutic claims for cannabis outside scientific approval processes, and ensure equitable access to supportive and nonpunitive substance use treatment.

2020 Publications

Assessment of Incorporation of Lessons From Tobacco Control in City and County Laws Regulating Legal Marijuana in California

JAMA Network, June 19, 2020

By Kelly C. Young-Wolff, Lynn D. Silver, Qiana L. Brown

What legal limits have cities and counties adopted since California legalized marijuana use for adults, and to what extent do these legal limits incorporate public health recommendations and lessons from tobacco control? This cross-sectional study of all 539 California cities and counties found that jurisdictions differed widely in how they regulated marijuana and that key public health recommendations and lessons from tobacco control have generally not been adopted, although local innovation is emerging.