Medical cannabis access linked to reduced alcohol sales – study

Access to medical cannabis is associated with a reduction in alcohol sales, a new Canadian study has found.

The data, published in the journal Health Policy, shows that the legalisation of medical cannabis in Canada was associated with a reduction in alcohol sales, suggesting it may be a substitute for alcohol consumption.

Associate professor of operations research at Brock University in Canada, Michael Armstrong, evaluated the relationship between medical cannabis legalisation and retail sales of alcohol in various regions of the country over an eight-year period.

This research compared legal medical cannabis sales to those of beer, wine, and liquor stores in Canada from 2015 to 2018. The analysis accounted for seasonal differences in alcohol sales and prices, consumer retail spending, unemployment rates, and impaired driving penalties.

According to the findings, sales of alcohol in Canada from 2017-2018 were roughly 1.8% lower than they otherwise would have been, suggesting that medical cannabis use replaced some alcohol consumption.

Professor Armstrong estimates that each dollar of legal cannabis sold was associated with alcohol sales decreases of around $0.74 to $0.84. 

However, while this shows that cannabis sales were correlated with alcohol sales changes, it does not not prove they caused them.

More generally, this could imply that lower alcohol use might reduce some impacts of cannabis legalisation, says Professor Armstrong. For example, increased cannabis-related health problems might be accompanied by decreased alcohol-related ones. And governments’ new cannabis tax income might be offset by lower alcohol tax revenues.

Previous research from the US identifies similar declines in alcohol sales following the adoption of statewide medical cannabis legalisation laws, including a 2017 paper and a more recent assessment of Youth Risk Behavior Survey data from 2021.

However, Professor Armstrong believes this to be the first Canadian research on legal cannabis and alcohol sales.

He argues that this could indicate what may happen in other countries where medical cannabis is legal, such as the UK and Australia.

Writing in the paper’s discussion, Professor Armstrong stated: “From an academic perspective, this study found evidence that cannabis on average was a substitute, not a complement, for alcohol in Canada. This suggests cannabis might also have a substitution effect in other countries that legalize it, though that remains to be seen.

“From a public health perspective, the results likewise imply that reductions in alcohol-related health impacts might partly offset the increased cannabis-related health impacts that legalization might bring… Furthermore, medical cannabis presumably improves the health of at least some patients by treating symptoms that alcohol had merely masked.”

He added: “Finally, from a political perspective, the results could make cannabis legalization slightly less attractive as financial policy but slightly less concerning as public health policy. This might influence legislative decisions in other countries that are considering legalization.”

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