In Northern California, looser retail and pricing rules were linked to teen…

PURPOSE: Research examining cannabis legalization effects on adolescents rarely accounts for local-level cannabis policies, which differentially expose youth to the cannabis marketplace. This study examined local policies and their association with adolescent use in Northern California. METHODS: Adolescents aged 13-17 years who attended well-child visits in Kaiser Permanente Northern California in 2021 and self-reported whether they used cannabis in the past year (N = 88,584) were study participants. Local cannabis policies restricting retailing, pricing, marketing, and products enacted as of January 1, 2021, were coded and linked to adolescent address data. Modified Poisson regression models examined the association of policy scores with cannabis use. RESULTS: Initial models showed adolescents living in jurisdictions with less restrictive retailing, marketing, pricing, and product policies had a greater prevalence of past-year cannabis use compared to adolescents in jurisdictions that banned cannabis retail. After adjusting for storefront retailer density, adolescents living in jurisdictions with less restrictive retailing and pricing policies had a higher prevalence of cannabis use than those in jurisdictions that banned retail. DISCUSSION: Local cannabis policy analysis is critical for understanding and mitigating the effects of legalization on youth. Weak regulation of retailing, marketing, pricing, and products may not be sufficient to protect youth from exposure to retail markets, but stronger approaches to retailing and pricing were associated with prevalence rates no different from those in jurisdictions with retail bans.