Birth Defects Res
June 2025
Objective: We evaluated associations between prenatal cannabis use and major structural birth defects of the child.
Methods: This population-based retrospective cohort study comprised singleton births (January 2011-July 2020) universally screened for substance use at entrance to prenatal care. Prenatal cannabis use was defined as self-reported use or a positive toxicology test during pregnancy.
Background: Local policies prohibiting cannabis sales and lower cannabis retail availability are associated with a lower prevalence of adolescent cannabis use. In this study, we examined whether local prohibitions on cannabis retail and cannabis retailer proximity and density are associated with adverse cannabis-related mental health outcomes among adolescents.
Methods: Cross-sectional study of 95,645 Northern California adolescents aged 13-17 who completed a well-check questionnaire in 2021 during standard pediatric care.
Objective: The study investigated whether California storefront and non-storefront cannabis retailers are adhering to online age-gating requirements and whether differences in website marketing practices exist.
Methods: Websites of 134 storefront and 115 non-storefront licensed retailers were randomly selected. Bivariate associations were tested between retailer type and website marketing, age-gating methods, and presence of age-gating at various purchase stages.
Int J Drug Policy
March 2025
Background: California boasts the largest regulated cannabis market in the world, but it is increasingly exposing youth to cannabis marketing, and the state's definition of content appealing to youth is vague. We aimed to identify the specific features of California cannabis ads that increase interest in cannabis use among adolescents to inform reasonably restrictive marketing policy.
Methods: Participants consisted of 409 youth (age 16-20 years) susceptible to using cannabis in the future and living in California.
J Subst Use Addict Treat
February 2025
Introduction: Cannabis use among adolescents is prevalent, and clinicians who work with adolescents have unique insights about how to treat cannabis use in this population.
Methods: This qualitative study interviewed 32 clinicians from addiction medicine recovery services (AMRS), the emergency department (ED), mental health (MH), and pediatrics in an integrated healthcare system to understand their perspectives and experiences regarding barriers and facilitators to treating adolescent cannabis use. The analysis was developed using thematic analysis of interviews.
JAMA Health Forum
November 2024
Importance: It is unknown whether state recreational cannabis legalization (RCL) is related to increased rates of prenatal cannabis use or whether RCL-related changes vary with cannabis screening methods or the local policy environment.
Objective: To test whether RCL in California was associated with changes in prenatal cannabis use rates, whether changes were evident in both self-report and urine toxicology testing, and whether rates varied by local policies banning vs allowing adult-use retailers post-RCL.
Design, Setting, And Participants: This population-based time-series study used data from pregnancies in Kaiser Permanente Northern California universally screened for cannabis use during early pregnancy by self-report and toxicology testing from January 1, 2012, to December 31, 2019.
To examine whether local cannabis policies and retail availability are associated with cannabis use and problematic cannabis use (PCU) among adolescents in Northern California. The sample comprised adolescents aged 13 to 17 years screened for past-year cannabis use during well-child visits in 2021. Exposures included local bans on cannabis storefront retailers, policy protectiveness, and retail proximity and density.
View Article and Find Full Text PDFInt J Drug Policy
September 2024
Importance: Many studies have evaluated whether in utero cannabis exposure is associated with fetal and neonatal outcomes, yet little is known about whether prenatal cannabis use is associated with maternal health outcomes during pregnancy.
Objective: To evaluate whether prenatal cannabis use is associated with maternal health outcomes during pregnancy.
Design, Setting, And Participants: This population-based retrospective cohort study included pregnancies in Northern California from January 2011 to December 2019 that lasted 20 weeks or longer and were screened for prenatal cannabis use.
Background: As more states legalize cannabis, studies are needed to understand the potential impacts of recreational cannabis legalization (RCL) on adolescents from the perspective of clinicians who care for them.
Methods: This qualitative study characterized clinician perspectives on whether cannabis legalization is associated with changes in adolescents' cannabis use beliefs, behaviors, and consequences. Semi-structured qualitative interviews were conducted with 32 clinicians in a large healthcare organization from 9/6/2022-12/21/2022.
As cannabis legalization expands and online marketing intensifies, this study examines whether online social cues can amplify youth-targeted cannabis advertising and whether cannabis warning labels (CWLs) can counteract these influences. A U.S.
View Article and Find Full Text PDFBackground: The full spectrum of associations between in utero cannabis exposure and adverse neonatal outcomes is still unclear.
Objective: This study aimed to evaluate the associations between in utero cannabis exposure and neonatal outcomes.
Study Design: This population-based retrospective cohort study of singleton births among Kaiser Permanente Northern California members (January 1, 2011-July 31, 2020) included parent-infant dyads in which the pregnant parent was screened for cannabis use as part of standard prenatal care, generally upon entrance into care.
Cannabis Cannabinoid Res
October 2024
The 2019 outbreak of e-cigarette or vaping product use-associated lung injury (EVALI) is believed to have been caused by vitamin E acetate, an additive used in some cannabis vaporizer products. Previous studies have primarily focused on changes in sales of electronic nicotine delivery systems following the initial advisory issued by the Centers for Disease Control (CDC) on August 17, 2019. The present study is intended to examine variation by age groups in sales of regulated cannabis vape products in the state of California before, during, and after the outbreak.
View Article and Find Full Text PDFIntroduction: As cannabis legalization continues to spread, best regulatory practice remains ill-defined and elusive, exposing the population to potential harms.
Methods: We conducted an annual, statewide, cross- sectional survey to assess cannabis-related laws in effect by January 1, 2020, in local California jurisdictions and at the state level and measured adoption of potential best practices.
Results: The current laws of all 539 jurisdictions were located; 276 jurisdictions allowed any retail sales (storefront or delivery) covering 58% of the population, an increase of 20 jurisdictions (8%) from year 1 of legalization (2018).
Background: Sugar sweetened beverage (SSB) taxes are a promising strategy to decrease SSB consumption, and their inequitable health impacts, while raising revenue to meet social objectives. In 2016, San Francisco passed a one cent per ounce tax on SSBs. This study compared SSB consumption in San Francisco to that in San José, before and after tax implementation in 2018.
View Article and Find Full Text PDFImportance: Prenatal cannabis use is associated with health risks for mothers and their children. Prior research suggests that rates of prenatal cannabis use in Northern California increased during the COVID-19 pandemic, but it is unknown whether increases varied with the local cannabis retail and policy environment.
Objective: To test whether pandemic-related increases in prenatal cannabis use were greater among pregnant individuals with greater retail availability of cannabis around their homes or among those living in jurisdictions that allowed storefront retailers.
Drug Alcohol Depend
August 2022
Background: This study experimentally examines whether enhanced cannabis warning labels (CWLs) outperform those currently required in the U.S. in improving recall of health risks, emotional responses, and perceived message effectiveness among at-risk young adults.
View Article and Find Full Text PDFBackground: Recent changes in California's tobacco and cannabis policies could impact the retail availability of little cigars/cigarillos (LCCs) and blunt wraps that are used for blunt smoking. This study was intended to test whether tobacco flavor bans and minimum pack sizes of LCCs have reduced tobacco availability in California jurisdictions, whereas, permissive policies on sales and marketing of cannabis increased availability.
Methods: Measures of retail availability of LCCs and blunt wraps were obtained from the 2016-2019 longitudinal sample of licensed tobacco retailers (LTRs, n = 4062) from California's Healthy Stores for Healthy Communities campaign.
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.
View Article and Find Full Text PDFAm J Public Health
September 2020
To identify lessons learned from implementation of the nation's first sugar-sweetened beverage (SSB) excise tax in 2015 in Berkeley, California. We interviewed city stakeholders and SSB distributors and retailers (n = 48) from June 2015 to April 2017 and analyzed records through January 2019. Lessons included the importance of thorough and timely communications with distributors and retailers, adequate lead time for implementation, advisory commissions for revenue allocations, and funding of staff, communications, and evaluation before tax collection begins.
View Article and Find Full Text PDFImportance: As marijuana continues to be legalized in many states, little is known about best regulatory practice, exposing the population to significant potential harm.
Objective: To assess the extent to which potential best practices, including those from tobacco control, were incorporated into state and local marijuana policies in California.
Design And Setting: California legalized medical marijuana in 1996 and adult recreational use in 2016, effective in January 2018.