Associations of Local Cannabis Policy and Retail Availability in Northern California with Adverse Adolescent Mental Health Outcomes

Subst Use Misuse. 2025 May 16:1-6. doi: 10.1080/10826084.2025.2505145. Online ahead of print.

ABSTRACT

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. Exposures included local bans on cannabis storefront and delivery retailers, and retail proximity and density in relation to adolescents’ geocoded residences. Past-year psychotic, depressive, and anxiety disorders were identified using ICD codes; self-reported depression symptoms came from the questionnaire.

RESULTS: Relative to adolescents in jurisdictions allowing storefront and delivery retail, those in jurisdictions prohibiting storefront retail only (aPR = 0.52; 95%CI: 0.32-0.85), or prohibiting both (aPR = 0.67; 95%CI: 0.48-0.92) had a lower prevalence of psychotic disorders. Greater retailer density (≥6 vs. 0 retailers within a 15-min drive) was associated with a greater prevalence of anxiety disorders (aPR = 1.11; 95%CI: 1.04-1.19), depressive disorders (aPR = 1.10; 95%CI: 1.02-1.19) and depression symptoms (aPR = 1.08; 95%CI: 1.01-1.15). Having a ≥20-min (vs. <5-min) drive to the nearest retailer was associated with a lower prevalence of psychotic (aPR = 0.53; 95%CI: 0.33-0.86), anxiety (aPR = 0.89; 95%CI: 0.82-0.97), and depressive disorders (aPR = 0.89; 95%CI: 0.81-0.98) and depression symptoms (aPR = 0.91; 95%CI: 0.84-0.99).

CONCLUSIONS: Local policies prohibiting storefront retail were associated with a lower prevalence of psychotic disorders. Greater retail availability of cannabis near adolescents’ residences was associated with a greater prevalence of psychotic, anxiety, and depressive disorders, and depression symptoms. Policies limiting retail density and availability may help reduce cannabis-related harms and merit further assessment.

PMID:40380774 | DOI:10.1080/10826084.2025.2505145