Additional detail on the LCA is provided in Appendix 5. In a final step, we then examined variation in demographic, socioeconomic, political, and retail market characteristics of the cities and counties falling into each alcohol-cannabis LCA policy class. Three localities had local governments but no people permanently residing within their boundaries; these localities were excluded from the analyses describing demographic, socioeconomic, political, and retail market characteristics by alcohol-cannabis regulatory approach. All analyses were conducted using R version 4.0.4. Analyses were not pre-registered.Across the 241 cities and counties, the average alcohol control policy stringency score was 7.7 . Fully 172 local governments banned retail businesses selling medical and recreational cannabis whereas 69 allowed at least one type of retail cannabis business. Even though receipt of home delivery of cannabis is legal statewide, cities and counties could still ban retail cannabis businesses from opening up within their borders. In the 29% of localities that allowed retail cannabis businesses to open, the average cannabis control policy stringency score was 9.0 . Local governments that banned retail cannabis businesses had less stringent alcohol regulations overall , implying an inverse relation between policies regulating alcohol versus cannabis. Among the subset of local governments that did not completely ban retail cannabis businesses , however, alcohol and cannabis control policy stringency scores were modestly positively associated. For every one-unit increase in the scaled alcohol policy stringency score we observed an average 0.37-unit increase in the scaled cannabis policy stringency score . Among the specific provisions that applied to both alcohol and cannabis,plant benches it was infrequent that local governments adopted the same policy for both . The provisions local governments most frequently adopted for both substances were requirements for local business permits and minimum distances between retail outlets and sensitive locations such as schools .

Local governments were most likely to approach alcohol and cannabis control differently when it came to the application of safety requirements such as night lighting and limits on hours of sale . After accounting for chance, only prohibitions on underage consumption showed significant agreement . Local governments in California also had the authority to regulate the co-location of cannabis and alcohol outlets by restricting how nearby cannabis outlets could be located in relation to alcohol outlets. Only two of 241 local governments took advantage of this authority by mandating a minimum distance between alcohol and cannabis outlets.The final LCA included 18 alcohol and cannabis policies. For cannabis, localities were best categorized into two classes: those that banned all retail cannabis businesses versus those that allowed at least one type of retail . For alcohol, the metrics used to select the best-fit model indicated that models with 2 or 3 classes fit the data better than models with 1, 4, or 5 classes, but did not clearly distinguish between models with 2 versus 3 classes. We therefore considered both the 2- and 3-class categorizations, which we named: “strict versus lenient” , or “universally strict”, “lenient but with social host laws”, and “intermediate restrictiveness without social host laws” . For interpretability, we present the two-class categorization of alcohol control in the main text and results for the three-class categorization in Appendix 5.Table 2 summarizes characteristics of the populations subject to the four alcohol-cannabis control approaches: strict on both alcohol and cannabis, lenient on both, strict/lenient, and lenient/strict. Overall, localities that were lenient on both alcohol and cannabis were the least population dense, least educated, with predominantly White residents, and contained the most alcohol and cannabis outlets per capita relative to localities with other alcohol-cannabis control approaches. In contrast, localities that were strict on both alcohol and cannabis tended to be urban, with intermediate levels of education and income, and high proportions of Asian residents.

Localities that were strict on alcohol but lenient on cannabis had the highest population density, with the highest levels of poverty, unemployment, the most liberal voters, the most Black and Hispanic residents, and the fewest White residents. Localities that were lenient on alcohol and strict on cannabis had intermediate population density, with the highest levels of education, least poverty and unemployment, most conservative voters, most Asian and White residents, and fewest Black and Hispanic residents.Public health experts have urged governments around the world to regulate recreational cannabis as they do alcohol, and some governments have tried to do so. Although cannabis and alcohol are different substances with different risks, there are inherent advantages in applying lessons learned from alcohol policy making to cannabis. This is the first effort to empirically examine if and how local recreational cannabis policies mirror existing alcohol policies. In this case study of 241 California cities and counties, we found little evidence that local governments were following a coordinated approach. The local governments studied here had been granted power to coordinate specific provisions in alcohol and cannabis , yet few chose to do so. All of the local governments we studied permitted alcohol sales, yet only 29% allowed businesses that sell retail cannabis. Localities with bans on retail cannabis tended to have less restrictive alcohol controls, suggesting an inverse, or discordant, relationship. Notably, only two of 241 local governments in this study chose to regulate the co-location of cannabis outlets in relation to alcohol outlets. Public health researchers have noted that under legalization, new cannabis outlets are often situated in neighborhoods already overburdened with alcohol outlets . Failure to regulate co-location could lead to the saturation of legal intoxicants in vulnerable communities, and resulting harms associated with substance use including binge drinking, crime, and cannabis use disorder . Because neighborhoods with high densities of both types of outlets are more likely to contain low-income and racial/ethnic minority residents , coordinating local policies with the explicit goal of deterring alcohol and cannabis outlet co-location is likely to be important for health equity.

The discordance we observed between alcohol and cannabis policies suggests that most local governments in California are not adapting existing alcohol controls to regulate cannabis. This discordance is indicated both by our findings that most local governments ban retail cannabis and that localities permitted retail cannabis sales rarely adopted the same specific provisions for regulating alcohol and cannabis. However, within the subset of 69 local governments that did not ban retail cannabis businesses, the stringency of alcohol and cannabis policies were positively associated. This suggests local governments with experience regulating both substances may be applying alcohol policies to cannabis . For example, of 90 localities with alcohol-related social host provisions , 17 expanded these provisions to cover cannabis. In contrast to alcohol, for which policies have been established for decades, many governments do not yet have the expertise to appropriately regulate cannabis and may choose to ban all cannabis retail to avoid more nuanced decision-making. Public health considerations or NIMBY influences could also be at play in these localities. For the local governments that opened the door to cannabis but lack capacity or expertise, learning from alcohol may offer a way forward. Modeling cannabis control policies after alcohol may also promote health equity in some contexts. We found that localities that were strict on alcohol but lenient on cannabis had the highest levels of poverty and unemployment and the most Black and Hispanic residents. If lenient cannabis policies lead to cannabis-related health problems, then this demographic patterning in policies implies that health inequities may be exacerbated. For further discussion of these concerns, see Matthay et al. . Approximately half of the localities we studied combined strict cannabis policies with lenient alcohol policies. Linkage to demographic, socioeconomic, political, and retail market characteristics indicated that these communities were distinguished by high social and economic advantages. There is evidence that affluent constituencies are biased toward the status quo, and that policymakers are more like to be responsive to their preferences than those of lower-income constituencies . In addition, conflicting federal and state laws in the US, and the preponderance of cannabis legalization via ballot initiatives may interfere with policy coordination,rolling bench particularly in contexts like the US where governments are more responsive to communities that are already economically advantaged . The political processes that have led to uncoordinated alcohol and cannabis policies in California have the same potential in other places to compromise public health equity by responding only to the wealthiest and most vocal constituents. To promote public health equity, national and sub-national governments legalizing recreational cannabis should take proactive measures to counteract these processes. Our study specifically evaluated California cities and counties which, although specific to the US context, involve the same kinds policies under consideration or enacted in other countries, including bans or limits on retail sales, limits on outlet density, and taxation. Cannabis policies have changed rapidly in the 21st century, with multiple countries legalizing possession and use. Our finding that California cities and counties rarely took similar approaches to alcohol and cannabis control raises concerns that reliance on sub-national governments may compromise the coordination of alcohol and cannabis policies in countries with federalist systems. Consistent with this, a systematic review of policymaker responsiveness found that sub-national representatives in both federalist and unitary countries were more likely to respond to constituent pressures that could undermine coordinated policies . These issues are relevant to both Brazil and Germany, which in 2022 began reconsidering their existing restrictions on cannabis . In these countries, monitoring the development of recreational cannabis policies and promoting their coordination with policies regulating other substances is warranted.

Our analysis investigated similarities and differences between alcohol and cannabis control policies, but could not definitively identify intentional coordination or barriers to coordination. The limitations of adapting alcohol controls to regulate cannabis should be further explored—for example, needed differences in restrictions on product types or potency due to differences in formulations, modes of administration, and psychoactive properties of each substance. This analysis does not identify the factors that shaped different policy decisions. Further research is needed on why local governments pursued certain policy approaches and how local policy making could achieve greater coordination. In particular, for the 12% of localities that were more restrictive on alcohol and less restrictive on cannabis, policy making may be motivated by the idea that cannabis is harm-reducing substitute for alcohol or opioids. Future research should also monitor the influence of the rapidly consolidating cannabis industry as a reason that local governments may pursue different policy approaches to alcohol and cannabis control. The financial incentives to advocate for lenient restrictions on cannabis are substantial, and industry interference in legal cannabis policy making is evident at the national level in the US, New Zealand, and the UK . Studies should also consider best practices of governments that have successfully coordinated alcohol and cannabis control policies, research that has the potential to better inform and direct policy making worldwide.Cannabis sativa L. is an annual herbaceous multi-purpose plant with a long history of human selective breeding. The genus Cannabis contains different types of chemicals with a diverse phytocannabinoid profile and range of effects. The differences in phytocannabinoids composition and quantities of cannabis chemotypes should be searched in the genetic background of their biosynthesis pathways and the environmental conditions where they have been evolved. Precursor synthesis of cannabinoids occurs from two distinct biosynthesis pathways: the polyketide and the methylerythritol phosphate pathways, which produce olivetolic acid and geranyl diphosphate , respectively. Geranylpyrophosphate:olivetolate geranyltransferase catalyse the alkylation of OLA with GPP, leading to formation of CBGA , the main precursor of various cannabinoids,responsible for producing acidic precursors of THC and CBD . Naturally these phytocannabinoids exist as both monocarboxylic acids and as decarboxylated forms ; however, heating promotes decarboxylation. Different types and concentrations of the cannabinoids, in particular, THC with psychotropic effects and CBD, a non-intoxicating metabolite, alongside applied morphological attributes may underpin the recreational, medicinal, and industrial uses of cannabis. The range of 0.3–1% THC that determines the border of drug-type and non-drug type cannabis of course seems to be only a widely accepted agreement to determine the restrictions of cultivation in different countries. Nowadays, there is intense competition for finding unique chemotypes or varieties with low THC and high CBD contents that can be industrially used or cultivated. Despite high potential as a multipurpose plant to produce drugs, fiber-based products, nutritional supplements and seed oil, and cosmetics, there remain critical gaps in knowledge.