Grant: CG: Moving Upstream - Structural Determinants of Health - Substance Use in Youth

Six years ago, on October 2018, Canada legalized non-medical cannabis for adult use. The health goals of legalization were to provide adults with a legal, regulated source for cannabis and to reduce access to cannabis for young Canadians. There are benefits to legalization, including eliminating harm from the criminalization of cannabis possession. Legalization and related policies also have potential to reduce or increase cannabis use and related harms. While data specific to cannabis is lacking, evidence suggests that policies controlling the minimum legal age of purchase (MLA) and the physical availability or alcohol, and tobacco can both reduce youth consumption of substances and related harms. While some evidence suggests that legalization was not associated with large changes in youth cannabis use and related outcomes long term evaluations of legalization and specific policies are lacking. The proposed project will examine long-term changes in population-level healthcare visits due to cannabis after legalization among youth aged 12 to 25. Our team will use healthcare data capturing all hospitalizations in Canada to monitor changes in youth hospitalization due to cannabis use after legalization We will use variations in approaches to cannabis policy across Canada (e.g., a MLA of 18 years in Alberta vs 21 in Quebec) to specifically evaluate the effectiveness of MLA laws for cannabis purchase on reducing youth hospitalizations due to cannabis and whether levels of cannabis retail store access are associated with youth cannabis hospitalizations. This project is well positioned to provide meaningful and timely findings on changes in healthcare visits due to cannabis in Canadian youth after legalization. In addition, the project will evaluate specific policies that may increase or decrease youth cannabis use and harms in regions with legal markets. These findings will be widely disseminated to inform future policy changes that prioritize youth health and wellbeing.